college of erbil technical health college

Ministry of Higher Education and Scientific research

Department of Physiotherapy

College of Erbil Technical Health College

University of Erbil Polytechnic University

Subject: Therapeutic Methods II

Course Book – (Year 3)

Lecturer's name MSc. Zekra Ali Aziz

Academic Year: For example 2020/2021

Directorate of Quality Assurance and Accreditation وه‌به‌رایه‌تی نیایی ڕێوه‌به‌رایه‌تیبه‌ ری ڵنیایید و ۆریجمتمانه‌به‌خشین

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Course Book

1. Course name Therapeutic Methods II

2. Lecturer in charge Zekra Ali Aziz

3. Department/ College Physiotherapy / Erbil Technical Health College 4. Contact e-mail: [email protected]

Tel: (optional)

5. Time (in hours) per week Theory: 2 Practical: 3

6. Office hours According to need

7. Course code

8. Teacher's academic profile

Starting work in the Ministry of Higher Education and Scientific Research since 2010 - Teaching in the physiotherapy department in Health Technical College many subjects as follows:

(Anatomy, Academic debate, Professional ethics, Physiotherapy modalities, and Therapeutic exercises).

-Teaching in the physiotherapy department in Medical Technical Institute many subjects as follows:

(Medical rehabilitation, Prosthesis and orthosis, Pathology and Physiotherapy devices).

- Head of the following: (physiotherapy department in the institute and the college, examination committee of physiotherapy department, teacher's evaluation committee in physiotherapy department and summer training committee of physiotherapy students). - Member in the following: (medical sector committee, medical committee for students of university, official discipline committee for officers of institute and evaluation committee of scientific seminar) - Responsible on quality assurance of physiotherapy department.

9. Keywords

10. Course overview: This course is concerned with developing theoretical and practical skills in the application

of basic exercise techniques including those specifically related to upper, lower limbs and

trunk. The course wills techniques and clinical uses of the various techniques of muscle

testing and evaluation through practical demonstration and practice sessions. Attention of



the students will be drawn to the specific clinical application of each test, position of

patient, body mechanics, effect of muscle weakness and contracture, and muscle anatomy.

Teaching and learning in this course will be through lectures and practice in the laboratory.

11. Course objective:On completion of this course the student will be able to: Mention the basic principles and procedures relating to some of the therapeutic exercise modalities. Explain The physiological and therapeutic effects of the different therapeutic exercise modalities. Define and enumerate indications, contraindications, dangers and precautions including techniques of applications. Explain advantages and disadvantages of the different modalities. Select the proper type of exercise depending on patient's diagnosis. Design the appropriate way of application for each modality. Apply different types of therapeutic exercises on her colleague. Demonstrate and acquire meaningful communications for instruction to the patient and ensure his/her comfort throughout the treatment. Know the importance and clinical benefits of test and measurements. Know how to prepare environment, equipment and patient for evaluation procedures. Know the difference between muscle weakness and contracture. Know the difference between gross and individual muscle testing. Classify and identify different grades of muscle evaluation. Apply accurate positions, grasp, stabilization and fixation. Recognize and be able to carry out basic techniques of muscle testing and take the proper precautions.

12. Student's obligationthe attendance and completion of all requirement as (quiz, presentation, practical application, and report)

13. Forms of teachingLecture, group discussion, role play, student prepare (presentation, report, and practical application) this done in lecture halls and laboratory with computers equipment for lecture

presentations, white board, data show, laboratory equipment for this purpose.‌14. Assessment scheme- Activity (15 degrees for every term) for (attendance, participation in lecture, laboratory, quiz, presentation, and report) = 30 degrees. - Practical (10 degrees for midterm and 15 degrees for final term) = 25 degrees. - Theory (20 degrees for midterm and 25 degrees for final term) = 45 degrees.

15. Student learning outcome:(1) Students will be able to application procedures relating to the therapeutic exercise.(2) Students will be able to know therapeutic effects of the different therapeutic exercise modalities.(3) Students will be able to select the proper exercises depending on patient's diagnosis.

(4) Students will be able to apply accurate positions, grasp, stabilization and fixation during application the exercises.



16. Course Reading List and References :▪ Key references: Therapeutic Exercise Foundations and Techniques, Sixth Edition - Kisner, Carolyn ▪ Useful references: Tidy's Physiotherapy, 14th Edition Stuart Porter ▪ Magazines and review (internet): http://www.journalofphysiotherapy.com https://www.physiotherapyexercises.com

17. The Topics: Lecturer's name( all of it given by dr. Zekra)

Joint mobilization:Definition – Mobilization, Manipulation, indications, limitations, contraindications and precautions, applications of Mobilization technique to various joints.

Stretching:Definition, determinants, type and effect of stretching, precautions, general applications of stretching technique.

Resisted exercise:Definition – strength, power, endurance. Guiding principle of resisted exercise, determinants, types Manual and Mechanical Resistance Exercise, Isometric Exercise, Dynamic Exercise , Isokinetic Exercise. Progressive Resistance Exercise - de Lormes, Oxford.

Proprioceptive Neuromuscular Facilitation – Principles, Diagonal patterns of movements, Basic procedures, Upper Extremity Diagonal patterns, Lower Extremity Diagonal Patterns. Technique in PNF – Rhythmic Initiation, Repeated. Contractions, Reversal of Antagonists, Alternating Isometrics, Rhythmic. Stabilization.

Aerobic Exercises – Definitions, Physiological response to Aerobic Exercise, Evaluation of aerobic capacity – exercise testing, Determinant of Aerobic Exercise, Physiological Changes with Aerobic Training, Aerobic Exercise Program, Applications of Aerobic Program in patients with chronic illness.



Hydrotherapy‌Introduction.‌Definition.‌Principle.‌Buoyancy.‌Hydrostatic‌pressure.‌Hydrodynamic‌pressure.‌Turbulence.‌Indication‌&‌Contraindication.‌Physiological‌&‌Therapeutic‌effects.‌Advantages.‌Exercises‌in‌hydrotherapy

Chest‌physiotherapyDefinition.‌Physiological‌basis.‌Classification.‌Vibration‌or‌Shaking.‌Percussion‌or‌Clapping

Breathing Exercises:Aims and Goals of Breathing Exercises, Procedures of Diaphragmatic Breathing, Segmental Breathing, Pursed-Lip Breathing, Preventing and Relieving Episodes of Dyspnea, Positive Expiratory Pressure Breathing, Respiratory Resistance Training, Glossopharyngeal Breathing. Exercises to mobilize the chest, Postural Drainage, Manual Technique used in Postural Drainage, Postural Drainage Positions, Modified Postural Drains

Gait Training:Definition, Different methods of Gait Training, Gait Training in Parallel Bars, Walking Aids: Types: Crutches, Canes, Frames; Principles and training with walking aids.Relaxation exercise. Yoga: History, Introduction, ClassificationMat‌activities‌and‌function‌re-education Introduction.‌Demonstrate‌common‌mat‌activities Rolling-Prone‌on‌elbows-Prone‌on‌hands-Hook‌lying-Bridging-Quadruped‌position-Long,sitting-Short‌sitting-Kneeling-Half‌kneeling-Standing-WalkingGroup‌exercisesIntroduction.‌Advantages‌&‌Disadvantages.‌IndicationFormation‌of‌group:‌Space.‌Selection‌of‌patients.‌Number‌of‌patients.‌Instruction‌to‌patients.‌Group‌type.‌Type‌of‌exercise‌Co-ordinationDefinition.‌Causes‌of‌co-ordination‌disorder.‌Condition.‌Tests‌for‌co-ordination.‌Co-ordination‌exercise‌Supine,‌Sitting,‌and‌Walking.‌Functional‌activity‌retraining:‌Brushing.‌Combing‌hair.‌Pick‌up‌small‌object‌from‌table‌or‌floor.‌Practice‌writing.‌Draw‌numbers‌or‌alphabetsTraction:



Definition.‌Mechanism‌of‌action‌of‌traction.‌Indication‌&‌Contraindication‌of‌traction‌4‌Types‌of‌tractionBased‌on‌methods‌of‌application-‌‌‌1.‌Manual‌‌‌2.‌Mechanical‌‌‌‌‌3.‌Positional‌‌‌4.‌Inversion‌‌‌5.‌Hydraulic18. Practical Topics Joint Mobilization to individual joint Stretching of individual and group musclesResisted exercises to individual and group muscles.PNF patterns to upper and lower limbAerobic ExercisesHydrotherapyVarious types breathing exercises , chest mobilization exercises, postural drainageGait training with various walking aidsMat‌activities‌and‌function‌re-educationGroup‌exercisesCo-ordination (6 hours)Traction (3 hours)19. Examinations:

Theory:

Q.1 Enumerate the types of joint arthrokinematics:Answer: 1. Roll 2.Slide 3. Spin 4.Compression 5.Distraction

Q. 2 what is the indications for mobilization

Answer:• Grades I and II - primarily used for pain

Small -amplitude oscillatory and distraction movements are used to stimulate the

mechanoreceptors that may inhibit the transmission of nociceptive stimuli at the spinal

cord or brain stem levels. • Grades III and IV - primarily used to increase range of motion

– Stiff or hypomobile joints should be treated 3-4 times per week –alternate with active motion exercises

Q. 3 mention the factor that influence the flexibility

Answer:

1- Joint structure: The type of joint determines the degree of ROM. For example; a ball- and-socket

joint, like shoulder has greater ROM than a hinge joint like wrist.

2- Age: With age, muscles go through a shortening process due to lack of physical activitiesand a loss of elasticity in the connective tissues surrounding the muscles.



3-The Elasticity: The elasticity of the skin, tendons and ligaments.

4-Gender: Females tend to be more flexible than males of similar age throughout life.

5-Exercise: Participation in regular exercise involving full ROM generally enhances flexibility,

while a sedentary lifestyle often results in diminished flexibility.

6-Muscle mass: Muscle mass can be a factor (for example, large hamstrings limits the ability to fully

bend the knees). Excess fatty tissue imposes a similar restriction.

Q. 4 define: - Dynamic stretching. Answer: Is

controlled, swings, and moving gently part of your body to the limits of your range of motion.

Q 5: Answer by true (T) or false (F):

1. PNF is based on that‌stronger‌muscle‌groups‌help‌weaker‌groups‌in‌completing‌a‌ particular‌movement Answer: 1. ( T )

Q. 6: select single appropriate answer:

1. Increase intramuscular tension without any change in the length of the muscle is: a. Isotonic

contraction

b. Isometric contraction

c. Eccentric contraction

d. Rhythmic contraction Answer : (b)

20. Extra notes:There is nothing to mention.

21. Peer review

Regarding the subjects, the quality is very good, and the time table for each subject is quiteenough.

Dr. Niaz Al-barzinjiAss. Professor of Rheumatology and Medical RehabilitationHawler Medical University/ College of Medicine


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