PT 892
Advanced Practice IV
Selected Topics in Rehabilitation Practice
- Widener University
- Institute For Physical Therapy Education
Spring 2003
[Readings]
[Assignments]
[Grading] [Schedule]
- Instructors: Robert Wellmon, PT, MS, NCS
- Phone Number (610) 499-1295
- E-mail Bob.Wellmon@widener.edu
- Course Mailing List: pt892@topica.com
Course Description:
The course focus is on providing opportunities for an advanced exploration of selected
topical areas in rehabilitation practice. The course will critically appraise the
theoretical foundations that are pertinent to current clinical practice in each of the
topical areas surveyed. Incorporated throughout the course are multiple opportunities for
structured and guided interactions with a patient population to promote integration of
practice with theory. The course is comprised of a total of 6 hours of lecture,
independent study and guided clinical observation per week.
Topics to be included in this course will vary each year and will be selected by the
students participating in course in consultation with primary course instructors. A
maximum number of four topics will be covered in the course. Maximum enrollment is limited
to a total of 6 participants.
Course Meeting Times:
Classroom meeting times are formally scheduled to be held on Mondays from 9:00-12:00. Additional meeting times for the course will be scheduled throughout the semester and will be held at local clinical facilities. Travel to the sites will be required. Attendance at all site visits is mandatory
Instructional Methods:
This course will be conducted using a seminar format. The focus will be on group discussions related to each topic area covered in the course. Faculty involved in the course will assume the role of group facilitator in each session. Independent exploration and study and preparation prior to attending class will be expected and required. Students involved in the course will be exposed to a variety of clinical practice settings and will received guided instruction and hands-on practice at each setting. Area clinicians will also be involved in providing instruction in both the classroom and clinical setting.
Course Objectives:
Upon completion of the semester the participant should be able to:
 | Discuss the impact of current theory on clinical practice in the examination and
treatment of individuals with neuromuscular dysfunction, balance impairment or
cardiopulmonary limitations. (3.8.3.9, 3.8.3.11) |
| Engage in a critical analysis of current research and the professional literature as it
applies to prevailing clinical practice for the management of individuals experiencing
neuromotor dysfunction, balance impairment or cardiopulmonary limitations. (3.1.3.10,
3.1.3.11) |
| Compare and contrast the various contextual frameworks for the physical therapy
management of individuals experiencing neuromotor dysfunction, balance impairments or
cardiopulmonary dysfunction. (3.8.3) |
| Recognize the importance of theory for clinical practice and describe the role of theory
in fostering evidenced based clinical practice.(3.7, 3.8.3.8) |
| Engage in the application of theory to the examination and treatment of individuals
experiencing neuromotor dysfunction, balance impairment or cardiopulmonary limitations.
(3.8.3.16, 3.8.3.17, 3.8.3.18, 3.8.3.21, 3.8.3.23, 3.8.3.24) |
| Describe and assess the contribution of physical, cognitive, and psychosocial factors in
fostering impairment, functional limitations and disability among individuals experiencing
neuromotor dysfunction, balance impairment or cardiopulmonary limitations. (3.8.3.2) |
| Utilize the Nagi Model and systems theory to discuss the interaction and impact of
multiple organ system impairments for individuals experiencing neuromotor dysfunction,
balance impairment or cardiopulmonary limitations. (3.8.3) |
| Formulate and implement an examination and intervention strategy for individuals
experiencing functional limitations and disability that are due to neuromotor dysfunction,
balance impairment or cardiopulmonary limitations. (3.8.3.16, 3.8.3.27, 3.8.3.28) |
| Discuss and critique the strategies for treating individuals experiencing motor system
dysfunction, balance impairments and cardiopulmonary compromise. (3.8.3) |
| Discuss the implications and relevance of the Guide to Physical Therapy Practice for the
examination, evaluation and diagnosis of neuromuscular and cardiopulmonary dysfunction.
(3.8.3.16, 3.8.3.17, 3.8.3.18, 3.8.3.21) |
| Present a comprehensive examination and treatment program using a case based study for individuals diagnosed with neuromuscular, central nervous system or cardiopulmonary dysfunction. (3.8.3.6, 3.8.3.32) |
General Program Objectives
| Identify information and resources necessary to address a clinical problem
and demonstrate effective clinical problem solving skills.(3.8.3.9,
3.8.3.11, 3.8.3.15, 3.8.3.26). |
| Recognize the influences of social and cultural factors, as well as age,
cognition and psychological factors on the achievement of goals.(3.8.3.2,
3.8.3.40) |
| Demonstrate an appreciation for the values of the profession and the
ability to engage in professional communication appropriate to the level of
education.(3.8.3.1) |
| Participate in the critical analysis of current research and professional
literature. (3.1.3.5) |
| Demonstrate an appreciation for the values of the profession and the
ability to engage in professional communication appropriate to the level of
education.(3.8.3.10, 3.8.3.12) |
| Articulate professional behaviors and outcomes in relation to personal goals in order to actively assess professional development. (3.8.3.3, 3.8.3.14) |
January 6, 2003
Gordon, J. (1987) Assumptions underlying physical therapy intervention: theoretical and historical perspectives. In: Carr, J.H., & Shepherd, R.B. (Eds.). Movement Science: Foundations for Physical Therapy in Rehabilitation. Rockville, MD: Aspen Publishers, Inc.
Horak, F.B. (1991). Assumptions underlying motor control for neurological rehabilitation. In: Lister, M.J., (Ed.), Contemporary Management of Motor Control Problems: Proceedings of the II Step Conference. Alexandria, VA: Foundation for Physical Therapy.
Heriza, C. (1990). Implications of a dynamical systems approach to understanding infant kicking behavior. Physical Therapy, 70, 214-217.
Heriza, C. (1991). Motor development: traditional and contemporary theories. In: Lister, M.J., (Ed.), Contemporary Management of Motor Control Problems: Proceedings of the II Step Conference. Alexandria, VA: Foundation for Physical Therapy.
Scholz, JP. (1990). Dynamic pattern theory - some implications for therapeutics. Physical Therapy, 70, 827-843.
Shumway-Cook, A. & Woollacott, M. (1995). Theories of motor control. In, Motor Control: Theory and Practical Applications. Baltimore, MD: Williams & Wilkins, Baltimore, 1995.
Guiliani, C.A. (1991). Theories of motor control: new concepts for physical therapy. In: Lister, M.J., (Ed.), Contemporary Management of Motor Control Problems: Proceedings of the II Step Conference. Alexandria, VA: Foundation for Physical Therapy.
January 13, 2003
Schenkman, M. & Butler R.B. (1989). A model for multisystem evaluation, interpretation, and treatment of individuals with neurologic dysfunction. Physical Therapy, 69:538-547.
Cavanaugh, J.T. & Schenkman, M. (1998). Physical therapy evaluation and treatment in stroke rehabilitation. Physical Therapy Case Reports, 1:200-209.
Schenkman, M.. (1993). Part 1: To unlock the logic of evaluation. PT Magazine, 2: 57-60.
Schenkman M. (1993). Part 2: To put logic into action. PT Magazine, 3: 61-63.
Carr, J. H., & Shepherd, R. B. (1988). A Motor Relearning Programme for Stroke. Rockville, MD: Aspen Publishers, Inc.
Giuliani C. A. (1995) Strength training for patients with neurological disorders. Neurology Report, 19:29-34
Robertson, E. (2001). The Neural Evaluation. Wild Iris Medical Education. Available: http://www.nursingceu.com/NCEU/courses/neuro/index.htm.
Valenstein, E. (2002). The Complete Neurological Examination. University of Florida College of Medicine. Available: http://www.medinfo.ufl.edu/year2/neuro/neuroexam/neuroexm.html.
January 20, 2003
Horak, F. B., Henry, S. M., & Shumway-Cook, A. (1997). Postural perturbations: new insights for treatment of balance disorders. Physical Therapy, 77:517-533.
Shumway-Cook, A. (1996). Critical analysis of measurement in balance: a clinical approach. Proceeding of the 16th Annual Eugene Michaels Forum, Alexandria, VA: American Physical Therapy Association Section on Research.
Winstein, C. J. (1989) Balance retraining: does it transfer? In Duncan PW (ed.): Balance: Proceedings of the APTA Forum, Alexandria, VA: American Physical Therapy Association.
Woollacott, M. H., & Shumway-Cook, A. S. (1990). Changes in posture control across the life span - a systems approach. Physical Therapy, 70:799-807.
January 21, 2003
NeuroCom International Website: http://www.onbalance.com/
January 27, 2003
Bennett, S. E., & Karnes, J. L.(1998). Theoretical approach to treatment. In: Neurological Disabilities Assessment and Treatment. Philadelphia: Lippincott.
Lee, T. D., Swanson, L. R., & Hall, A. L. (1991). What is repeated in a repetition? Effects of practice on motor skill acquisition. Physical Therapy, 71: 150-156.
Schmidt, R. A. (1991). Motor learning principles for physical therapy. In: Lister, M.J., (Ed.), Contemporary Management of Motor Control Problems: Proceedings of the II Step Conference. Alexandria, VA: Foundation for Physical Therapy.
Winstein, C. J. (1991). Knowledge of results and motor learning - implications for physical therapy. Physical Therapy, 71: 140-149.
Winstein, C. J. (1991). Designing practice for motor learning: clinical implications. In: Lister, M.J., (Ed.), Contemporary Management of Motor Control Problems: Proceedings of the II Step Conference. Alexandria, VA: Foundation for Physical Therapy.
February 3, 2003
February 10, 2003
Bierman, J. NDT theoretical overview. (1997). NDTA Network, 10.
Montgomery, P. C. (1991). III. Neurodevelopmental treatment and sensory integrative theory. In: Lister, M.J., (Ed.), Contemporary Management of Motor Control Problems: Proceedings of the II Step Conference. Alexandria, VA: Foundation for Physical Therapy.
Whiteside, A. (1997). Clinical goals and application of NDT facilitation. NDTA Network,
Karas, M. A., (1991). Integrating the practice of neurodevelopmental treatment techniques with motor learning principles. Neurology Reports, 15: 27-29.
Carr, J. H., & Shepherd, R. B. (1988). A Motor Relearning Programme for Stroke. Rockville, MD: Aspen Publishers, Inc.
Umphred, D. (1991) Merging neurophysilogic approaches with contemporary theories. I . Setting the stage for discussion. In: Lister, M.J., (Ed.), Contemporary Management of Motor Control Problems: Proceedings of the II Step Conference. Alexandria, VA: Foundation for Physical Therapy.
February 17, 2003
Website 2%
Course Paper 30%
Case Presentation 30%
Class Participation 20%
Course Assignments 18%
Note from the MRH Clinical Site Visit - 6%
Reflection on the Musings of Two Non-PT’s: An Editorial Response to Latash and Anson - 6%
Mondays in Rehab Class - A Self-reflection on the Meaning of the PT 678 for Clinical Practice - 6%
Course Mailing List and Online Grading Sign-up
Successful completion of this assignment will require a visit to course web page to sign-up for the class mailing list and online grade accessibility. The mailing list is being hosted by Topica and there is a subscription form on the website that automates the task. Due date for completion of the assignment is Monday, January 13, 2003. Percent of Final Grade = 2%.
Course Paper and Class Presentation
The topic for the course project is an evidenced based examination of literature that supports the use of augmented sensory information to treat clients with neurological dysfunction. There is a general lack of evidence to support many of the treatment techniques used by physical therapist to facilitate motor learning and motor skill acquisition for clients with neurological dysfunction.
The broad question to be addressed by the course paper is as follows: "Is there evidence to support the use of augmented sensory information in the treatment of clients with CNS dysfunction?"
Presentation. Each person will have a maximum of 15 minutes to present their perspective on the course project topic. Ten minutes are allotted for your formal presentation. The remaining five minutes are for audience and presenter discussion.
The specific elements that are to be included in the presentation are as follows:
PowerPoint must be used during the presentation. The maximum number of slides that can be included is 18. A title slide must be included and should contain the title of your presentation. your professional credentials and professional association.
Each presenter must provide all of the course participants with a handout at the time of the presentation. The handout is limited to a maximum of 2 double sided pages and must include all of the slides from the presentation and a bibliography of the references used both to support your opinions or answer the clinical question posed for the course project.
The tenor of the presentation represents your professional and well-reasoned opinion regarding the clinical question. All opinions must be supported by a presentation of relevant references from the peer-reviewed scientific literature. Grading will be based on the average of the grades assigned by the instructors attending the presentation.
Course Paper. The course paper is a formalization of the presentation. The course paper is limited to a maximum of 10 double spaced pages and peer-reviewed references must be used liberally to support any and all opinions offered in the paper.
The format of the paper is one inch margins on all sides and 10 or 12 point font. The title page and bibliography are not counted in the page limit. Reference style is APA.
The paper must also be organized as follows: (1) a cover page with a title that is reflective of th paper’s content, (2) an introduction which presents a brief overview of the problem from your perspective, (3) a purpose statement that is consistent with the title of the paper and the content contained in the paper, (4) a review of the relevant literature which is integrative and consistent with the purpose statement, (5) a conclusion section which briefly summarizes your professional opinion and the content presented in the review of the literature, and (5) a bibliography which starts on a separate page from the conclusion section of the paper. The conclusion section of the paper does not need to contain references. Non-course references must be used liberally in the paper. I would strongly encourage you to use subheadings to identify the major sections of the paper and the major themes that are presented in the paper.
Two copies of the paper are due by Friday, April 4, 2003. Papers can be sent electronically via email. Course papers can be turned in prior to the listed due date. Grading will be based on a numerical average of at least 2 readers.
Class Participation
The class participation grade will based on attendance at scheduled meetings, the quantity and quality of participation in the classroom discussions, and evidence of prior class preparation.
Grading Policy:
Point distribution is determined by the individual faculty member responsible for the course. Points vary by the nature of the course content and purpose, as well as the number of examinations and assignments. Conversion to a final letter grade is consistent for all of the courses in physical therapy. Grade assignment is as follows:
| A 94-100 | C+ 77-79 |
| A- 90-93 | C 73-76 |
| B+ 87-89 | C- 70-72 |
| B 83-86 | F 69 and below |
| B- 80-82 |
Final course grades are rounded to two decimal places and converted to the corresponding letter grade.
No further mathematical or letter adjustments are made to final course grades.
Grades will be emailed at the end of the semester.
Course Assignments
Clinical Note. As part of the clinical site visit to MossRehab Hospital, each person will complete an initial physical examination note using the facility’s documentation. The noted must be handwritten and must include the following: HPI, PMH, SH/FH, environmental assessment, findings from the physical examination, an evaluation or summary of the relationship between the problems and rationale for the functional limitations and disabilities, prognosis, diagnosis using the Guide to Physical Therapy Practice, problem list, long and short term outcomes, and a plan of care with a recommendation for frequency and duration of treatment. Due date is Friday, January 24, 2003.
Reflections on the Latash and Anson Article - A Letter to the Editor. The Latash and Anson article, "What are "normal movements" in atypical populations", generated quite a bit of discussion in the rehabilitation community when it was first published in 1996. The article, while lengthy, is worthwhile reading as it seems to challenge some of our beliefs about the rehabilitative process and our world view of clients with disabilities. Latash and Anson are known for their contributions as movement scientists. Both are proponents of the Bernstein perspective on motor control. Neither are involved in providing care to a population with impairments but have done investigations examining how movement is being controlled by individuals with pathology. Adding to the length of the article are the many authors who were invited to provided commentary. Many of the invited authors are renowned rehabilitation researchers and practitioners.
The assignment is to formulate a personal reaction paper to the ideas presented by Latash and Anson. The format for the paper is a letter to the editor. Due date for the assignment is Monday, February 18, 2003 and the maximum length of the paper is two pages. The format should be similar to the ones that are contained in the editorial commentary that appear at the end of the main body of the article. Please feel free to use references when replying to authors. Your letter to the editor, which will respond to one or more of the ideas presented by Latash and Anson, must be well reasoned.
Mondays in Rehab - A Self-reflection on the Meaning of the PT 678 for Clinical Practice. The purpose of the paper is to have you reflect on how knowledge gained from participating in the course has potentially changed or not changed the way you will practice clinically. The emphasis for the paper is on how you have changed or not changed as a clinician. The paper is designed to be reflection on your own feelings about clinical practice and the course content - readings, lab and lecture activities. Think about and discuss how your philosophical approach to treating clients may have changed. The paper is limited to a maximum of two pages and is due on Friday, May 2, 2003. The paper must be submitted electronically and cannot be submitted prior to the due date.
Tentative
Class Schedule
|
Date |
Topic |
Faculty |
|
1/6/03 |
Theory
and Practice in Treating Clients with CNS Impairments: A Critical Review
of the Multiple Perspectives on Examining and Treating Movement
Dysfunction |
Robert
Wellmon, PT, MS, NCS |
|
1/13/03 |
Examination
and Treatment of Neuromuscular Dysfunction - Issues in Motor Learning
and Control |
Robert
Wellmon, PT, MS, NCS |
|
1/16/03 |
Team
Meeting – Constructing the Screen for Balance Impairment 12:00-1:00
PM |
Robert Wellmon, PT,
MS, NCS |
|
1/19/03 |
Site
Visit - MossRehab Hospital: Examination and Treatment of Neuromuscular
Dysfunction 8:30AM-3:00PM |
Robert
Wellmon, PT, MS, NCS |
|
1/20/03 |
Site
Visit – East Side Ministries: Examination and Evaluation of Balance
– Screening for Fall Prevention
9:00AM-12:30PM |
Robert
Wellmon, PT, MS, NCS |
|
1/21/03 |
Site Visit – Mercy
Fitzgerald Hospital: Examining Balance Using the NeuroCom Balance Master 5:00-6:30 PM |
Paul Vidal, PT, MS |
|
1/27/03 |
Treatment
of Functional Deficits Due to Neuromuscular Impairments - A Neuro-Handling
Approach - PNF |
Gary
Crandall, PT, MA |
|
1/29/03 |
Site Visit –
MossRehab Hospital: Treatment of Functional Deficits Due to
Neuromuscular Impairments - A Neuro-Handling Approach – PNF 4:00-6:00 PM |
Gary
Crandall, PT, MA |
|
2/3/03 |
Examination
of Cognitive Dysfunction |
Gina
Mancuso, PT, MPT |
|
2/5/03 |
Site Visit –
MossRehab Hospital: Evaluating the Impact of Cognitive Dysfunction on
Functional Performance in Adults with TBI 4:00-6:00 PM |
Gina
Mancuso, PT, MPT |
|
2/10/03 |
Treatment
of Functional Deficits Due to Neuromuscular Impairments - A Neuro-Handling
Approach – NDT… Part I |
Robert
Wellmon, PT, MS, NCS |
|
2/12/03 |
Site
Visit - Bryn Mawr Rehabilitation Hospital: Treatment of Functional
Deficits Due to Neuromuscular Impairments - A Neuro-Handling Approach
– NDT… Clinical Applications 4:00-7:00
PM |
Robert
Wellmon, PT, MS, NCS |
|
2/17/03 |
Treatment
of Functional Deficits Due to Neuromuscular Impairments - A Neuro-Handling
Approach – NDT… Part II |
Caitlin
Gardner, PT |
|
2/19/03 |
Journal
Club: Responding to Latash & Anson 12:00-1:00PM
Lunch will be Provided |
Robert
Wellmon, PT, MS, NCS |
|
2/24/03 |
Combining
Treatment Approaches - NDT, PNF, Modern Motor Learning Theory, and Swiss
Gym Ball Interventions Course
Presentations Course
Wrap-Up |
Robert
Wellmon, PT, MS, NCS Sandy Campbell, PT, MBA |