Teaching organisation150 hours of focused learning.
Unit rationale, description and aim
Physiotherapists work with people presenting with neuromusculoskeletal disorders of the upper limb. This requires the ability to formulate a problem list, and develop, implement, evaluate and progress an intervention program which is efficient, effective, culturally responsive, evidence-based and person-centred. In this unit students will build on the knowledge acquired, and clinical reasoning skills developed in earlier units of study (specifically clinical measurement, biomechanics of movement, exercise prescription). Students will gain new knowledge in the assessment and management of people with neuromusculoskeletal conditions of the upper limb across the lifespan as well as the medical and physiotherapy management of upper limb orthopaedic conditions following trauma or elective orthopaedic surgery. The overall aim for the unit is to prepare students for professional practice in the area of musculoskeletal physiotherapy.
|Learning Outcome Number||Learning Outcome Description|
|LO1||Apply knowledge of musculoskeletal physiology and pathophysiology, and movement science to inform and justify a safe, effective, person-centred physiotherapy management plan (assessment, intervention, evaluation and progression)|
|LO2||Adapt and perform an interview|
|LO3||Select, and safely and effectively apply and interpret, measurement and testing procedures to assess a person presenting with a neuromusculoskeletal disorder of the upper limb, and to monitor and evaluate the effectiveness of a physiotherapy management|
|LO4||Select, modify, and safely and effectively apply, physiotherapy interventions for a person presenting with a neuromusculoskeletal disorder of the upper limb|
|LO5||Accurately document a physiotherapy management plan|
Topics will include:
Pathology of upper limb and shoulder girdle
- Fractures and arthroplasties
- Fractures of upper limb and shoulder girdle
- Principles of management including physiotherapy management
- Complications of immobility, trauma and fractures
- Overuse injuries
- Neuromotor control disorders
- Muscle injuries
- Neural mechanosensitivity disorders
- Motor asynchrony
- Reconstructive and plastic surgery
- Traumatic hand injuries
Physiotherapy assessment of the upper limb and shoulder girdle
- Subjective examination
- Physical examination
- Muscle strength and length
- Movement pattern assessment
- Range of motion
- Joint stability and integrity
- Special orthopaedic tests to identify painful structures
- Identification of contraindications to physiotherapy intervention
- Neurological assessment
- Modification of a physiotherapy assessment to accommodate cultural, social and ethical considerations
Physiotherapy interventions for the upper limb and shoulder girdle
- Exercise therapy
- Principles of exercise and evidence for exercise therapy across the lifespan
- Functionally specific exercise
- Muscle re-education
- Slings, springs, weights, pulleys and theraband
- Principles of exercising in water
- Principles of individual education
- Biofeedback techniques
- Contraindications and precautions
- Manual therapy
- Mobilisation and manipulation techniques
- Massage and other soft tissue techniques
- Neurodynamic techniques
- Taping and bracing
- Electrophysical agents (EPA)
- Physiological principles and effects of EPA
- Therapeutic ultrasound
- Interferential therapy
- Electrical stimulation
- Application and safety issues with the use of EPA
- Dangers, precautions and contraindications with EPA
- Evidence for the use of EPA
- Modification of a physiotherapy interventions to accommodate cultural, social and ethical considerations
- Pain assessment
- Functional limitation assessment
- Range of motion
- Muscle strength
- Movement patterns
- Evaluation of the effectiveness and efficiency of physiotherapy interventions
- Modification of application of outcome measures to accommodate cultural, social and ethical considerations
Learning and teaching strategy and rationale
This unit involves 150 hours of learning with a combination of face-to-face, online and other directed independent learning activities. The theoretical knowledge underpinning assessment and intervention will be delivered via lectures and online modules. Practical classes provide students with the opportunity to develop their clinical reasoning skills through the use of case studies and, communication, assessment and treatment skills through simulation learning activities.
Students will be expected to take responsibility for their learning and to participate actively within group activities, demonstrating respect for the individual as an independent learner.
Assessment strategy and rationale
Assessment tasks 1-3 align with the presentation of the content in this unit of study and students should learn while, as well from, undertaking these tasks. This unit takes an authentic assessment approach allowing students to demonstrate their learning and competency for clinically relevant scenarios. Assessment tasks 1 and 2 (practical examinations) require students to assimilate and apply theoretical knowledge, and perform clinical practice skills, in order to demonstrate their emerging professional competence in the areas of assessment and treatment of people with neuromusculoskeletal conditions of the upper limb. Assessment task 3 (written examination) requires students to demonstrate acquired theoretical knowledge and assimilate and apply this knowledge to clinically relevant case scenarios.
Overview of assessments
|Brief Description of Kind and Purpose of Assessment Tasks||Weighting||Learning Outcomes|
Assessment task 1: Mid-semester practical examination:
Requires students to demonstrate competency in professional behaviour, clinical reasoning and the ability to undertake appropriate assessment and treatment techniques on a peer for conditions covered in the first half of the semester.
Assessment task 2: End-semester practical examination:
Requires students to demonstrate competency in professional behaviour, clinical reasoning and the ability to undertake appropriate assessment and treatment techniques on a peer for conditions covered in the second half of the semester.
Assessment task 3: End-semester written examination:
Requires students to demonstrate their acquisition of knowledge and understanding of the implications for physiotherapy practice for neuromusculoskeletal disorders of the upper limb and, to articulate the rationale for assessment and intervention choices for clinically relevant case scenarios.
Representative texts and references
Brukner, P., Clarsen, B., Cook, J., Crossley, K., Hutchinson, M, McCrory, P, Bahr, R., & Khan, K. (2017). Brukner & Khan’s clinical sports medicine (5th ed.). Volume 1: Injuries. Sydney: McGraw-Hill.
Butler, D. S. (2000). The sensitive nervous system. Adelaide: Noigroup Publications.
Donatelli, R. (2012). Physical therapy of the shoulder (5th ed.). St. Louis: Elsevier Churchill Livingstone.
Hattam, P. & Smeatham, A. (2010). Special tests in musculoskeletal examination: An evidence- based guide for clinicians. Edinburgh: Elsevier Churchill Livingstone.
Hengeveld, E. & Banks, K. (2014). Maitland’s peripheral manipulation. (5th ed.). Edinburgh: Elsevier Butterworth-Heinemann.
Robertson, V., Ward, A., Low. J., & Reed, A. (2006). Electrotherapy explained: principles and practice (4th ed.). Boston, MA Butterworth-Heinemann.