ATRG 5322 Therapeutic Exercise

(Effective Fall 2019)

An examination of the theory, use, and effects of rehabilitative exercises used in the treatment of orthopedic injuries. Students will practice designing and implementing comprehensive rehabilitative programs in both the laboratory component and during clinical experience hours under preceptor supervision.

Credits

4

Prerequisite

ATRG 5222

Typically Offered

Demorest Campus: spring

Student Learning Outcomes

Alignment	Current Objective
CIP-1	Administer testing procedures to obtain baseline data regarding a client’s/patient’s level of general health (including nutritional habits, physical activity status, and body composition). Use this data to design, implement, evaluate, and modify a program specific to the performance and health goals of the patient. This will include instructing the patient in the proper performance of the activities, recognizing the warning signs and symptoms of potential injuries and illnesses that may occur, and explaining the role of exercise in maintaining overall health and the prevention of diseases. Incorporate contemporary behavioral change theory when educating clients/patients and associated individuals to effect health-related change. Refer to other medical and health professionals when appropriate.
CIP-8	Demonstrate the ability to recognize and refer at-risk individuals and individuals with psychosocial disorders and/or mental health emergencies. As a member of the management team, develop an appropriate management plan (including recommendations for patient safety and activity status) that establishes a professional helping relationship with the patient, ensures interactive support and education, and encourages the athletic trainer's role of informed patient advocate in a manner consistent with current practice guidelines.
CIP-3	Develop, implement, and monitor prevention strategies for at-risk individuals (e.g., persons with asthma or diabetes, persons with a previous history of heat illness, persons with sickle cell trait) and large groups to allow safe physical activity in a variety of conditions. This includes obtaining and interpreting data related to potentially hazardous environmental conditions, monitoring body functions (e.g., blood glucose, peak expiratory flow, hydration status), and making the appropriate recommendations for individual safety and activity status.
AC-36	Identify the signs, symptoms, interventions and, when appropriate, the return-to-participation criteria for specific conditions.
CIP-4	Perform a comprehensive clinical examination of a patient with an upper extremity, lower extremity, head, neck, thorax, and/or spine injury or condition. This exam should incorporate clinical reasoning in the selection of assessment procedures and interpretation of findings in order to formulate a differential diagnosis and/or diagnosis, determine underlying impairments, and identify activity limitations and participation restrictions. Based on the assessment data and consideration of the patient's goals, provide the appropriate initial care and establish overall treatment goals. Create and implement a therapeutic intervention that targets these treatment goals to include, as appropriate, therapeutic modalities, medications (with physician involvement as necessary), and rehabilitative techniques and procedures. Integrate and interpret various forms of standardized documentation including both patient-oriented and clinician-oriented outcomes measures to recommend activity level, make return to play decisions, and maximize patient outcomes and progress in the treatment plan.
TI-19 TI-20	Select and incorporate interventions (for pre-op patients, post-op patients, and patients with nonsurgical conditions) that align with the care plan. Interventions include (but are not limited to) the following: Cardiovascular training
CIP-7	Select and integrate appropriate psychosocial techniques into a patient's treatment or rehabilitation program to enhance rehabilitation adherence, return to play, and overall outcomes. This includes, but is not limited to, verbal motivation, goal setting, imagery, pain management, self-talk, and/or relaxation.
EBP-10 EBP-12 EBP-13 EBP-14	Students will apply and interpret clinical outcomes to assess therapeutic intervention efficacy, patient status, progress toward goals, using psychometrically sound outcome instruments and develop a relevant clinical question (e.g., PICO, PIO, or CAT) based on desired outcome (patient-based or clinician-based) and available evidence (patient-oriented or disease-oriented).
TI-10 TI-11	Students will assess a patient to identify indications, contraindications, and precautions applicable to the intended therapeutic intervention and design and implement a treatment program that integrates self-treatment, when appropriate, to meet specified treatment goals.
CE-7	Students will assess and interpret findings from a physical examination (including posture, gait, and movement patterns) that is based on the patient’s clinical presentation to identify participation restrictions (disabilities), activity limitations (functional limitations), and overall impact of the condition on the patient’s life and goals.
CE-21a	Students will assess and interpret findings from a physical examination (including posture, gait, and movement patterns) that is based on the patient’s clinical presentation to identify participation restrictions (disabilities), activity limitations (functional limitations), and overall impact of the condition on the patient’s life and goals.
CE-21c CE-21d	Students will collect, assess, and interpret findings from a physical examination that includes: Observation/inspection, palpation, muscle function assessment, osteokinematic joint motion, cardiovascular function, pulmonary function, gastrointestinal function, genitourinary function, ocular function, EENT function, and dermatological function.
TI-12	Students will communicate the expected treatment effects and potential adverse reactions to the patient, position/prepare them prior to treatment, apply the intervention using parameters appropriate to the intended outcome, and reassess the patient to determine the immediate impact of the intervention when complete and if it should be progressed, regressed, or discontinued.
PHP-27 PHP-30	Students will compare and contrast the various types of flexibility, strength training, and cardiovascular conditioning programs to include expected outcomes, safety precautions, hazards, and contraindications and design a fitness program to meet an individual patient's needs.
CE-15 CE-19	Students will demonstrate the ability to modify the diagnostic examination process and return-to-play decision according to the demands of the situation and patient responses and current status.
EBP-6 EBP-7	Students will describe and contrast research and literature resources including databases, online critical appraisal libraries, and other resources and conduct relevant searches to answer a specific clinical question.
TI-1	Students will describe and differentiate between the physiological and pathophysiological responses to inflammatory and non-inflammatory conditions and the influence of these responses on the design, implementation, and progression of a therapeutic intervention across the lifespan.
EBP-4	Students will describe and differentiate the types of quantitative and qualitative research, research components, and levels of research evidence and use a systematic approach to create and answer a clinical question through review and application of existing research.
CE-1	Students will describe body systems' structures, their functional inter-relation, and how they change through the lifespan.
PHP-3	Students will describe components of a preparticipation physical examination as recommended by contemporary guidelines and its role in identifying modifiable and non-modifiable risk factors related to injury and illness.
CE-23	Students will describe setting-specific (e.g., high school, college) and activity-specific rules and guidelines for managing injuries and illnesses.
PS-1 PS-2 PS-3	Students will describe the basic principles of personality traits, trait anxiety, locus of control, intrinsic and extrinsic motivation, stress response, confidence, and patient and social environment interactions as they affect patient interactions, clinical decision making, and eventual return to activity/participation for injuries or forced inactivity.
PHP-4	Students will describe the concepts (case definitions, incidence versus prevalence, exposure assessment, rates) and uses of injury and illness surveillance and outcome measures relevant to athletic training and use the resulting data to assess an injury/illness prevention strategy.
EBP-8	Students will describe the differences between narrative reviews, systematic reviews, and meta-analyses.
TI-9	Students will describe the laws of physics that underlay the application of thermal, mechanical, electromagnetic, and acoustic energy to the body and form the foundation for the development of therapeutic interventions (e.g., stress-strain, leverage, thermodynamics, energy transmission and attenuation, electricity).
CE-4 CE-5	Students will describe the principles of osteokinematics and arthrokinematics and their influence on body movement and assess a patient's function for pathomechanical motion.
PS-14 PHP-46 PHP-47	Students will describe the psychological and sociocultural factors, signs, symptoms, and physiological and psychological responses of patients displaying disordered eating and devise appropriate management and referral strategies that are consistent with current practice guidelines.
TI-13 TI-14 TI-15	Students will describe the relationship between therapeutic modality use, active and passive exercise, and/or manual therapies (massage, myofascial techniques, muscle energy techniques, joint mobilization, traction, etc.) in pain reduction and the restoration of joint mobility/flexibility and perform those techniques as indicated by physical examination findings.
HA-30	Students will describe the role and functions of various healthcare providers and protocols that govern the referral of patients to these professionals.
PHP-25 PHP-26 PHP-28 PHP-29	Students will describe the role of physical fitness in maintaining a healthy lifestyle and preventing chronic disease and administer standard tests, testing equipment, and testing protocols (body composition, posture, flexibility, muscular strength, muscular endurance, power, speed, agility, and cardiorespiratory endurance) to assess their physical status and readiness for activity.
PS-11 PS-12 PS-13	Students will describe the roles of different mental healthcare providers, identify patients demonstrating psychosocial disturbances, and formulate a referral plan for a patient with mental health or substance abuse problems.
PD-10	Students will develop educational healthcare programming specific to a target audience that uses appropriate multimedia tools to create a professional product.
CE-14	Students will differentiate between an initial injury evaluation and follow-up/reassessment as a means to evaluate the efficacy of the patient’s treatment/rehabilitation program, and make modifications to the patient’s program as needed.
PHP-19 TI-17 TI-18	Students will evaluate a patient's gait, posture, biomechanics, and use of ergodynamics and instruct them to make corrections/modifications to meet outcome goals or prevent illness or injury.
PHP-43	Students will explain how changes in the type and intensity of physical activity influence the energy and nutritional demands placed on the body, describe the principles and validated methods to measure body composition, and assess a patient's body composition in relation to their health status or to monitor changes related to weight management, strength training, injury, disordered eating, menstrual status, and/or bone density.
PS-10	Students will explain the impact of sociocultural issues that influence the nature and quality of healthcare received (e.g., cultural competence, access to appropriate healthcare providers, uninsured/underinsured patients, insurance) and formulate and implement strategies to maximize client/patient outcomes.
CE-8 CE-9 EBP-11	Students will explain the theoretical foundation of clinical outcomes assessment (e.g., disablement, health-related quality of life) and describe common methods of outcomes assessment in athletic training clinical practice (generic, disease-specific, region-specific, and dimension-specific outcomes instruments).
TI-19 TI-20	Students will identify manufacturer, institutional, state, and/or federal standards that influence approval, operation, inspection, maintenance and safe application of therapeutic modalities and rehabilitation equipment and inspect equipment in the treatment environment for potential safety hazards.
PHP-31	Students will instruct a client/patient regarding fitness exercises and the use of muscle strengthening equipment to include correction or modification of inappropriate, unsafe, or dangerous lifting and/or spotting techniques.
AC-5 CE-13	Students will obtain a thorough medical history that includes the pertinent past medical history, underlying systemic disease, use of medications, the patient’s perceived pain, and the history and course of the present condition appropriate for the patient's ability to respond.
CE-16	Students will recognize the signs and symptoms of catastrophic and emergent conditions and demonstrate appropriate referral and physician return-to-play clearance following traumatic and brain injuries (concussion, subdural and epidural hematomas, second impact syndrome, and skull fracture).
PS-7 PS-8 PS-9	Students will select and integrate appropriate psychosocial techniques into a patient's treatment, pain management, or rehabilitation program to enhance adherence, return to play, and overall outcomes. This includes, but is not limited to: motivation, goal setting, imagery, anxiety reduction, positive self-talk, and/or relaxation.
TI-16	Students will select, apply, evaluate, and modify appropriate standard protective equipment, taping, wrapping, bracing, padding, and other custom devices for the client/patient in order to prevent and/or minimize the risk of injury to the head, torso, spine, and extremities for safe participation in sport or other physical activity.
PS-18	Students will summarize and demonstrate effective interpersonal and cross-cultural communication and educational intervention strategies for patients and others involved in their healthcare to effect positive behavioral change and impact the patient's psychological and emotional well-being while protecting their privacy.
CE-17	Students will use clinical reasoning skills to formulate an appropriate differential diagnosis for common illness/disease and orthopedic injuries/conditions.
EBP-9	Students will use standard criteria or developed scales (PEDro, CAT) to critically appraise the structure, rigor, and overall quality of research studies.
PD-9 CE-20d CE-21e CE-21f CE-21g CE-22	Students will use standard techniques and procedures (history taking, inspection/observation, palpation, functional assessment, special tests, neurological assessments, capsular and ligamentous stress testing, and joint play assessment) to complete a clinical examination for a common injury, condition, illness, or disease and interpret their findings to determine when referral is necessary.