COLLEGE OF CHARLESTON ATEP 430: THERAPEUTIC EXERCISE (3 credits) Mondays, Wednesdays, Fridays: 8:00-8:50 Fall 2011

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1 COLLEGE OF CHARLESTON ATEP 430: THERAPEUTIC EXERCISE (3 credits) Mondays, Wednesdays, Fridays: 8:00-8:50 Fall 2011 Instructor: Anh-Dung Yum Nguyen, PhD, ATC Office Location: 316 Silcox Center Office Hours: Posted weekly on office door. Please sign-up for appointment. Office Phone: Class Website: Hosted by OAKS Prerequisites: BIOL 201/202 and ATEP 245, 345, and EXSC 330 (AT Students) BIOL 201/202 and EXSC 330 (Non-AT Students) Non-AT students are requested to confer with the instructor prior to enrolling in this course. Note: This class carries a component lab worth zero hours. Required Technical Competencies: Internet, , OAKS Course Description: This course provides information on planning and implementing a comprehensive rehabilitation/reconditioning program for injuries/illnesses sustained during physical activity. Emphasis will be placed on the didactic and psychomotor development of the following comprehensive rehabilitation program components: determination of therapeutic goals and objectives, selection of therapeutic treatment and exercise, methods of evaluating and recording rehabilitation progress, and the development of criteria and progression for return to physical activity. This course is required for both the athletic training major and the exercise science concentration within the Department of Health and Human Performance. The class is well integrated into the athletic training curriculum, but is substantially different from most other classes in the exercise science curriculum. Exercise science students may lack a general understanding of common musculoskeletal injuries. However, the assigned readings will provide adequate background in musculoskeletal injury to excel in this course. Learning Objectives: Upon successful completion of this course the student should be able to: 1. Describe the physiological process of wound healing and tissue repair and its implications (limitations, contraindications) on the development and progression of an appropriate rehabilitation or reconditioning program 2. Describe and interpret appropriate measurement and functional testing procedures as they relate to therapeutic exercise 3. Interpret objective measurement results (muscular strength/endurance, range of motion) as a basis for developing individualized therapeutic exercise program 4. Describe common surgical techniques, pathology, and any subsequent anatomical alterations that may affect the implementation of a therapeutic exercise program 5. Interpret the results of injury assessment and determine an appropriate therapeutic exercise program to return the patient to physical activity 6. Define the basic components of activity specific functional progressions in a therapeutic exercise program 7. Describe the appropriate exercise program and appropriate therapeutic goals and objectives based on the initial assessment and frequent reassessments 8. Describe the mechanical principles applied to the design and use of therapeutic exercise equipment (leverage, force) 9. Describe the appropriate selection and application of therapeutic exercises taking the following into consideration: a. The physiological responses of the human body to trauma b. The physiological effects of inactivity and immobilization on the musculoskeletal, cardiovascular, nervous, and respiratory systems of the human body c. The associated anatomical and/or biomechanical alterations of commonly used primary and reconstructive surgery d. The physiological adaptations induced by the various forms of therapeutic exercise, such as fast- versus slow-twitch muscle fibers e. The physiological responses of additional factors, such as age and disease

2 10. Describe the indications, contraindications, theory, and principles for the incorporation and application of various contemporary therapeutic exercises and techniques 11. Determine goals, objectives, and criteria for progression and return to activity based on the level of functional outcomes 12. Describe appropriate methods of assessing progress in a therapeutic exercise program and interpret the results 13. Interpret physician notes, post-operative notes, and physician prescriptions as they pertain to a therapeutic exercise program 14. Describe appropriate medical documentation for recording rehabilitation, functional, and reconditioning progress 15. Explain the effectiveness of taping, wrapping, bracing, and other supportive/protective methods for facilitation of safe progression to advanced therapeutic exercises and functional activities 16. Describe manufacturer s guidelines for the inspection and maintenance of therapeutic exercise equipment 5th Edition Educational Competencies: The content of this course will in part or completely cover the following competencies from the 5th edition of the NATA Educational Competencies: 1. Describe the principles and concepts of body movement, including normal osteokinematics and arthrokinematics. 2. Describe the influence of pathomechanics on function. 3. Differentiate between an initial injury evaluation and follow-up/reassessment as a means to evaluate the efficacy of the patient's treatment/rehabilitation program, and make modifications to the patient's program as needed. 4. Explain the theoretical foundation of clinical outcomes assessment (eg, disablement, healthrelated quality of life) and describe common methods of outcomes assessment in athletic training clinical practice (generic, disease-specific, region-specific, and dimension-specific outcomes instruments). 5. Understand the methods of assessing patient status and progress (eg, global rating of change, minimal clinically important difference, minimal detectable difference) with clinical outcomes assessments. 6. Apply and interpret clinical outcomes to assess patient status, progress, and change using psychometrically sound outcome instruments. 7. Describe and contrast research and literature resources including databases and online critical appraisal libraries that can be used for conducting clinically-relevant searches. 8. Instruct clients/patients in the basic principles of ergodynamics and their relationship to the prevention of illness and injury. 9. Identify and describe the standard tests, test equipment, and testing protocols that are used for measuring fitness, body composition, posture, flexibility, muscular strength, power, speed, agility, and endurance. 10. Compare and contrast the various types of flexibility, strength training, and cardiovascular conditioning programs to include expected outcomes, safety precautions, hazards, and contraindications. 11. Describe and differentiate the physiological and pathophysiological responses to inflammatory and non-inflammatory conditions and the influence of these responses on the design, implementation, and progression of a therapeutic intervention. 12. Integrate self-treatment into the intervention when appropriate, including instructing the patient regarding self-treatment plans. 13. Design therapeutic interventions to meet specified treatment goals. This should include the following: a. Assess the patient to identify indications, contraindications, and precautions applicable to the intended intervention. b. Position and prepare the patient for various therapeutic interventions. c. Describe the expected effects and potential adverse reactions to the patient. d. Instruct the patient how to correctly perform rehabilitative exercises. e. Apply the intervention, using parameters appropriate to the intended outcome. f. Reassess the patient to determine the immediate impact of the intervention. 14. Use the results of on-going clinical examinations to determine when a therapeutic intervention should be progressed, regressed or discontinued. 15. Describe the relationship between the application of therapeutic modalities and the incorporation of active and passive exercise and/or manual therapies, including therapeutic massage, myofascial techniques, and muscle energy techniques. 16. Describe the use of joint mobilization in pain reduction and restoration of joint mobility.

3 17. Explain the relationship between posture, biomechanics, and ergodynamics and the need to address these components in a therapeutic intervention. 18. Identify manufacturer, institutional, state, and/or federal standards that influence approval, operation, inspection, maintenance and safe application of therapeutic modalities and rehabilitation equipment. 19. Inspect therapeutic equipment and the treatment environment for potential safety hazards. 20. Analyze the impact of immobilization, inactivity, and mobilization on the body systems (eg, cardiovascular, pulmonary, musculoskeletal) and injury response. 21. Compare and contrast the variations in the physiological response to injury and healing across the lifespan. 22. Describe common surgical techniques, including interpretation of operative reports, and any resulting precautions, contraindications, and co-morbidities that impact the selection and progression of a therapeutic intervention program. 23. Identify patient- and clinician-oriented outcomes measures commonly used to recommend activity level, make return to play decisions, and maximize patient outcomes and progress in the treatment plan. 24. Explain the theory and principles relating to expected physiological response(s) during and following therapeutic interventions. 25. Describe the laws of physics that (1) underlay the application of thermal, mechanical, electromagnetic, and acoustic energy to the body and (2) form the foundation for the development of therapeutic interventions (eg, stress-strain, leverage, thermodynamics, energy transmission and attenuation, electricity). Required Texts: 1. Houglum, P. A. (2010). Therapeutic Exercise for Musculoskeletal Injuries, 3 rd Ed. Champaign, IL: Human Kinetics. 2. Supplemental Readings on OAKS. Attendance Policy: Students are expected to attend all classes. Students are held responsible for all material covered and any assignments given should any class be missed. Laboratory attendance is tied to your laboratory grade. To achieve full credit for each lab session you must 1) complete the laboratory assignment and 2) attend the entire lab session. Your Lab instructor may have additional requirements. Note: If for some reason I am not at class at 8:00 am please wait at least 15 minutes. Please use this time to review class notes and material. Late Work Policy: All written work will have a specific due date. A 10% deduction will be made for each 24 hours (beginning at the start of the class period on the due date) that an assignment is turned in late. Neither missing class nor arriving late for class on the day an assignment is due prevents you from incurring a late penalty. Once an assignment is handed back, no late assignments will be accepted Examination Policies: You will be notified at least one week in advance if there is a change in a test date. Missed exams may not be made up unless prior arrangements have been made. Special emergencies will be handled on a case-by-case basis. Student Evaluation: Three Written Examinations 45% (15% each exam) Final Comprehensive Examination 15% Quizzes 5% Term Paper 15% 10 peer reviewed articles 5 pts. Descriptive Outline 10 pts. 1 st draft 45 pts. Final draft 30 pts. Peer Evaluation 10 pts. Therapeutic Exercise Laboratory 20% Three Written Examinations: The exams will consist of essay questions. All testing material will be extracted from the course lectures and laboratories, as well as text book and supplemental readings. Exams will focus on critical thinking skills where the student will be asked to apply knowledge gained in class and readings to clinically relevant situations. Comprehensive Final Examination: The exam will consist of essay questions. All testing material will be extracted from the course lectures and laboratories, as well as text book and supplemental readings. The exams will focus on critical thinking skills. The student will be

4 asked to apply knowledge gained in class and readings over the entire course to clinically relevant situations. Quizzes: Because of the large amount of material presented in this class, preparation is key. If you re not prepared, you ll spend the entire class frantically taking notes and will not be able to participate in the discussion. Quizzes will be either announced and scheduled or unscheduled and unannounced. Quizzes will be administered at the start of the class period. Students arriving after the quiz has been started will not receive additional time to complete the quiz. Students arriving to class after the quiz has been collected or time has ended will not be provided with the quiz or a make-up quiz. Term Paper: Students will work in groups of 2 and complete a term paper by selecting an approved orthopedic injury with an accompanying surgical video that requires rehabilitation. The videos are all located at: FAILURE TO ATTAIN APPROVAL OF TOPICS BY THE INSTRUCTOR BY THE POSTED DEADLINE WILL RESULT IN A FAILING GRADE FOR THE ENTIRE TERM PAPER ASSIGNMENT. Each group will be required to view the online surgical, review current literature related to the specific area, and then write a term paper (maximum 15 pages) demonstrating application of knowledge to rehabilitation concepts. Each group will have a different topic that requires approval from the instructor. Topics will be approved on a first-come, first-serve basis. Specific instructions relative to format and content for this term paper will be posted on OAKS. Grading Criteria: Grade A % A % B % B 80-84% B % C % C 70-74% C % D % D 64-65% D % F <62% Numerical Grade Honor Code And Academic Integrity: It is expected that each student in this class will conduct him or herself within the guidelines of the honor system. (See Student Handbook*) All academic work should be done with the high level of honesty and integrity that this institution demands. Incidents where the instructor determines the student s actions are related more to a misunderstanding will be handled by the instructor. A written intervention designed to help prevent the student from repeating the error will be given to the student. The intervention, submitted by form and signed both by the instructor and the student, will be forwarded to the Dean of Students and placed in the student s file. Cases of suspected academic dishonesty will be reported directly by the instructor and/or others having knowledge of the incident to the Dean of Students. A student found responsible by the Honor Board for academic dishonesty will receive a XF in the course, indicating failure of the course due to academic dishonesty. This grade will appear on the student s transcript for two years after which the student may petition for the X to be expunged. The student may also be placed on disciplinary probation, suspended (temporary removal) or expelled (permanent removal) from the College by the Honor Board.

5 Students should be aware that unauthorized collaboration--working together without permission-- is a form of cheating. Unless the instructor specifies that students can work together on an assignment, quiz and/or test, no collaboration during the completion of the assignment is permitted. Other forms of cheating include possessing or using an unauthorized study aid (which could include accessing information via a cell phone or computer), copying from others exams, fabricating data, and giving unauthorized assistance. Research conducted and/or papers written for other classes cannot be used in whole or in part for any assignment in this class without obtaining prior permission from the instructor. * A complete version of the Honor Code and all related processes can be found in the Student Handbook at Personal Electronic Devices: Personal electronic devices such as smart phones, cell phones, ipods, and PDA s are not permitted to be used in class. Students needing to bring such devices to class must be sure the device is TURNED OFF (not set to vibrate) and secured inside a book-bag, purse, or pocket for the entire class time. Students removing an electronic devices from its secured location or using personal electronic devices during class time will be asked to leave the classroom for the remainder of the class meeting time. Disability Statement: This College abides by section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act that stipulates no student shall be denied access to an education solely by reason of a handicap. Disabilities covered by law include, but are not limited to, learning disabilities and hearing, sight or mobility impairments. If you have a documented disability that may have some impact on your work in this class and for which you may require accommodations, please see an administrator at the Center of Disability Services, (843) or me so that such accommodation may be arranged. If there is a student in this class who has a documented disability and has been approved to receive accommodations through SNAP Services, please feel free to come and discuss this with me during my office hours.

6 ATEP 430 COURSE AGENDA FALL 2011 DATE TOPIC READINGS Wed, Aug 24 th Course Introduction Syllabus Fri, Aug 25 th Essential Components of a Rehabilitation Program CH 1 Mon, Aug 29 th A Phased Approach to Rehabilitation Planning and Implementation CH 1 Wed, Aug 31 st Effect of Injury on Body Systems: Tissue Healing **DEADLINE FOR APPROVAL OF TERM PAPER TOPICS** Fri, Sept 2 nd Effects of Injury on Body Systems: Immobilization and Disuse CH 2, 5 ( ) Mon, Sept 5 th Biomechanical Principles of Therapeutic Exercise and Ergonomics CH 3 Wed, Sept 7 th Restoration of Range of Motion: Soft Tissue Techniques CH 5 & 6 Fri, Sept 9 th Restoration of Range of Motion: Joint Mobilization Techniques CH 6 Mon, Sept 12 th Restoration of Proprioception & Neuromuscular Control: Neurophysiology **TERM PAPER PEER REVIEWED ARTICLES DUE** Wed, Sept 14 th Restoration of Proprioception & Neuromuscular Control: Neurophysiology CH 8 CH 2 CH 8 Fri, Sept 16 th Mon, Sept 19 th EXAM #1 Restoration of Proprioception & Neuromuscular Control: Exercise Selection and Progression CH 8 Wed, Sept 21 st Proprioceptive Neuromuscular Facilitation CH 8 ( ) Fri, Sept 23 rd Proprioceptive Neuromuscular Facilitation CH 8 ( ) Mon, Sept 26 th Restoration of Muscle Function: Muscle Strength and Endurance CH 7 Wed, Sept 28 th Restoration of Muscle Function: Muscle Strength and Endurance CH 7 Fri, Sept 30 th Principles of Isokinetic Exercise and Testing Mon, Oct 3 rd Restoration of Muscle Function: Speed, Agility and Plyometrics CH 9 Wed, Oct 5 th Fri, Oct 7 th EXAM #2 Restoration of Muscle Function: Speed, Agility and Plyometrics **DESCRIPTIVE OUTLINE DUE** CH 9 Mon, Oct 10 th Rehabilitation Considerations for the Cervical and Thoracic Spine CH 18 ( ) Wed, Oct 12 th Rehabilitation Considerations for the Cervical and Thoracic Spine CH 18 Fri, Oct 14 th Rehabilitation Considerations for the Lumbosacral Spine CH 18 Mon, Oct 17 th NO CLASS FALL BREAK Wed, Oct 19 th Rehabilitation Considerations for the Lumbosacral Spine CH 18 Fri, Oct 21 st Rehabilitation Considerations for the Lumbosacral Spine CH 18 Mon, Oct 24 th Rehabilitation Considerations for the Shoulder CH 19 Wed, Oct 26 th Rehabilitation Considerations for the Shoulder CH 19 Fri, Oct 28 th Rehabilitation Considerations for the Shoulder CH 19 Mon, Oct 31 st Wed, Nov 2 nd Rehabilitation Considerations for the Shoulder **TERM PAPER 1 ST DRAFT DUE** Restoration of Function: Selection and Progression of Upper Extremity Functional Activities CH 19 CH 10 Fri, Nov 4 th Rehabilitation Considerations for the Elbow and Forearm CH 20 Mon, Nov 7 th Rehabilitation Considerations for the Wrist and Hand CH 21

7 Wed, Nov 9 th Rehabilitation Considerations for the Wrist and Hand CH 21 Fri, Nov 11 th Rehabilitation Considerations for the Hip and Thigh CH 24 Mon, Nov 14 th EXAM #3 Wed, Nov 16 th Rehabilitation Considerations for the Hip and Thigh CH 24 Fri, Nov 18 th Rehabilitation Considerations for the Knee CH 23 Mon, Nov 21 st Rehabilitation Considerations for the Knee CH 23 Wed, Nov 23 rd Fri, Nov 25 th NO CLASSES THANKSGIVING BREAK NO CLASSES THANKSGIVING BREAK Mon, Nov 28 th Rehabilitation Considerations for the Knee CH 23 Wed, Nov 30 th Rehabilitation Considerations for the Foot and Ankle CH 22 Fri, Dec 2 nd Rehabilitation Considerations for the Foot and Ankle CH 22 Mon, Dec 5 th Mon, Dec 12 th Restoration of Function: Selection and Progression of Lower Extremity Functional Activities **FINAL TERM PAPER DUE** 8:00 11:00 a.m. CUMMULATIVE FINAL EXAMINATION Schedule is tentative and subject to change CH 10