Applied Health Physical Therapy 860

AHPT 860: Advanced Orthopedics
Prerequisite: AHPT 814, AHPT 826, or permission of the Department
Credit Hours: (4)

Advanced Orthopedics focuses on hands-on methods and techniques related to therapeutic activities, manual therapy, and patient handling techniques in neuromusculoskeletal cases of varying complexity. Students will analyze patient case scenarios and develop appropriate intervention plans. Students will participate in didactic and laboratory oral / participatory demonstrations of patient care situations.

Detailed Description of Course

Week 1 - Introduction, Overview of the McKenzie Method and Lumbar Screening

Week 2 - McKenzie Method continued

Week 3 - Lumbar Manual Therapy

Week 4 - Lumbar Manual Therapy continued; Review of Evidence

Week 5 - McKenzie Method - Cervical Spine

Week 6 - McKenzie Method - Cervical Spine; Exam I

Week 7 - Competency I; Review of Materials

Week 8 - Spring Break

Week 9 - Cervicothoracic Manual Therapy

Week 10 - Cervicothoracic Manual Therapy

Week 11 - Cervicothoracic Manual Therapy

Week 12 - Alternative approaches; Review of Materials

Week 13 - Exam II, Preparation for Competency, Sports Taping

Week 14 - Competency II; TMJ/TMD

Week 15 - Practice and Review of all course concepts; Competency III

Week 16 - Finals Week - CPE II
    No scheduled class (Practical Retakes if necessary)

Detailed Description of Conduct of Course

Didactic and laboratory learning will occur in both laboratory and classroom environments. Online course materials (in the form of narrated lectures) will also be provided for the students in addition to class discussions, laboratory demonstrations and traditional lecture delivery methods.

Class Attendance and Professionalism: Attendance is mandatory. Class participation will be monitored every class period. This involves posing questions in class, being able to answer questions based on past material, and laboratory involvement. Any student who is absent from a class in which an exam is scheduled will receive a "0" on the exam unless other arrangements are made in advance. All students will start with a 100% for the Attendance grade. If a student misses lecture or lab (or is more than 5 minutes late) this will be considered an unexcused absence and the grade will drop by 10%. Several basic assignments will be given throughout the semester and these will be graded as complete or incomplete. For each assignment that is late the Assignment grade will drop by 10%. For each incomplete assignment the Attendance and Assignment grade will drop by 15%. Students are responsible for providing documentation of an "unavoidable" circumstance when requesting an excused absence.

Goals and Objectives of this Course

Will require students to:

1) Describe the principles of the McKenzie method for the evaluation and treatment of a patient with either Lumbopelvic or Cervicothoracic pathology (CC-5.28; CC-5.29; CC5.31; 7D17; 7D18; 7D19k,n,p,r,s,t);

2) Differentiate characteristics and identify treatment goals and plan of care for each stage of healing for a patient with Lumbopelvic or Cervicothoracic pain (CC-5.30j; 7B7; 7D11; 7D20; 7D22);

3) Compare and contrast the symptom reproduction model to the pathoanatomical model of orthopedic evaluation and/or classification schemes (CC-5.31; CC-5.33; CC-5.30k; 7A8; 7a10; 7D20; 7D22);

4) Demonstrate critical thinking and appropriate decision making in planning the sequence of a spinal examination and subsequent treatment (CC-5.31; CC-5.39d; 7B7; 7D11; 7D17);

5) Conduct an appropriate systems review to guide further examination, or referral/consultation to other appropriate healthcare professionals, when findings indicate a non-musculoskeletal source of symptoms (CC-5.29; CC-5.30k; 7D16; 7D17; 7D18; 7D19k,n,p,r,s,t);

6) Based on a hypothetical client/patient, develop an appropriate clinical question, analyze the evidence, and develop a plan of care that utilizes both the current literature and patient preferences (CC-55.32; CC-5.63; 7C10; 7D9; 7D11; 7D24);

7) Given history, pain assessment findings, and examination findings in a hypothetical patient with spinal pain, formulate a diagnosis and prognosis, and modify the plan of care based on patient goals and outcomes (CC-5.30p; CC-5.32; CC-5.33; CC-5.47; CC-5.48; 7C15; 7D11; 7D17; 7D18; 7D20; 7D22; 7D24);

8) Demonstrate knowledge of patient education parameters relative to a patient's demographics, medical characteristics and specific impairment findings (CC-5.38; CC-5.39a; 7B1; 7D27h; 7D27);

9) Critically analyze current literature related to techniques for treatment of the patient with Lumbopelvic or Cervicothoracic pain (CC-5.63; 7B8; 7D11; 7D9);

10) Make clinical judgements based on analysis of evaluation findings in order to create an evidence-informed treatment plan (CC-5.31; CC-5.47; 7B7; 7D11; 7D16; 7D20; 7D24);

11) Based on the results of a hypothetical spinal examination, develop a minimum of three differential diagnosis for those findings and select the appropriate evaluation tools for securing the proper diagnosis (CC-5.32; CC-5.47; 7C15; 7D11; 7D19k; 7D20; 7D22);

12) Design and manage a plan of care that complies with the standards of practice and is evidence-based and individualized to best meet patient needs (CC-5.63; 7B8; 7D11; 7D16; 7D24);

13) Describe the theoretical basis and identify patient populations that will benefit from therapeutic taping strategies (CC-5.23; CC-5.31; 7D11; 7D20);

14) Perform appropriate taping techniques for orthopedic and sports-related conditions (CC-5.30o; 7D27f; 7D27h);

15) List indications for accessory and physiologic spinal joint mobilization techniques (CC-5.39d; 7D19k);

16) Identify contraindications to spinal manipulation techniques (CC-5.39d; 7d37; 7D16);

17) Describe the basic concepts of muscle energy techniques and demonstrate proper use of this technique in correcting lumbar, sacral, and innominate dysfunctions (CC-5.39d; 7C10; 7D19k);

18) Select and demonstrate the appropriate tests to differentiate an iliosacral problem from a sacroiliac problem (CC-5.30k, CC-5.30s; 7D19k; 7D19s);

19) Demonstrate the proper techniques for examining and treating spinal hypomobility (CC-5.30k; CC-5.30s; CC-5.39d; 7D11; 7D19k);

20) Select and perform evidence-based interventions for hypothetical patients with spinal, sacroiliac, TMJ, and post-surgical orthopedic dysfunctions (CC-5.25; CC-5.30k; 7D11; 7D27C,f,h,l); 

21) Describe the appropriate steps of a TMJ evaluation (CC-5.30f; 7D17; 7D18);

22) Differentiate between myogenic and capsular source of TMJ pain and dysfunction (CC-5.30f; 7A8; 7D20; 7D22);

23) Given a hypothetical patient with a spinal or TMJ problem, develop a plan of care and demonstrate the appropriate joint mobilization techniques for this patient (CC-5.35; CC5.39d; 7D11; 7D19k,q,s; 7D24); 

24) Identify special considerations, treatment goals, and plan of care for pre-surgical and post-surgical management, including the patient with complex medical problems based on best evidence (CC-5.35; 7C16; 7D11; 7D24);

25) Analyze past and current post-surgical protocols for selected orthopedic conditions (spine, hand flexor and extensor tendon repairs) and explain their evidence-informed rationale (CC-5.63; 7D9; 7D11);


Assessment Measures

Written Exam I - 15%, Written Exam II - 20%, Quizzes - 10%, Practical Exams - 40%, Competency - 5%, Attendance / Assignments - 10%

Other Course Information

Required Texts:

1) Orthopaedic Manual Physical Therapy by Christopher Wise. First Edition, 2015. ISBN: 0803614977
2) Orthopedic Physical Assessment by Magee. Fifth Edition. Saunders. ISBN: 0721605710
3) Manual Mobilization of the Joints: Vol II The Spine by Kaltenborn. Fifth Edition. OPTP.

Review and Approval

April 30, 2018

February 10, 2014