College of Health & Human Services Department of Physical Therapy and Athletic Training AT 370W Therapeutic Exercise of Athletic Injuries Fall 2013 Debbie Craig, PhD, AT, LAT CHP 121B (928) 523-0704 Debbie.Craig@nau.edu Glenn Edgerton, EdD, AT, LAT CHP 121A (928)523-6837 Glenn.Edgerton@nau.edu Office Hours: MWF 9am-11am Office Hours: M-F 11a-12p Credit Hours: 4 Prerequisites: AT milestone Course Description: This course is designed to help you learn how to plan and implement sport-specific functional rehabilitation programs. Emphasis is placed on development of comprehensive, individualized rehabilitation protocols incorporating open and closed kinetic chain activities, proprioceptive training techniques, plyometrics, core stability, and other functional activities based on pre-determined therapeutic goals and objectives. Student Learning Outcomes: Upon successful completion of this course, you will: Understand the tissue healing process and incorporate it into the rehabilitation process; (exam) Identify and assess the physical/physiological parameters that serve as the basis for development of individualized athletic injury rehabilitation programs (e.g. strength, ROM, etc.); (exam) Identify major considerations associated with return-to-play following a sports injury; (group projects) Plan and implement a sport-specific functional rehabilitation program, including development of therapeutic objectives, selection of functional activities, and assessment of rehabilitation progress; (exam, grp projects) Select and integrate appropriate motivational techniques into the rehabilitation program; (exam, grp projects) Identify environmental risk factors affecting the safe return of injured athletes to play; (exam) Identify, compare, and evaluate various commercial and fabricated protective devices commonly used during the functional phase of sports injury rehabilitation; (group projects) Incorporate commonly used functional activities into comprehensive, progressive functional rehabilitation programs; (exam, group projects) Identify the role of various exercise equipment/devices commonly used during the functional phase of rehabilitation and reconditioning; (exam) Apply the basic principles and concepts of functional testing as related to assessment of rehabilitation progress and return-to-play criteria. (exam, group projects) Course Structure/Approach: This course will introduce material through discussion, lecture, research, and laboratory classes. Interaction and participation in rehabilitation exercises is strongly encouraged. This course will satisfy the University s junior-level writing requirement. Students will be expected to put in 2 hours outside of class for every hour spent in class. Text and Required Materials: Required text: Prentice WE. Rehabilitation Techniques for Sports Medicine and Athletic Training, 5 th Ed., Boston, MA: McGraw-Hill, 2011. ISBN# 0-07-246210-8 Recommended text: Magee DJ. Scientific Foundations & Principles of Practice in Musculoskeletal Rehabilitation. St. Louis, Missouri: Saunders, 2007. ISBN-13#: 978-1-4160-0250-5
Week: Course Outline Readings: Unit One Basic Concepts 1 Concepts of Rehabilitation; Wound Healing; Tissue Healing Rates Prentice Ch. 1, 2 2 Rehab Plan Aspects & Phases Group Exercises Prentice Ch. 4-6 3 Decision Making for Rehab Progressions; Motivational Techniques Prentice Ch. 7-9 Sept. 10 th - initial EBP paper question due Sept. 12 th library day meet at Cline Library 4 Unit 1 Exam Tuesday, Sept. 17 th ; PICO worksheet due Unit Two Basic Tools of Rehab 4 Manual Therapy; Functional Exercise; Labs Prentice Ch. 12, 14, 17 Stretching, Scar Mob., Massage, Resistance Exercises Sept. 20 th library apptmt date and time due 5 Rehab Equipment; Plyometrics; Swiss Balls; Balance Brds; etc. Prentice Ch. 11 Isokinetic machines; Lab for each type of equipment 6 Proprioceptive Neuromuscular Facilitation (PNF) and Lab Prentice Ch. 15 Speaker Valerie Carter, PT PNF Techn. Joint MobilizationTechniques and Lab Oct. 3 rd brief EBP paper outline due 7 Aquatherapy and Lab Oct. 8 th WEAR YOUR SWIMSUITS!! Prentice Ch. 16 Therapeutic Exercise Precautions Post-surgical; Review Prentice Ch. 3 8 Oct. 15 th - Unit Two Exam Unit Three Specific Rehab Programs 8 Problem 1 - Shoulder and Arm Rehab Prentice Ch. 18, 19, 20 9 Problem 1 - Presentations Oct. 24 th references & list of databases due 10 Problem 2 Low Back & Pelvis Rehab; Core Stability Prentice Ch. 10, 25 11 Problem 2 - Presentations Nov. 5 th detailed outline due 12 Problem 3 Knee Rehab Prentice Ch. 21, 22 13 Problem 3 Presentations 14 Problem 4 - Foot, Ankle, and Lower Leg Rehab Prentice Ch. 23, 24 Nov. 26 th final term paper due! *************************Nov. 28 to Dec. 1 Fall Break************************** 15 Problem 4 Presentations; Review for final exam 16 TBA - Unit Three Exam (Final Exam!) Evaluation Methods and Deadlines Assignments The University s junior-level writing requirement will be satisfied in this course by the completion of a term paper (minimum 10 pgs.) and a self evaluation essay. Both should be written in AMA style. An example sheet regarding AMA style is posted on Vista. Term Paper: () This assignment will require you to employ Evidence-Based Practice (EBP) methods. This requires you to: determine a question you have about a rehabilitation issue/technique/outcome in the clinical setting; further develop your question using the PICO worksheet; once you have identified the PICO elements, put your final question together; perform your literature search and review; and finally, write your paper. Papers should be 10-12 pages in length. Guidelines and dues dates for several steps in this process are in the project handout and in the Course Outline above. All papers will be run through the Safe Assign website to ensure original work by the student. Papers must contain no more than 20% quoted material from other authors. Please see the Course Policy section of this syllabus regarding plagiarism policy.
Self-Evaluation: (50 points) The essay (2-3 pages) should be a thoughtful evaluation of your strengths/areas of needed improvement in Athletic Training. Relate your strengths to your professional goals and discuss areas for improvement in order to reach your goals. Course Teaching Evaluation: Each student is required to complete the end-of-the-semester Course Teaching Evaluation. This may be an online evaluation. Due to the critical nature of these evaluations, grades will not be posted without their completion. Examinations A 100 point written examination will follow Unit 1, Unit 2, and Unit 3. All examinations must be passed with a percentage score of 70% or better. If the student scores lower than 70%, they must re-take the exam until they score 70% or better. At that time, they will receive a top score of 70% for the exam. Grading System Final grades will be based on the percentage of total points accumulated on written examinations, laboratory practical exams, and class assignments. Unit One Exam Unit Two Exam Final Exam Term Paper PBL participation peer grade Self-Evaluation Paper Total: 50 points 50 points 500 points 90% (450 points) = A 80% (400 points) = B 70% (350 points) = C 60% (300 points) = D 50% (250 points) = F Course Policy Retest/makeup tests Arrangements must be made with instructor prior to the scheduled exam date. In the case of an unforeseeable situation, contact must be made with the instructor at your earliest convenience. Attendance Class attendance is mandatory. Any absences should be cleared with the instructor prior to missing class. In the event of an uncontrollable event please contact the instructor as soon as possible. Unexcused absences will result in a 10 point deduction. Cell Phone/Browsing All cell phones are to be turned off and put away before class begins. If a student is found using their cell phone in any manner during class or browsing the internet with their laptop, they will be dismissed immediately and a 20 point deduction will be recorded per incident. Statement on plagiarism and cheating See University policies at: http://home.nau.edu/images/userimages/awf/9476/academic%20dishonesty.pdf Withdrawal Policy The university course drop deadline is September 9, 2013. The university course withdrawal deadline is October 30, 2013. It is the policy of the College of Health and Human Services that petitions to withdraw after November 15, 2013, will not be considered. University Policies See website containing University policies regarding Safe Working and Learning Environment, Students with Disabilities, Institutional Review Board, and Academic Integrity at: http://home.nau.edu/studentlife/handbook.asp
Competencies: EBP-4. Describe a systematic approach (eg, five step approach) to create and answer a clinical question through review and application of existing research. EBP-5. Develop a relevant clinical question using a pre-defined question format (eg, PICO= Patients, Intervention, Comparison, Outcomes; PIO = Patients, Intervention, Outcomes). EBP-6. Describe and contrast research and literature resources including databases and online critical appraisal libraries that can be used for conducting clinically-relevant searches. EBP-7. Conduct a literature search using a clinical question relevant to athletic training practice using search techniques (eg, Boolean search, Medical Subject Headings) and resources appropriate for a specific clinical question. EBP-11. Explain the theoretical foundation of clinical outcomes assessment (eg, disablement, health-related 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). EBP-12. Describe the types of outcomes measures for clinical practice (patient-based and clinician-based) as well as types of evidence that are gathered through outcomes assessment (patient-oriented evidence versus disease-oriented evidence). EBP-13. 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. EBP-14. Apply and interpret clinical outcomes to assess patient status, progress, and change using psychometrically sound outcome instruments. CE-7. Identify the patient s participation restrictions (disabilities) and activity limitations (functional limitations) to determine the impact of the condition on the patient s life. CE-8. Explain the role and importance of functional outcome measures in clinical practice and patient health-related quality of life. CE-9. Identify functional and patient-centered quality of life outcome measures appropriate for use in athletic training practice. CE-14. 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. CE-19. Determine criteria and make decisions regarding return to activity and/or sports participation based on the patient s current status. Therapeutic interventions include: Techniques to reduce pain Techniques to limit edema Techniques to restore joint mobility Techniques to restore muscle extensibility Techniques to restore neuromuscular function Exercises to improve strength, endurance, speed, and power Activities to improve balance, neuromuscular control, coordination, and agility Exercises to improve gait, posture, and body mechanics Exercises to improve cardiorespiratory fitness Functional exercises (eg, sports- or activity-specific) Exercises which comprise a home-based program Aquatic therapy Therapeutic modalities Therapeutic medications (as guided by applicable state and federal law) TI-4. Analyze the impact of immobilization, inactivity, and mobilization on the body systems (eg, cardiovascular, pulmonary, musculoskeletal) and injury response.
TI-5. Compare and contrast the variations in the physiological response to injury and healing across the lifespan. TI-6. Describe common surgical techniques, including interpretation of operative reports, and any resulting precautions, contraindications, and comorbidities that impact the selection and progression of a therapeutic intervention program. TI-7. 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. TI-10. Integrate self-treatment into the intervention when appropriate, including instructing the patient regarding self-treatment plans. TI-11. Design therapeutic interventions to meet specified treatment goals. TI-11a. Assess the patient to identify indications, contraindications, and precautions applicable to the intended intervention. TI-11b. Position and prepare the patient for various therapeutic interventions. TI-11c. Describe the expected effects and potential adverse reactions to the patient. TI-11d. Instruct the patient how to correctly perform rehabilitative exercises. TI-11e. Apply the intervention, using parameters appropriate to the intended outcome. TI-11f. Reassess the patient to determine the immediate impact of the intervention. TI-12. Use the results of on-going clinical examinations to determine when a therapeutic intervention should be progressed, regressed or discontinued. TI-13. 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. TI-14. Describe the use of joint mobilization in pain reduction and restoration of joint mobility. TI-15. Perform joint mobilization techniques as indicated by examination findings. TI-18. Explain the relationship between posture, biomechanics, and ergodynamics and the need to address these components in a therapeutic intervention.