Neurological Physiotherapy

 

Module aim: The aim of the module is to provide specialized knowledge in relation to current, complex, changing developments in the field of Neurological Physiotherapy. Special feature of the module will be the discussion of current knowledge of a wide range of topics.

Learning objectives: Upon successful completion of the module, students will be able to:

1. Demonstrate knowledge, understanding and ability to develop knowledge from the first and second cycle of their studies on the pathological mechanisms of postural, motor and balance disorders, as manifested in neurological patients. To endorse their thorough understanding, as well as their ability to use it, based on sound clinical reasoning.
2. Set individualized short-term and long-term goals depending on the assessment, re-assessment and therapeutic course of the patient. Develop a physiotherapy plan, acknowledging whether or not the patient is progressing and the expected levels of improvement.
3. Have the ability to incorporate informed knowledge, manage complex clinical issues, and make decisions with incomplete or limited information.
4. Show an extended understanding and reflection on the social and ethical responsibilities associated with the application of their knowledge and decisions in the clinical assessment and rehabilitation of neurological and neurosurgical cases.
5. Identify new aspects of functional and clinical applications of therapeutic techniques and interventions in support or contrast of previous ones that are established based on current clinical guidelines, technological developments and documented data.
6. Upgrade the therapeutic techniques, based on international instructions and guidelines from global & international organizations.

 

Module content:

• Current provision of Physiotherapy services. Interdisciplinary approach and neurorehabilitation. Principles, ethical parameters, objectives and goals. Record keeping. Reflective practice diary keeping.
• Current approaches to the evaluation, measurement and clinical observation in relation to the neurological disease, its stage, and the clinical picture of the patient. Appropriate tools, validity and reliability, customization.
• Clinical reasoning – research evidence – justification. Current clinical guidelines in physiotherapy for patients, such as stroke, TBI and brain tumors, spinal cord injuries, multiple sclerosis, basal ganglia disorders, cerebral palsy, hydrocephalus, developmental disorders. Designing costumised physiotherapy programs based on different scenarios.
• Modern technological means of monitoring and physiotherapy intervention for the treatment of disorders affecting muscle tone, somatosensation, physical condition, balance and gait. Assistive technology in neurological rehabilitation.
• Motor disability, quality of life, self-care and autonomy in neurological patients. Accessibility and aids. Effects of long-term disability.
• Treatment of disorders of muscle tone and muscle weakness, disorders of neuromuscular coordination, balance and gait. Treatment of sensory, cognitive and perceptual deficits.
• Group therapeutic exercise programs in neurological diseases.
• Knowledge of the psychiatric semiology of neurological diseases in physiotherapy.
• Physiotherapeutic approach in pediatric neurological patients. Neurodevelopmental intervention model versus muscle retraining.
• Physiotherapeutic approach to chronic fatigue syndrome in neurological patients.
• Non-invasive brain stimulation techniques in neurorehabilitation and their neurophysiological effects. Technological approaches to neurorehabilitation. Transcranial Magnetic Stimulation (TMS). Transcranial Direct Current Stimulation (tDCS). Functional Electrical Stimulation (FES).
• Applications of special therapeutic techniques and approaches in neurological patients, research evidence.
  • Mirror therapy
  • Constrained induced movement therapy
  • Functional training
  • Robotic assisted training
  • Virtual reality training
  • Facilitation and activity-oriented approaches
• Cognitive rehabilitation aiming at attention deficits, neglect.

 

Teaching methods and means: 13 weeks X 2 hours theory & 1 hour practice

Evaluation methods:

The evaluation of students will be carried out in accordance with the regulation of the Post Graduate Program and the relevant decisions of the Assembly of the Department of Physiotherapy, as a weighting of their grade in mid-evaluation (20%), in the individual essay (30%) and the final examination (50%) of the module.

 

Indicative Bibliography:

1. Adler SS., Beckers D. & Back M. PNF in Practice: An Illustrated Guide. 4th Edition Springer 2014.
2. Armutlu K., Fil A., Ozcelik Y. Spasticity and its management with physical therapy applications (neurodegenerative diseases – laboratory and clinical research). Nova science pub inc, 2010.
3. Barnes M., Johnson G. Σύνδρομο Ανώτερου Κινητικού Νευρώνα και Σπαστικότητα. Εκδόσεις Παρισιάνου, 2008.
4. Barral JP., Croibier A Manual Therapy for the Peripheral Nerves. Churchill Livingstone 2007.
5. Braddom R. Physical medicine and rehabilitation. Saunders; 3rd edition, 2006.
6. Campbell S., Palisano R., Vander Linden D. Physical Therapy for Children. Saunders, 2005.
7. Car J., Shepherd R. Νευρολογική Αποκατάσταση. Βελτιστοποίηση των Κινητικών Επιδόσεων. Εκδόσεις Παρισιάνου; 2002.
8. Edwards S. Neurological Physiotherapy: A problem-solving approach. 2nd edition, Churchill-Livingstone 2002.
9. Dyck PJ., Thomas PK. Peripheral Neuropathy I & II Elsevier 2005.
10. Edwards, S. Neurological Physiotherapy. A problem-solving approach Churchill Livingstone 2002.
11. Jewell D. Guide to evidence-based physical therapy practice. Jones & Bartlett publishers; 1st edition, 2007.
12. FitzGerland T, Gruener G & Mtui E. Κλινική Νευροανατομία & Νευροεπιστήμες Πασχαλίδης 2009
13. Jessell TM Kandel ER, Schwartz JH, Νευροεπιστήμη & Συμπεριφορά Πανεπιστημιακές Εκδόσεις Κρήτη 2011.
14. Lundy-Ekman L. Neuroscience: Fundamentals for rehabilitation. Saunders; 3rd edition, 2007.
15. Martin S., Kessler M. Neurologic interventions for physical therapy. Saunders; 2nd edition, 2006.
16. Montgomery P., Connolly B. Clinical applications for motor control. Slack incorporated; 2nd edition, 2002.
17. Magee D.J. Orthopaedic Physical Assessment. 4th ed. W.B. Saunders, Philadelphia,2002
18. Nichols-Larsen DS, Kegelmeyer DA, Buford JA, Kloos AD, Heathcock JC, Michele Basso D. Νευρολογική Αποκατάσταση: Νευροεπιστήμη και Νευροπλαστικότητα στην Εφαρμοσμένη Φυσικοθεραπεία, Ελληνική έκδοση, Αθήνα: Ιατρικές Εκδόσεις Κωνσταντάρας, 2017
19. Μπάκας Ελ., Αποκατάσταση Ασθενή με Κάκωση Νωτιαίου Μυελού Κωνσταντάρας 2012
20. Raine S., Meadows L & Lynch-Ellerington M. Bobath Concept: Theory and Clinical Practice in Neurological Rehabilitation Willey-Blackwell ,2009
21. Preston & Shapiro Electromyography and Neuromuscular Disorders: Clinical- Electrophysiologic Correlations Elsevier, 2013
22. Scrutton D., Damiano D., Mayston M. Αντιμετώπιση των κινητικών διαταραχών στα παιδιά με εγκεφαλική παράλυση. Εκδόσεις Παρισιάνου, 2009.
23. Seymour, R, Prosthetics and orthotics. Lippincott Williams & Wilkins 2002.
24. Shumway-Cook A., Woollacott M. Motor control translating research into clinical practice. Williams &Wilkins, Baltimore, 5th edition; 2017
25. Steiner, W. A., Ryser, L., Huber, E., Uebelhart, D., Aeschlimann, A., & Stucki, G. (2002). Use of the ICF model as a clinical problem-solving tool in physical therapy and rehabilitation medicine. [Case Reports]. Phys Ther, 82(11), 1098-1107
26. Stokes M. Physical Management in Neurological Rehabilitation. Second edition. Elsevier, Mosby; 2004.
27. Stokes, M. Physical Management in Neurological Conditions Churchill Livingstone 2011
28. Tecklin J. Pediatric physical therapy. Lippincott Williams & Wilkins; 4th edition, 2007
29. Umphred DA., Neurological Rehabilitation, 6th ed. Mosby-Elsevier 2006.
30. Freddy MH Lam a, Mei-Zhen Huang a, Lin-Rong Liao b, Raymond CK Chung a, Timothy CY Kwok c, Marco YC Pang. Physical exercise improves strength, balance, mobility, and endurance in people with cognitive impairment and dementia: a systematic review. Journal of Physiotherapy (64) 4–15, 2018.
31. Blakeman, T., Bower, P., Reeves, D., & Chew-Graham, C. Bringing self-management into clinical view: a qualitative study of long-term condition management in primary care consultations. Chronic Illness, 6(2),136-150, 2010.
32. Frost, J., Grose, J., & Britten, N. A qualitative investigation of lay perspectives of diagnosis and self-management strategies employed by people with progressive multiple sclerosis. Health:, 21(3),316-336, 2017.
33. Taylor, S. J., Pinnock, H., Epiphaniou, E., Pearce, G., Parke, H. L., Schwappach, A., … & Sheikh, A. A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS–Practical systematic Review of Self-Management Support for long-term conditions, 2014.
34. Powers, W.J. Rabinstein A.A., Ackerson T., Adeoye, O.M. Bambakidis , N.C. Becker , Biller, K. J. M. Brown, Demaerschalk B.M., Hoh, B. et al. Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association Originally published30 Oct 2019https://doi.org/10.1161/STR.0000000000000211Stroke. 2019;50:e344–e418
35. National Institute for Health and Care Excellence. Stroke rehabilitation: long-term rehabilitation after stroke (clinical guideline CG162). 2013. http://guidance.nice.org.uk/CG162.
36. Multiple sclerosis in adults: management Clinical guideline [CG186] Published date: 08 October 2014 Last updated: 11 November 2019
37. Keus, S., Munneke, M., Graziano, M., Paltamaa, J., Pelosin, E., Domingos, J., Bruhlmann S., Ramaswarry B., Prins J., Struiksma C., Rochester, L., Nieuwboer A., BloemB.,(2014). European physiotherapy guideline for Parkinson’s disease. KNGF/ParkinsonNet.
38. Verbeck, J.M., Van Wegen, E.E.H., Van Peppen RRs, Hendriks, H,J,M,. et al 2014. KNGF Clinical Practice Guideline for Physical Therapy in patients with stroke. Royal Dutch Society for Physical Therapy, the Netherlands.
39. National Institute for Health and Care Excellence Stroke rehabilitation: long-term rehabilitation after stroke. Clinical Guideline 162. London: NICE, 2013. Available online at www.nice.org.uk/guidance/cg162.