Applied Health Physical Therapy 844
AHPT 844: Neuromuscular Development and Control I
Prerequisite: AHPT 830 or permission of the Department
Credit Hours: (4)
Neuromuscular Development and Control I emphasizes the theoretical and clinical basis for the examination and treatment of patients with neurological impairments. This course focuses on physical therapy management of adult neurological disorders. Clinical implications and applications of treatment approaches will be discussed based on current best practices utilizing the International Classification of Functioning (ICF) model. The format for the course will be lecture/lab style, including patient demonstrations, case studies, movement analysis, standardized tests and outcome measures. This course prepares students to participate in their second and third clinical experiences.
Detailed Description of Course
Methods of Instruction: Lecture, laboratory experiences, group discussions, guest lectures, case analysis.
Week 1
Online Lecture: Introduction to the Neurological Examination
Lecture: Introduction of course and course intructors. Disablement Models.
Lab: Introduction to neurological evaluation
Week 2
Online Lecture: Neurological Examination
Lecture: Class discussion and review Neurological Examination
Lab: Neuro Exam, Gait and Balance Assessment, Fall risk screening, Outcome measures
Quiz 1
Week 3
Online Lecture: Outcome Measures
Lecture: Class discussion and review Outcome measures utilized in the neurological setting
Lab: Outcomes Lab and functional mobility assessment
Week 4
Online Lecture: PNF
Lecture: Class discussion and review PNF
Lab: PNF application UE/LE
Quiz 2
Week 5
Online Lecture: Motor Control / Balance Interventions
Lecture: Class discussion and review of balance and neurological interventions
Lab: Task Analysis, Balance Intervention
Week 6
Mid Term Written Exam
Neurological Exam Competency
Week 7
Online Lecture: Stroke - Incorporating examination findings into therapeutic interventions. Postural Control and Bed mobility
Lecture: Class discussion and review of interventions for postural control and bed mobility
Lab: Therapeutic Interventions for CVA: Postural Control and Bed mobility interventions
Week 8
Online Lecture: Transfer and Gait training
Lecture: Class discussion and review of transfer and gait interventions for Stroke Population
Lab: Therapeutic Interventions for Stroke - Transfers and gait training
Week 9
Online Lecture: Advanced gait, stairs and orthotics. Introduction to UE Interventions
Lecture: Class discussion and review of stroke gait interventions
Lab: Cerebellar gait, stair training. Special Guest: Doug Walters, CPO Excel Prosthetics reviewing orthotics. UE interventions
Quiz 3
Week 10
Online Lecture: Stroke Interventions UE/LE
Lecture: Class discussion and review of stroke intervention for UE/LE
Lab: LE interventions. Treatment of different stroke syndromes
Week 11
Online Lecture: Introduction to Brain Injury
Lecture: Class discussion and review of Brain injury treatment concepts
Lab: Neurologic Intervention Competency
Week 12
Online Lecture: Brain Injury Evaluation and Treatment
Lecture: Class discussion and review of Brain Injury Evaluation and treatment
Lab: Brain Injury Evaluation and interventions based on cognitive level
Quiz 4
Week 13
Thanksgiving Break!
Week 14
Online Lecture: Acquired Brain Injury, Concussion, Returning to the community after brain injury
Lecture: Class discussion and review of acquired brain injury concepts
Lab: Concussion (Special Guest), Memory book, Brain Injury support group presentation
Week 15
Online Lecture: Review of critical concepts
Lecture: Class discussion and review for final examination
Final Practical Examination
Week 16
Final Written Exam: Date and time to be announced
Detailed Description of Conduct of Course
Course content may be delivered by lecture, laboratory learning experiences (e.g., movement analysis), demonstration, small-group cooperative learning, case study analysis/ presentations and student debates.
Goals and Objectives of this Course
Will require students to:
1) Describe current healthcare models, including International Classification of Functioning (ICF), and explain their implications on physical therapy practice (CC-5.30; CC-5.32; 7A; 7D21);
2) Demonstrate understanding of current perspectives of Nervous System function based on scientific literature, and analyze their implications in physical therapy practice (CC-5.30 CC-5.32; 7A; 7C);
3) Identify and define the theories of motor control, the principles of motor learning; analyze their clinical implications and limitations and formulate applications to patient treatments and education (CC-5.30; CC-5.32; 7A; 7D10, 7D11);
4) Describe the current evidence on stages of motor recovery following neurological injuries, including stroke, and its implications on physical therapy practice (CC-5.30; 5.39; 7D10; 7D11);
5) Identify developmental reflexes and implications on reflex integrity following neurological injuries in adults (CC-5.30; CC-5.32);
6) Analyze normal gait cycle in relation to functional tasks, compare and contrast the theories of neural control of gait and their clinical implications; evaluate common gait deviations following neurological disorders like stroke and TBI; and create appropriate gait training interventions (CC-5.30; 5.32; 7D19i);
7) Examine the role of sensory integrity and processing in postural control/balance and motor function using evidence-based examination tools including, but not limited to, CTSIB, DGI, BESTest (CC-5.30; CC-5.32; 7D19u; 7D19d);
8) Evaluate deficits in postural control and balance mechanisms following neurological injuries; and develop appropriate treatment interventions based on current task-oriented approaches (CC-5.30; CC-5.32; 7D19d; 7D27g);
9) Perform comprehensive neurological examination identifying deficits in the various components of neurological structures/functions, including mental function, sensation, tone, voluntary/involuntary movements, reflex integrity, coordination, motor function, balance, gait, functional mobility, and analyze implications on activity and participation levels (CC-5.30; CC-5.32; 7D19d,g,i,l,m,n,r,t,u; 7D20);
10) Demonstrate understanding of the current concepts and principles of neuroplasticity, and develop appropriate treatment interventions utilizing those concepts to improve functional mobility following neurological insults (CC-5.30; CC-5.32; 7A; 7D11; 7D24);
11) Analyze and perform the various standardized tests and outcome measures that are relevant for individuals with neurological disorders (7D9; 7D19d.i.m.n);
12) Develop a comprehensive plan of care for individuals with neurological disorders, including stroke and TBI, which address the relevant deficits in body structure and function to improve motor function, activity and participation levels. Identify clinical indications to monitor and adjust plan of care based on patient status. (CC-5.30; 5.32; 7D24; 7D23);
13) Apply appropriate PNF techniques to improve ROM, strength and motor control deficits following neurological injuries (CC-5.30; CC-5.39; 7D27g);
14) Apply the Hypothesis Oriented Algorithm for Clinicians II (HOAC II) for evidence-based clinical decision making and documentation of plan of care (CC-5.30; CC-5.39; 7B; 7D20; 7D23; 7D22);
15) Demonstrate appropriate patient-handling techniques based on neurodevelopment treatment approaches to improve posutral control and functional mobility (CC-5.30; CC-5.39; 7D27g);
16) Demonstrate treatment progressions based on the current perspectives of stages of motor control to improve functional tasks, including bed mobility, transfers, ambulation and stair clmbing abilities (CC-5.30 CC-5.39; 7D27g);
17) Demonstrate understanding of clinical indications for use of different kinds of assistive technology available for individuals with neurological disorders and their impact on functional mobility. Competently perform physical therapy interventions related to prescription and application of assistive technology (CC-5.30 CC-5.39; 7D27b);
Assessment Measures
May include but not limited to:
Assignments/Quizzes 15%, Competency I 10%, Competency II 10%, Laboratory Practical 25%, Mid-Term Written Examination 20%, Final Written Examination 20%.
Other Course Information
Methods of Instruction: Lecture (online and in class), laboratory experiences, group discussions, guest lectures and case analysis.
Required Texts
Required Printed Materials for this course include the following:
- Physical Rehabilitation, O'Sullivan and Schmitz. 5th edition
ISBN: 9780803612471 (6th edition ISBN: 9780803625792)
- Neurological Interventions For Physical Therapy 2nd edition by Martin and Kessler.
ISBN: 9780721604275
- Motor Control: Translating Research into Clinical Practice by Shumway-Cook.
ISBN: 9781608310180
Supplementary and/or suggested further readings
- Special Tests for Neurologic Examination by Scifers
ISBN: 9781556427978
- Neuro Notes: Clinical Pocket Guide, Claudia Fenderson PT EdD PCS, Wen K. Ling PT PHD.
1st edition ISBN-10:080361747X
Review and Approval
April 30, 2018
May 9, 2017
February 10, 2014