NEUROMUSCULOSKELETAL MANAGEMENT

SHE Level 2
SCQF Credit Points 20.00
ECTS Credit Points 10.00
Module Code M2B122676
Module Leader Janet Bonn
School School of Health and Life Sciences
Subject Physiotherapy
Trimester
  • A (September start)-B (January start)

Pre-Requisite Knowledge

Successful completion of Level 1 BSc Hons Physiotherapy Modules.

Summary of Content

This module relates the pathophysiology of tissue injury to the clinical features of a variety of musculoskeletal conditions and their physiotherapy assessment, planning, treatment and management. It also considers the potential impact of physchosocial factors such as age, gender, culture and socio-economic status. It considers the theory and practical application of a variety of physiotherapy treatment management strategies (including electrophysical agents) used in the treatment of neuromusculoskeletal pathologies of the peripheral and vertebral joints. It considers the indications, dosage, cautions, contraindications, progressions and modifications of all treatments, whilst promoting professionalism, health and safety, infection control, communication skills, clinical reasoning and reflective practice. It also includes critical appraisal of relevant current literature. The ability to document physiotherapy findings in an agreed format (POMR/SOAP) taking credence of professional statutory bodies and legal requirements will be developed. This viva examination format of this module is designed to simulate the clinical neuromuscular assessment, management and clinical reasoning necessary for professional practice.

Syllabus

Applied Pathophysiology Mechanisms of injury, cellular injury and inflammation Tissue healing and repair and factors influencing rate of healing Pathophysiology and biomechanics of bone, joints (both peripheral and spinal), muscles, ligaments, capsule, intervertebral discs meninges, nerve roots, peripheral nerve, and pain mechanisms. Treatment and Management Issues This module relates the pathophysiology of tissue injury to the clinical features of a variety of musculoskeletal conditions, and their assessment planning, treatment and management. It considers potential impact of age, gender, culture and socio-economic status. It will include: -360 ~ Fractures, splinting and bracing ~ Clinical features of mechanical orthopaedic conditions ~ Spinal Anatomy and spinal pathology to include the sacro-iliac joint,disc lesions, facet joints, nerve involvement and dural tension. ~ Rheumatological conditions and related inflammatory arthropathies ~ Principles of peripheral, vertebral and neural tissue triage, examination, assessment, treatment, management, education, prognosis, progression and contraindications. ~ Theory and practical application of manual therapy procedures including passive accessory. passive physiological, massage, soft tissue techniques and nerve mobility. ~ Principles of treatment and management of Muscle Imbalance ~ Principles of formulating an appropriate progressive exercise regime. ~ Patient education, restoration of functional activity, including pain management, joint mobility, soft tissue extensibility, muscle rehabilitation and nerve mobility. ~ Advice on posture, prophylaxis, joint protection, ergonomics and pain management. ~ Principles of cold, ultrasound, pulsed shortwave, inferential and T.N.S. Physiological effects and use in the modification of pain and the inflammatory process. Practical application and considerations of dosages, indications, dangers and contraindications ~ Acute and chronic disease management, personal. ergonomic impact on patient, family, carers and the community. ~ Evidence from literature related to the management of neuromusculoskeletal problems will be critically appraised and evaluated. ~ Principals of recording data for clinical records. ~ Discussion of roles and contributions within the multidisciplinary team in delivery of health and social care. ~ Discussion of aspects of professionalism and communication in the delivery of health and social care. ~ Use of clinical reasoning panels to help diagnostic decision making and development of timely interventions within the therapeutic management of patients. Health and safety issues -360 ~ Adherence to the HPCP Code of performance, ethics and fitness to practice policy. ~ Skills performance according to HPCP and CSP standards. ~ Students will be expected to read, understand and apply all protocols for treatment as detailed in the Protocol Booklet for treatment principles

Learning Outcomes

Upon successful completion of the module, students should be able to:-1. Integrate knowledge and understanding of the course and nature of tissue damage.and of tissue changes which occur in response to pathology including the influence of gender, socioeconomic group, culture and age..2. Analyse and integrate clinical findings to pathological processes in a variety of common peripheral and spinal neuromusculoskeletal conditions.3. Analyse the impact of pathological processes and associated problems in these areas.4. Formulate shared treatment short and long term goals from the analysis of examination data and place these in order of priority.5. Justify, plan, implement and modify a treatment programme appropriate to examination findings and pathology, adapting these according to age, gender, psychosocial and cultural issues6. Justify the management of acute and chronic neuromusculoskeletal conditions using critical analysis of appropriate evidence based literature.7. Integrate an awareness of the different psychosocial needs of each patient, significant others and issues raised by culture, socioeconomic groups and age in the planning and delivery of health care.8. Perform assessment and treatment techniques in a safe, professional and competent manner.9. Explain the dosage, dangers, safety precautions and contraindications which apply in the various assessment and treatment techniques including electrophysical agents.10. Demonstrate knowledge and understanding of health and safety issues and infection control.11. Demonstrate the application of ethical and legal issues relevant to physiotherapy practice as required by professional and statutory bodies.12. Demonstrate the ability to document physiotherapy findings in an agreed format (POMR/SOAP) taking credence of professional statutory bodies and legal requirements. 13 Use clinical reasoning and reflective practice from simulated clinical problems.

Teaching / Learning Strategy

A variety of strategies will be used, with the emphasis on encouraging the student to take an active part in their knowledge and skill acquisition and to engage in critical reflection of their clinical reasoning, problem solving and learning throughout the module. Theoretical elements will be delivered by tutorials, seminars, hand outs and workbook based activities. These will be supported by tutorial sessions where clinical reasoning, problem solving, reflective practice and t practical skills required for assessment planning, treatment management and patient education will be used to solve clinical based problems. The breadth of subject area will be addressed by small student working groups who will research specific areas and combing their findings in seminar sessions to the benefit of the class. Practical classes will be used to refine assessment planning, treatment, management techniques, ensuring safety and professionalism. Students will be encouraged to provide formative feedback to peers in these sessions. The subject area will be put in context through patient contact and simulated clinical scenarios.

Indicative Reading

Essential Day, R., Fox, J. & Paul-Taylor, G. 2009, Neuro-musculoskeletal clinical tests: a clinician's guide, Churchill Livingstone, Edinburgh Norris C ( 2010) Sports Injuries ( 3rd Edition) Butterworth Heinemann, Edinburgh Palastanga, N. & Soames, R. 2011, Anatomy and human movement: structure and function, 6th edn, Butterworth Heinemann, Oxford. Petty, N.J. 2011, Neuromusculoskeletal examination & assessment, 4th edn, Churchill Livingstone, Edinburgh. Petty, N.J. 2011, Principles of neuromusculoskeletal treatment and management, 2nd edn, Churchill Livingstone Edinburgh. Watson T 2008 Electrotherapy Evidence based practice . Churchill Livingstone. Edinburgh. 12 th Edition Recommended Abernethy, B., et al. 2013, Biophysical foundations of human movement, 3rd edn, Human Kinetics, Leeds. Atkinson, K., Coutts, F. & Hassenkamp, A.M. 2005, Physiotherapy in orthopaedics, 2nd edn, Churchill Livingstone, Edinburgh. Butler, D. 1991, Mobilisation of the nervous system, Churchill Livingstone, Edinburgh. Butler, D. & Moseley, L. 2003, Explain pain, Noigroup Publications, Adelaide. Clarkson, H.M. 2013, Musculoskeletal assessment: joint motion and muscle testing, 3rd edn, Lippincott Williams & Wilkins, Baltimore. Clarkson, H.M. 2005, Joint motion and function assessment: a research-based practical guide, Lippincott Williams & Wilkins, Baltimore. Chartered Society of Physiotherapy, 2011. Code of Members' Professional Values and Behaviour. CSP: London, [Online]. Available at: <http://www.csp.org.uk/publications/code-members-professional-values-behaviour> [Accessed 26th June 2013]. Chartered Society of Physiotherapy, 2012 Information paper: Record Keeping guidance PD061, CSP London,[Online], <http://www.csp.org.uk/publications/record-keeping-guidance> . [Accessed 26th June 2013]. David, C. & Lloyd, J. 1999, Rheumatological physiotherapy, Mosby, London. Eustace, S., Johnston, C. & O'Neill, P. 2007, Sports injuries examination, imaging & management, Churchill Livingstone, Edinburgh. Field, D. 2013, Anatomy palpation & surface markings, 5th edn, Butterworth Heinemann, Oxford. Hengeveld, E. & Banks, K. Eds. 2005, Maitland's peripheral manipulation, 4th edn, Butterworth Heinemann, Oxford. Hertling, D. & Kessler, R.M. 2006, Management of common musculoskeletal disorders, 4th edn, Lippincott Williams & Wilkins, Baltimore. Health and Care Professions Council, 2012. Standards of conduct, performance and ethics. HCPC: London, [Online]. Available at: <http://www.hpc-uk.org/aboutregistration/standards/standardsofconductperformanceandethics/> . [Accessed 26th June 2013]. Kendall, F.P., McCreary, E.K., Provance, P.G., Rodgers, M. & Romani, W.A. 2005, Muscles: testing and function, 5th edn, Lippincott Williams & Wilkins, Baltimore. Lederman, E. 2005, The science and practice of manual therapy, 2nd edn, Churchill Livingstone, Edinburgh. Kolt, G.S. & Snyder-Mackler, L. Eds. 2003, Physical therapies in sport and exercise, Churchill Livingstone, Edinburgh. Lee D 2004 The Pelvic Girdle. Churchill Livingstone. Edinburgh. 2 nd Ed. Magee D.J., Sueki D., 2011 Orthopaedic Physical Assessment Atlas and Video- selected special tests and Movements. Elseviier. Edinburgh Maitland G.D., Hengeveld E., Banks K., English K. 2001 Maitland's Vertebral Manipulation . Butterworth Heinemann. London. 6 th Ed. Maitland G.D, 2003 Peripheral Manipulation Butterworth Heinemann. London. 4 th Ed McKenzie R. 1986 The Lumbar Spine. Mechanical Diagnosis and Therapy. Spinal Publications. New Zealand. McKenzie. R., 1990 The Cervical and Thoracic Spine. Mechanical Diagnosis and Therapy . Spinal Publications. New Zealand. Mulligan, B.R., 2010, Manual Therapy: Nags, snags, 6th edn, Plane View Services, Wellington. Perry, J. & Burnfield, J.M. 2010, Gait analysis: normal & pathological function, 2nd edn, Slack Incorporated, Thorofare, New Jersey. Robertson, V., Ward, A., Low, J. & Reed, A. 2006, Electrotherapy explained: principles & practice, 4th edn, Butterworth Heinemann, Oxford. Sahrmann S. 2002 Diagnosis and Treatment of movement impairment syndrome . Mosley Shamley, D. 2005, Pathophysiology: an essential text for the allied health professions, Butterworth Heinemann, Oxford. Thein-Brody, L. & Hall, C.M. 2011, Therapeutic exercise: moving toward function, 3rd edn, Lippincott, Williams & Wilkins, Baltimore. Tiildus, P.M. 2008, Skeletal muscle damage and repair, Human Kinetics, Leeds. van Griensven H., 2005 Pain in Practice. Theory and Treatment Strategies for Manual Therapists. Elsevier. Edinburgh Vicenzino, W., Hing, W., Rivett, D. & Hall, D. 2011, Mobilisation with movement, the art and the science, Churchill Livingstone, Edinburgh Whittle, M. 2012, Gait analysis, 5th edn, Butterworth Heinemann, Oxford Wilson A (2002) Effective Management of Musculoskeletal Injury. Churchill Livingstone

Transferrable Skills

In this module there will be the opportunity to develop skills which will be useful in other modules and in clinical practice. In the class emphasis will be placed on professionalism, effective communication, organisational, decision making, group work presentation skills ,teaching and clinical reasoning skills.. In addition clinical experiences will enhance the ability to communicate with professional colleagues and patients.

Module Structure

Activity Total Hours
Independent Learning (FT) 108.00
Tutorials (FT) 24.00
Assessment (FT) 20.00
Practicals (FT) 48.00

Assessment Methods

Component Duration Weighting Threshold Description
Exam (Dept) 01 0.75 100.00 40% Viva Exam
Coursework 1 n/a 0.00 35% Clinical Reasoning Panel - Compulsory Formative Assessment