Behavioral Objectives:

At the completion of this course the student will be able to:

I: Wound Care/Skin Care

  1. 1 Describe the four stages of pressure sores.
  2. 2 Distinguish between and describe treatment techniques appropriate for the following types of wounds: diabetic ulcers, arterial insufficient ulcers, venous insufficient ulcers, and pressure sores.
  3. 3. Understand the therapeutic effects and limitations of the following treatment modalities in wound care: electrical stimulation, ultrasound, hydrotherapy, bandaging, unna boots, and intermittent compression.
  4. 4. Define vocabulary commonly used to describe wound exudates.
  5. 5. Contrast acute versus chronic inflammation.
  6. 6. Define primary versus secondary union or intention.
  7. 7. Briefly describe the three phases of wound healing.
  8. 8. Describe the importance of and techniques used to maintain sterile fields for wound dressing.
  9. 9. Defend the practicality of universal precautions.
  10. 10. List bony prominences that are at risk for tissue breakdown in the hypomobile person.
  11. 11. Develop a skin care prevention plan for a bed fast person.
  12. 12. Describe major risk factors for skin breakdown.
  13. 13. List 6 types of pressure relief devices for use when patients are in bed or in a chair.
  14. 14. Describe the warning signs for pressure sore development.
II: Burn Care
  1. 1. State the protective mechanisms provided by skin.
  2. 2. Site 6 physical therapy goals for the burn patient.
  3. 3. Describe the 5 different burn classifications.
  4. 4. List 4 factors that determine the severity of a burn.
  5. 5. Define autographs, allographs, xenographs and artificial skin and their role in burn care management.
  6. 6. Know the basic principles for positioning the burn patient.
  7. 7. Describe the therapeutic benefit of ultrasound, deep friction massage, ROM programs, constant pressure garments, hydrotherapy and cardiovascular training for the burn patient.
III: Parkinson's Disease (P.D.)
  1. 1. Briefly describe the neurological pathologies causing P.D..
  2. 2. List the classic signs of P.D..
  3. 3. Describe common postural changes seen in later stage P.D..
  4. 4. Describe common gait deviations seen in P.D. patients.
  5. 5. List 5 secondary complications of P.D..
  6. 6. List 3 long term physical therapy goals for the P.D. patient.
  7. 7. List 6 short term physical therapy goals for the P.D. patient.
  8. 8. Describe specific treatment techniques used by the PTA for the P.D. patient (i.e.: relaxation exercise, ROM programs, mobility exercises, and ambulation training).
IV: Limb Amputation
  1. 1. State the major causes of LE and UE amputation.
  2. 2. Describe the following types of amputations in reference to level of amputation and/or prosthetic requirement and subsequent energy increase needed for ambulation with the prosthetic device: digital amputation, transmetatarsal amputation, Chopart's amputation, symes amputation, knee disarticulation, below knee amputation, and above knee amputation.
  3. 3. Devise a complete pre-prosthetic amputee treatment program given basic patient evaluation information.
  4. 4. Describe the basic components in a below and above knee prosthesis.
  5. 5. List the common above knee gait deviations and state possible amputee and prosthetic causes for the deviations.
  6. 6. List the common below knee gait deviations and state possible amputee and prosthetic causes for the deviations.
  7. 7. Describe the importance of early stump wrapping for the amputee.
  8. 8. State 4 goals of stump wrapping.
  9. 9. State types of bandages used with and AKA and BKA and describe how to care for ace bandages.
  10. 10. List 2 precautions to consider when stump wrapping.
  11. 11. Describe the technique and importance of pressure gradation with stump wrapping.
V: Cerebral Vascular Accidents
  1. 1. Define the following terms: lacunar state, transient ischemic attack, ischemia, infarction, apraxia, hemianopsia, and synergy patterns.
  2. 2. Classify stroke patients into one of Brunnstrom's Six Stages of Recovery based on written scenarios.
  3. 3. Describe the major/most common deficits seen with CVAs in the distributions of the middle cerebral artery, anterior cerebral artery, the posterior cerebral artery and the vertebral/basilar arteries.
  4. 4. Identify 6 stroke risk factors.
  5. 5. Identify the components of the various categories of classifying CVA; management, etiological and anatomical site.
  6. 6. Differentiate between the three types of cerebral infarctions as to their causes, clinical picture, prognosis and treatment.
  7. 7. Differentiate between the typical characteristics ascribed to the left vs. right CVA patient.
  8. 8. List the common complications following a CVA and their respective interventions.
  9. 9. Describe the common aphasias; their respective etiologies and treatment interventions.
VI: Head Injury/Trauma
  1. 1. Differentiate between closed and opened head injuries.
  2. 2. Define contusion and concussion of the brain.
  3. 3. List both the common complications following a TBI and the respective interventions.
  4. 4. Define coup and countrercoup.
  5. 5. Know the 3 items graded by the Glasgow Coma Scale.
  6. 6. Interpret the clinical implications of a low score versus an high score on the Glasgow Coma Scale.
  7. 7. Describe the eight levels of patient functioning as outlined by the Rancho Los Amigos Levels of Cognitive Functioning Scale.
  8. 8. List the common treatment strategies utilized for each Rancho's level.
VII: Spinal Cord Injury
  1. 1. Identify the common etiology for SCI
  2. 2. Describe the clinical presentation of the acute SCI patient
  3. 3. Describe the classifications of SCI.
  4. 4. Describe and diagram the following; Brown-Sequard syndrome, anterior cord syndrome, central cord syndrome, posterior cord syndrome and cauda equina lesion.
  5. 5. List the critical levels of innervation.
  6. 6. Define the following terms associated wit the spinal cord and spinal cord injury: conus medullaris, cauda equina, quadriplegia, paraplegia, spinal shock, automonic dysreflexia, postural hypotension and heterotopic bone formation.
  7. 7. Describe the common complications and their respective interventions for the SCI patient.
  8. 8. Describe the functional outcomes for the various levels of SCI.
VIII. Multiple Sclerosis
  1. 1. Identify the important pre-treatment assessment information.
  2. 2. List nine clinical features and their respective treatment interventions.
  3. 3. List the common complications and their respective treatment interventions for the MS patient.
  4. 4. List four precautions in treating a patient with MS.
Laboratory Objectives:
  1. 1. List common gait deviations seen in stroke pts at the hip, knee and ankle.
  2. 2. State basic muscular/balance control needed prior to ambulation for patients with the following diagnosis; CVA, TBI, SCI, P.D., MS, amputation.
  3. 3. Demonstrate progression of balance training from static sitting to dynamic standing for patients with the following diagnosis; CVA, TBI, SCI, P.D., MS, amputation.
  4. 4. Demonstrate 3 different pre-amb activities for patients with the following diagnosis; CVA, TBI, SCI, P.D., MS, amputation.
  5. 5. List common gait deviations seen in patients with the following diagnosis; CVA, TBI, SCI, P.D., MS, amputation.
  6. 6. State basic muscular/balance control needed by SCI pts for transfers and sitting
  7. 7. Demonstrate proper positioning and transfer technique for a SCI pt. List common ROM restrictions found in Parkinson's pts.
  8. 8. Perform a general home stretching program for a Parkinsonian patient.
  9. 9. List 3 common abnormalities of a Parkinsonian gait and suggest treatment intervention techniques to decrease these abnormalities.
  10. 10. Describe how to establish and maintain a sterile field.
  11. 11. Demonstrate correct wrapping of an amputee stump.
  12. 12. List types of ace bandages necessary to wrap an AKA and BKA.
  13. 13. Demonstrate stretching exercises used during preprosthetic training.
  14. 14. Demonstrate basic LE strengthening exercises for amputees.
  15. 15. Demonstrate proper head, ankle, UE, LE, and hand positioning in bed following body burns to these areas.
  16. 16. Identify the following structures on a prosthetic device: foot-ankle assembly, shank, socket, thigh corset, supracondylar cuff suspension, and knee unit.
  17. 17. Identify endoskeletal versus exoskeletal shank.
  18. 18. Identify the anterior and posterior channels on a metal AFO.
  19. 19. State which channel on a metal AFO controls DF and which controls PF.
  20. 20. State how to increase or decrease dorsiflexion and plantarflexion in a metal AFO by adjusting channel pins.
  21. 21. Describe the effect an AFO has on the knee joint.