Management of Neurological Disorders

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Comprehensive rehabilitation techniques of selected neurological disorders. Forty-eight lecture hours and forty-eight lab hours per semester (completed in four weeks).

Course Learning Objectives

Describe management of patients with neurological disorders; demonstrate rehabilitation techniques for neurological disorders; demonstrate communication skills.

After completing this course, the student should be able to:

Describe common characteristics and components of neurologic physical therapy intervention.
Describe the symptoms, etiology, prognosis and prevention of cerebrovascular accidents (CVA).
Develop and assess treatment interventions within the plan of care for patients following brain injury.
Describe the symptoms, etiology and prognosis of traumatic brain injury (TBI).
Develop and assess treatment strategies and interventions within the plan of care for patients following TBI.
Describe the symptoms, etiology and prognosis of spinal cord injury (SCI).
Develop and assess treatment interventions within the plan of care for patients following SCI.
Describe the symptoms, etiology and prognosis of common congenital and early-acquired neurologic deficits.
Develop and assess treatment interventions within the plan of care for patients with common congenital and early-acquired neurologic deficits.
Describe the symptoms, etiology, prognosis and treatment of selected neurologic diseases.

Student Learning Outcomes

Describe common characteristics and components of neurologic physical therapy intervention. (F1, F11, C5, C7)
1. Compare and contrast treatment approaches used for orthopedic and neurologic patients.
2. Explain common interventions and strategies used in neurologic physical therapy.
3. Identify and explain patient responses that necessitate immediate action or adjustments within the plan of care and communication with the supervising physical therapist.
Describe the symptoms, etiology, prognosis and prevention of cerebrovascular accidents (CVA). (F1, F8, F9, F11, F12, C5, C7)
1. Identify warning signs and risk factors for CVA.
2. Discuss common CVA types and syndromes.
3. Infer symptoms that would likely result from damage to various parts of the brain.
4. Describe factors affecting prognosis following CVA.
5. Describe and differentiate visual impairments that may result from brain injury.
6. Describe sensory impairments that may result from brain injury.
7. Describe and differentiate perceptual impairments that may result from brain injury.
8. Describe and differentiate communication impairments that may result from brain injury.
9. Describe orofacial and respiratory impairments that may result from brain injury.
10. Describe prevention of shoulder and upper extremity dysfunction following brain injury.
11. Describe, differentiate and categorize motor impairments that may result from brain injury.
Develop and assess treatment interventions within the plan of care for patients following brain injury. (F1, F8, F9, F11, C5, C7, C18)
1. Compare and contrast selected treatment approaches commonly used following brain injury.
2. Identify treatment strategies for patients with visual impairments.
3. Identify treatment strategies for patients with perceptual impairments.
4. Identify treatment strategies for patients with communication impairments.
5. Identify treatment strategies for patients with orofacial and respiratory impairments.
6. Identify treatment strategies for patients with CVA-induced shoulder impairments.
7. Demonstrate skill in the application of interventions for gait and functional training following brain injury.
Describe the symptoms, etiology and prognosis of traumatic brain injury (TBI). (F1, F8, F11, C5, C7)
1. Identify and discuss etiological factors that contribute to TBI.
2. Categorize and discuss severity and prognosis of TBI based on patient history and presentation.
3. Describe and categorize typical deficits produced by TBI.
4. Describe assessment tools used with TBI patients.
Develop and assess treatment strategies and interventions within the plan of care for patients following TBI. (F1, F8, F9, F11, C5, C7, C18)
1. Categorize patients using the Glasgow Coma Scale and the Rancho Levels of Cognitive Functioning.
2. Identify appropriate treatment strategies for TBI patients based on level of cognitive functioning.
3. Identify appropriate treatment interventions to address selected deficits following TBI.
Describe the symptoms, etiology and prognosis of spinal cord injury (SCI). (F1, F8, F11, C5, C7)
1. Describe and differentiate characteristics of selected spinal cord syndromes and lesion types (complete, incomplete, UMN, LMN, etc.).
2. Describe and differentiate characteristics of selected spinal cord injury levels.
3. Explain the causes and progression of symptoms and deficits following spinal cord injury.
4. Describe dermatome levels typically used in SCI assessment.
5. Identify potential functional outcomes following SCI at selected injury levels.
Develop and assess treatment interventions within the plan of care for patients following SCI. (F1, F8, F9, F11, C5, C7, C18)
1. Identify appropriate interventions for selected spinal cord injury levels, deficits and syndromes.
2. Describe potential complications, and precautions to be observed with selected SCI patients.
3. Demonstrate skill in the application of selected interventions used with SCI patients.
Describe the symptoms, etiology and prognosis of common congenital and early-acquired neurologic deficits. (F1, F8, F11, C5, C7)
1. Identify normal developmental milestones.
2. Discuss characteristics, classification and prognostic indicators of cerebral palsy.
3. Discuss characteristics, classification and prognostic indicators of myelomeningocele.
Develop and assess treatment interventions within the plan of care for patients with common congenital and early-acquired neurologic deficits. (F1, F8, F9, F11, C5, C7, C18)
1. Identify appropriate interventions and management strategies for patients with cerebral palsy throughout the lifespan.
2. Identify appropriate interventions and management strategies for patients with myelomeningocele throughout the lifespan.
Discuss the symptoms, etiology, prognosis and treatment of selected neurologic diseases. (F1, F8, F9, F11, C5, C7, C18)
1. Describe and differentiate symptoms, etiology and progression of selected neurologic diseases.
2. Identify appropriate interventions and treatment strategies within the plan of care for selected neurologic diseases

Required Textbooks

Textbooks: Neurologic Intervention for Physical Therapy; 3^rd Edition; Martin & Kessler; Saunders, 2015

Course Packet: PTHA 2431 Course Packet for Spring 2016 (available in Moodle classroom)

Evaluation Standards

Course Requirements

In order to receive credit for this course, all students must:

1. Complete all unit tests.

2. Complete all laboratory sessions and worksheets.

3. Complete all assigned projects and class presentations.

3. Complete the final exam.

Grade Compilation

Labs (See Below)

Quizzes and Tests 70%

Final Exam 30%

Active participation in every lab session is expected throughout the course. Active participation includes being present in the lab and interacting appropriately with faculty and other students to learn and practice clinical skills for the entire duration of each lab session. Students who do not actively participate in all lab sessions will have 5 percentage points deducted from their overall course grade at the end of the semester. This means that a student with a combined test/final exam score of less than 75% would fail the course if they did not actively participate in all lab sessions.

Grading Scale

A 90-100%

B 80-89%

C 70-79%

F <70%

Professional Behavior

Professional behavior is absolutely essential both while the individual is a student in this program as well as after graduation. The Professional Behaviors Assessment form provides a standard for behavior and a mechanism for self-assessment by the student as well as assessment by faculty during the academic component of the program. If a faculty member observes consistent failure to demonstrate acceptable professional behavior by a student, the faculty member will utilize the assessment form as a tool for counseling the student. Failure to respond appropriately to counseling regarding professional behaviors will result in dismissal from the program.

Course Progression

INTRO TO NEUROLOGIC INTERVENTIONS
1. Treatment Approach Used With Neuro Patients
2. Brain Functions
CVA
1. Introduction to Cerebrovascular Accidents
2. Common Stroke Syndromes
3. Visual Impairments
4. Sensory Impairments
5. Perceptual Impairments
6. Communication Impairments
7. Orofacial Deficits
8. Respiratory Impairments
9. Shoulder Dysfunction
10. Motor Impairments
11. Specific Treatment Approaches
12. Medications
13. General Treatment Guidelines
14. Positioning
15. ROM Exercises
16. Functional Training
17. Mat Program

TRAUMATIC BRAIN INJURY (TBI)
1. Introduction
2. Incidence
3. Pathophysiology
4. Signs and Symptoms
5. Specific Deficits Post Head Injury
6. Prognostic Indicators and Outcome Predictors
7. Treatment for Patients at Rancho Levels I - VIII
8. Medications Commonly Used with TBI
9. Hints to Enhance Recovery From TBI
SPINAL CORD INJURY
1. Introduction
2. Etiology
3. Classification of SCI
4. Mechanisms of Injury
5. Brown-Séquard (sa kar’) Syndrome
6. Anterior Cord Syndrome
7. Central Cord Syndrome
8. Posterior Cord (Dorsal Column) Syndrome
9. Sacral Sparing
10. Cauda Equina Injuries
11. Root Escape
12. Clinical Picture Following SCI
13. Complications
14. Acute Management - Fracture stabilization
15. P.T. Assessment
16. Treatment
PEDIATRICS
1. Developmental Process
2. Cerebral Palsy
3. Treatment of Cerebral Palsy
4. Myelomeningocele
5. Treatment of Myelomeningocele
MULTIPLE SCLEROSIS
1. Introduction
2. Clinical Signs/Symptoms and Treatment
3. Pt/Family Education
PARKINSON'S DISEASE
1. Introduction
2. Clinical Signs
3. Drug Management
4. Surgical Management
5. Physical Therapy Intervention
GUILLAIN-BARRÉ SYNDROME
1. Introduction
2. Clinical Signs/Symptoms
3. Physical Therapy Intervention
POSTPOLIO SYNDROME
1. Introduction
2. Clinical Signs/Symptoms
3. Physical Therapy Intervention

Absences

Regular attendance at lecture and lab is essential and has a direct effect on the final grade that a student earns in class. Non-attendance on the part of a student may result in grade penalty or may lead to dismissal from the program.

A student should attend all lecture and laboratory sessions. Habitual or patterned absenteeism in lecture or lab will not be tolerated. As soon as such a problem is identified, the student will be required to meet with the faculty to determine a course of action and, if the problem is not corrected, the student will be subject to dismissal from the program. Absences in laboratory sessions are particularly problematic because of the lost opportunity to practice skills; therefore, students will be penalized for missing more than one lab session per semester. Should a student miss more than one lab session, one point for each missed session will be deducted from the final course grade.

All absences must be reported to the appropriate faculty member prior to the start of class. If the faculty member cannot be reached directly, a voice mail message may be left. Failure to notify the faculty prior to an absence will affect the student’s Professional Behaviors Assessment.

Acceptance of Late Assignments

Projects or outside assignments are due at the beginning of class on the assigned due date. Late papers will receive a 5% per day grade penalty. This penalty will continue to be assessed each day the assignment is not turned in.

Missing an Exam

Exams are defined as formally scheduled examinations covering a major portion of the course content and cumulatively comprising a relatively large percentage of the overall grade for a course. Every effort should be made by the student to be present for all exams. If it is necessary for a student to miss an exam, the instructor must be notified prior to the scheduled exam time and arrangements must be made for make-up. It is the instructor’s option to give the same exam as the one missed or a different exam over the same content. If arrangements to make up the exam are not made within one class day, a 5% per day penalty will be assessed each day the exam is not taken.

Projects

Detailed instructions will be given during the course at the appropriate time.

Instructional Methods

Lectures, laboratory activities, reading assignments, individual and/or group projects and assignments. Some components of this course will be computer based. Student access to a computer/printer will be required for completing assignments. Computers are available to students in the Academic Support Center in the Mineral Wells Education Center.

Disabilities

ADA Statement:

Any student with a documented disability (e.g. learning, psychiatric, vision, hearing, etc.) may contact the Office on the Weatherford College Weatherford Campus to request reasonable accommodations. Phone: 817-598-6350 Office Location: Office Number 118 in the Student Services Building, upper floor. Physical Address: Weatherford College 225 College Park Drive Weatherford, TX.

Academic Integrity

Academic Integrity is fundamental to the educational mission of Weatherford College, and the College expects its students to maintain high standards of personal and scholarly conduct. Academic dishonesty of any kind will not be tolerated. Academic dishonesty includes, but is not limited to, cheating on an examination or other academic work, plagiarism, collusion, and the abuse of resource materials including unauthorized use of Generative AI. Departments may adopt discipline specific guidelines on Generative AI usage approved by the instructional dean. Any student who is demonstrated to have engaged in any of these activities will be subject to immediate disciplinary action in accordance with institutional procedures.

Hope Statement

Any student who faces challenges securing basic resources such as food, clothing, or housing and believes this may affect their performance in their course of study is urged to contact the Director of Student Resources, Dr. Deborah Cregger, for support at (817) 598-6444. Her office is on the first floor of Student Services. If the student prefers, they may contact their instructor, who can reach out on their behalf. Weatherford College also provides the Coyote Pantry. The Pantry maintains boxed and canned foods for students in need. The location of the Coyote Pantry is two blocks west of the Weatherford campus at the Baptist Student Ministry (118 E. Park Ave., Weatherford). Pantry hours are Mon-Thurs. 8:30 am-4:30 pm and Fri. 8.30 am-12:00 pm (817-599-6586).

SCANS

The Secretary’s Commission on Achieving Necessary Skills (SCANS) identified Competencies in the area of Resources, Interpersonal, Information, Systems, and Technology; and foundation skills in the areas of Basic Skills, Thinking Skills, and Personal Qualities. This course is part of a program in which each of these Competencies and skills are integrated. The specific SCANS Competencies that are recognized throughout this course are noted at the end of the appropriate competencies or task listed.

SCANS COMPETENCIES

Foundation Skills	Workplace Competencies
*Basic Skills: Reads, writes, performs arithmetic & mathematical operations, listens, and speaks*	*Resources: Identifies, organizes, plans & allocates resources*
F1	Reading: Locates, understand, & interprets written information in prose & in documents such as manuals, graphs, & schedules	C1	Time & Selects goal-relevant activities, ranks them, allocates time, & prepares & follows schedules
F2	Writing: Communicates thoughts, ideas, information, & messages in writing; & creates documents such as letters, directions, manuals, reports, graphs, & flow charts	C2	Money & Uses or prepares budgets, makes forecasts, keeps records, & makes adjustments to meet objectives
F3	Arithmetic: Performs basic computations ; uses basic numerical concepts such as whole numbers, etc.	C3	Material & Facilities & Acquires, stores, allocates, & uses materials or space efficiently
F4	Mathematics: Approaches practical problems by choosing appropriately from a variety of mathematical techniques	C4	Human Resources & Assesses skills & distributes work accordingly, evaluates performance & provides feedback
F5	Listening: Receives, attends to, interprets, & responds to verbal messages & other cues	*Information: Acquires & uses information*
F6	Speaking: Organizes ideas & communicates orally	C5	Acquires & evaluates information
*Thinking Skills: Thinks creatively, makes decisions, solves problems, visualizes, knows how to learn, & reasons*	C6	Organizes & maintains information
F7	Creative Thinking: Generates new ideas	C7	Interprets & communicates information
F8	Decision Making: Specifies goals & constraints, generates alternatives, considers risks, & evaluates & chooses best alternative	C8	Uses computers to process information
F9	Problem Solving: Recognizes problems & devises & implements plan of action	*Interpersonal: Works with others*
F10	Seeing Things in the Mind’s Eye: Organizes, & processes symbols, pictures, graphs, objects & other information	C9	Participates as a Member of a Team: Contributes to group effort
F11	Knowing How to Learn: Uses efficient learning techniques to acquire & apply new knowledge & skills	C10	Teaches others new skills
F12	Reasoning: Discovers a rule or principle underlying the relationship between two or more objects & applies it when solving a problem	C11	Serves Clients/Customers: Works to satisfy customers’ expectations
*Personal Qualities: Displays responsibility, self-esteem, sociability, self-management, integrity, & honesty*	C12	Exercises Leadership: Communicates ideas to justify position, persuades & convinces others, responsibly challenges existing procedures & policies
F13	Responsibility: Exerts a high level of effort & perseveres towards goal attainment	C13	Negotiates: Works toward agreements involving exchange of resources, resolves divergent interests
F14	Self-Esteem: Believes in own self-worth & maintains a positive view of self	C14	Works with Diversity: Works well with men & women from diverse backgrounds
F15	Sociability: Demonstrates understanding, friendliness, adaptability, empathy, & politeness in group settings	*Systems: Understand complex interrelationships*
F16	Self-Management: Assesses self accurately, sets personal goals, monitors progress, & exhibits self-control	C15	Understands Systems: Knows how social, organizational, & technological systems work & operates effectively with them
F17	Integrity/Honesty: Chooses ethical courses of action	C16	Monitors & Corrects Performance: Distinguishes trends, predicts impacts on system operations, diagnoses systems’ performance & corrects malfunctions
		C17	Improves or Designs Systems: Suggests modifications to existing systems & develops new or alternative systems to improve performance
		*Technology: Works with a variety of technologies*
		C18	Selects Technology: Chooses procedures, tools or equipment including computers & related technologies
		C19	Applies Technology to Task: Understands overall intent & proper procedures for setup & operation of equipment
		C20	Maintains & Troubleshoots Equipment: Prevents, identifies, or solves problems with equipment, including computers & other technologies.