Department of Kinesiology
ATR 415 Therapeutic Modalities and Pharmacology
Professors:
Offices:
Office Phone:
Cell Phone:
Email:
Nicole Cosby, PhD, ATC
P.E. Office #7
(619) 849-2901
(951) 515-3054
nicolecosby@pointloma.edu
Susan Ganz, PhD, ATC
Athletic Training Clinic
(619) 849-2704
(619) 701-2567
susanganz@pointloma.edu
Course Description
This course will provide an overview of the use, physiological effects, and contraindications of
thermal, electrical, acoustic, and cryogenic modalities. In addition, drug classifications and
medico-legal aspects of therapeutic and pharmacological treatments will be discussed.
Course Aim
This course aims to provide you with in-depth study and eventual mastery of the
knowledge and skills you will need as a health professional to utilize the appropriate
therapeutic modalities to treat musculoskeletal pathologies in an athletic population.
Students will learn how to apply the following therapeutic modalities and gain a working
knowledge of pharmacological principles in athletic training:
 Thermal Modalities
 Electrical Modalities
 Therapeutic Ultrasound
 Manual Therapies
 Biofeedback
In the process, you will develop an emerging mastery of the Educational Competencies
of the NATA’s Educational Council (See Appendix D for details on these Competencies
in preparation for the Board of Certification Examination for Athletic Trainers)
To be successful in this course, students must synthesize information presented in the
lecture and laboratory and apply it to the clinical setting. Specifically, this means that
studying for quizzes and tests should involve reviewing and integrating the essential ideas
contained in both the lectures and the textbook. Where possible, we will do activities in
class or have study sessions to improve your retention. Graded assignments (e.g., tests,
quizzes, assessment outlines and review of literature paper) will be used to help students
identify, recall, synthesize and apply the key concepts in therapeutic modalities and
pharmacology.
Course Learning Outcomes
1
Upon completing this course, you should be able to:
o
Utilize and apply the appropriate therapeutic modality to musculoskeletal injuries.
o
Appreciate the importance of the role of therapeutic modalities in the treatment of
athletic injuries.
o
Describe and understand the parameters, settings, indications and
contraindications of the therapeutic modalities learned in this class.
o
Research, summarize and critique the use of pharmacological agents in the
treatment of musculoskeletal injury.
o
Through laboratory sessions, practice and become proficient in the clinical
applications of therapeutic modalities in an athletic population.
o
Pass each therapeutic modality lab practical with an 80% or better.
Textbooks
Required:
Title
Therapeutic Modalities (3rd edition)
Author
Chad Starkey
ISBN
978-0-8036-1139-9
Publisher
F. A. Davis Company
Publication Date
September 1, 2009
Title
Therapeutic Medications for Athletic Trainers (2nd edition)
Author
Micheal Koester
ISBN
978-0-7360-6877-2
Publisher
Human Kinetics
Publication Date
August 3, 2007
Academic Accommodations
While all students are expected to meet the minimum academic standards for completion of
this course as established by the instructor, students with disabilities may require academic
accommodations. At PLNU, students requesting academic accommodations must file
documentation with the Disability Resource Center, located in the Bond Academic
Center. Once the student files documentation, the Resource Center will contact Dr. Sullivan
and provide written recommendations for reasonable and appropriate accommodations to
meet your individual learning needs. Please accomplish all documentation during the first
week of the semester.
*This policy assists the University in its commitment to full compliance with Section 504 of the Rehabilitation Act
of 1973, the Americans with Disabilities (ADA) Act of 1990, and ADA Amendments Act of 2008, all of which
prohibit discrimination against students with disabilities and guarantees all qualified students equal access to
and benefits of PLNU programs and activities.
2
Course Requirements
*Please Note: The PLNU Catalog states that 1 semester unit represents an hour of class per week,
and 2 hours of preparation are normal for each hour of class. Therefore, if you spend about 6 hrs
per week outside of class in preparation, you will significantly increase your chances of doing well!
Course Assignments
Discussion Boards (3 points each)
We will utilize the Discussion Board feature of eclass to expand upon topics raised during
class and from your reading of the textbook and outside journals. You will have the
opportunity, via the Discussion Boards, to interact with your fellow students and with me
and to discuss topics of interest to you. You are invited to become engaged with others in
this class as you debate issues raised in the questions, examine and analyze case studies
related to the content, and respond to the comments of your classmates.
For each Discussion Board topic, you will be required to post one response of your own
and to post one reply to a classmate’s response. Thus, you must respond at least twice to
each Discussion Board topic on eclass. Your response to a classmate’s post may include
one or more of the following:
• Ask a probing question
• Share an insight from having read your classmate’s post
• Offer and provide evidence to support an opinion
• Validate a classmate’s idea with reference to your own experiences
• Make a suggestion for improvement
• Expand on your classmate’s post.
To receive full credit for your participation, your posts MUST also be MADE IN A
TIMELY WAY. Specifically, this means that you must post a response during the week
after we first encounter a new chapter or topic. So, for instance, if we first start discussing
the Ankle on March 1st , then you will need to make your posts on the Learning Discussion
Board topic(s) by March 8th in order to receive full credit.
I will review the input that you have given to these Discussion Boards and will award up to
3 points for each Discussion Board posting that you have made. THE PROVISION OF 3
POINTS FOR YOUR POSTING WILL BE BASED ON THE QUALITY OF YOUR
POST. The maximum points available for Discussion Board participation is 30 POINTS.
I will also post these instructions with some ground rules on eclass.
Journal Article Reviews (30 points each)
An article will be given to students to evaluate and analyze. The article will contain important
findings or conclusions relative to current topics discussed in lecture and tested in lab. The reviews
should be 1-2 pages in length (double spaced, 12 pt. font, Times New Roman or equivalent).
Journal article reviews should include the following information:
• Purpose
• What were the significant findings and
implications?
• Hypothesis
• Strengths and weaknesses of article?
• Methods
• Would you recommend the article to be
• Results
used again?
• conclusions
3
Group Project – Sales Person for an Assigned Modality (50 points)
In groups of 2 or 3, students will be assigned an electrical modality (TBA by professor) in
which they must research and become the sales person for their assigned modality. Groups
will be responsible for providing the class with a rationale for why we should buy the
modality that they are selling. This discussion/in promptu should include the following
information but not be limited to:
Waveform, types of musculoskeletal injuries that can be treated with the assigned modality,
any negatives or contraindications for the companies selected modality and then provide a
justified (research based) argument for we should buy your product.
Pharmacology Project (50 points)
With a partner you will be assigned specific over-the-counter medications (OTC). You will
compare and contrast brand name and store name medications for each drug. A detailed
guideline will be provided.
Clinical Application of Therapeutic Modalities and Pharmacology Project (100
points)
With a partner you will create a detailed modality/pharmacology treatment plan. Each
group will be given a specific surgical procedure that you will be treating. As many
modalities as possible should be used in each stage of the rehabilitation process. Your
application of modalities should be based on the current research available for each
modality. Also what drugs used to treat that specific injury for each phase. A detailed
guideline will be provided.
Course Exams
Lecture Exams (100 points each)
The exams will be designed to test the students’ comprehension of the material presented
via lectures and independent studying of the textbook. Questions will include: multiple
choice, fill in the blank, matching, true/false, short answer, and essay formats.
Final Exam (150 points)
The final exam will be cumulative and summative. Information from the entire semester
will be tested.
Lab Practicals (15 points each)
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
Traction
Ultrasound
Massage
Electrical stimulation
T.E.N.S.
M.E.N.S.
Intermittent compressions
Paraffin bath
Hot whirlpool
Hydrocollator
k.
l.
m.
n.
o.
p.
q.
r.
s.
t.
4
Cold whirlpool
Biofeedback
EMG
Laser
Iontophoresis
U.V.
Diathermy
Heat
Cold
Orthotic therapy
Course Grading
Item
Total Points
1. Quizzes
2. Lecture Exams
3. Article Reviews
4. Clinical Man. Project
5. Pharmacology Project
6. Sales Project
7. Final Exam
8. Lab Practicals
9. Discussion Board Posts
4 @ 15 points each
4 @ 100 points each
3 @ 30 points
1@100 points
1@50 points
1@25 points
1@150 points
12@15 points
4 @ 3 points
60
400
90
100
50
25
150
180
12
1067
Total
GRADE
POINT VALUE
A
AB+
B
BC+
C
CD+
D
DF
94-100
90-93
88-89
84-87
80-83
78-79
74-77
70-73
68-69
64-67
60-63
0-59
Course Rules/Guidelines
Class Attendance and Participation
Class experiences contain information that you will need in order to do well in this course. A
pattern of missing classes will cause your grade to be lowered or you may be “de-enrolled” (Six
misses, total from all sections, will qualify you for de-enrollment). Each student is required to
be in every class meeting without fail. Responsible attendance and promptness are essential to
gain the maximum benefits from this class. There are no allowed or excused absences.
(Exceptions: When necessitated by certain college-sponsored activities and are approved in
writing by the Academic Dean.)
Excused absences for emergencies are accepted with notification ASAP. Role will be
taken and students missing more than 6 classes will be de-enrolled from the class. If an
eclass quiz is due on the day a student misses class the student will receive a 0 on that
quiz whether it was completed or not.
Late Work
Assignments not turned in the day they are due will immediately be docked 20%. If the
assignment is two weeks late or more the grade will be docked 40%.
5
Make-Ups
Make up exams/quizzes will be given only if the professor is notified of the excused
absence prior to the missed class or if the student has a legitimate emergency. No makeup labs will be allowed.
Email
Email will be the MAIN form of communication used by the professor outside of class.
Students are expected to check their email at least ONCE A DAY. If you know of issues
with your @pointloma.edu account please notify the professor immediately.
Acceptable behavior
 Make sure cell phones are turned off and put away (no texting or
making/receiving calls during class).
 Even if you don’t always agree, you will have respect for each others’ opinions as
to what is being discussed in class.
 Everyone learns at a different rate; at no time should you make other’s feel
inadequate.
6
Tentative Therapeutic Modality/Pharmacology Outline **Subject to Change**
Date
Topic
1-10-12 (T)
1-11-12 (W)
1-16-12 (M)
1-18-12 (W)
Introduction; The Injury Response
Injury Response, Physiology of Pain
1-20-12 (F)
1-23-12 (M)
1-25-12 (W)
1-30-12 (M)
2-1-12 (W)
Pain Theories/Review
2-6-12 (M)
2-8-12 (W)
2-13-12 (M)
Ultrasound
Ultrasound
Lab: Ultrasound/Phonophoresis
2-15-12 (W)
2-20-12 (M)
2-22-12 (W)
2-27-12 (M)
Assignments Due
NO CLASS
Physiology of Pain/Pain Theories
Chapter 1
Chapters 1, 2
DB Post #1 Due “which
pain theory would you
want to be and why?”
Exam #1
Thermal Modalities
Thermal Modalities, Diathermy, Light Modalities
Lab Thermal/Light
Article Review 1
DB Post #2 Due “What
was the most
interesting finding in
your article review and
how will you apply that
to clinical practice?”
DB Post #3 “US is it:
overrated, overused,
abused or a good
clinical tool?”
Exam #2 and Lab Practical #1
Physics of Electricity
Physics of Electricity/High Volt, Electrotherapy: IFC, Premod,
Russian
Electrotherapy: TENS, Ionto, micro
Sales Person Pitch
Presentations #1
Article Review #2
Lab: Electrotherapy
3-19-12 (M)
3-21-12 (W)
3-26-12 (M)
3-28-12 (W)
Massage
Lab: Traction, Biofeedback, EMG, Intermittent Compression
Article Review #3
Lab: Massage, Active Release, Kinesio taping
Exam #4 Lab Practical #3
Pharmacology:
Basic pharmacology, admin of drugs, etc.
Anti-Inflammatory Drugs: Aspirin & NSAID’s
EASTER BREAK!!!
Anti-Inflammatory Drugs: Corticosteroids
Quiz 1
Analgesics & local anesthetics
Drugs for Bacterial, Fungal &Viral Infections
Quiz 2
Respiratory Drugs
Management of Asthma in Athletes
http://www.nata.org/statements/position/asthma.pdf
Drugs for GI disorders
Chapter 7 & 8
Diabetes Mellitus
Clinical Management
Management of the Athlete with Type 1 Diabetes
Papers Due
http://www.nata.org/jat.reader/archieves/42/4/10-62-6050-42-4536.pdf
Circulatory Medications
Quiz 3
Neurological Medications /Review for Final
Quiz 4
FINAL EXAMINATION 10:30-12:30
4-2-12 (M)
4-4-12 (W)
4-5 – 4-9
4-11-12 (W)
4-13-12 (F)
4-16-12 (M)
4-18-12 (W)
4-20-12 (F)
4-23-12 (M)
4-25-12 (W)
4-27-12 (F)
5-4-2011
Chapters 2, 3
Chapter 3
Chapters 5, 6
Chapter 5, 6, 9, 19
Chapters 7, 8
Chapters 7,8
Chapters 11, 12
Chapters 11, 12, 13
Chapter 13
Sales Person Pitch
Presentations #2
2-29-12 (W)
3-5 – 3-9
3-12-12 (M)
3-14-12 (W)
Traction, Biofeedback
Required Reading
Spring Break!
Exam #3 Lab Practical #2
DB Post #4 “based on
the sales pitches which
modality is most
flexible and which one
would you use in
clinical practice?”
7
Chapters 17, 18
Chapter 16
Chapters 1,2
Chapter 3
Chapter 4
Chapter 5 & 6
Chapter 9
Chapter 10
Chapters 12,13
Comprehensive
Code
RM-C18
Competency/Proficiency
AC-C17
Explain the principles and concepts related to the fabrication, modification, and appropriate application or use of orthotics and
other dynamic and static splints. This includes, but is not limited to, evaluating or identifying the need, selecting the appropriate
manufacturing material, manufacturing the orthosis or splint, and fitting the orthosis or splint.
Explain the application principles of rest, cold application, elevation, and compression in the treatment of acute injuries.
AC-C18
Describe the signs, symptoms, and pathology of acute inflammation.
TM-C1
TM-C3
Describe the physiological and pathological processes of trauma, wound healing and tissue repair and their implications on the
selection and application of therapeutic modalities used in a treatment and/or rehabilitation program.
Explain the principles of physics, including basic concepts associated with the electromagnetic and acoustic spectra (e.g.,
frequency, wavelength) associated with therapeutic modalities.
Explain the terminology, principles, basic concepts, and properties of electric currents as they relate to therapeutic modalities.
TM-C4
Describe contemporary pain-control theories.
TM-C5
Describe the role and function of the common pharmacological agents that are used in conjunction with therapeutic modalities
TM-C6
Explain the body's physiological responses during and following the application of therapeutic modalities.
TM-C7
Describe the electrophysics, physical properties, biophysics, patient preparation and modality set-up (parameters), indications,
contraindications, and specific physiological effects associated with commonly used therapeutic modalities.
Identify appropriate therapeutic modalities for the treatment and rehabilitation of injuries and illness.
TM-C2
TM-C8
TM-C9
TM-C9a
TM-C9b
TM-C9c
TM-C9d
Describe the process/methods of assessing and reassessing the status of the patient using standard techniques and
documentation strategies to determine appropriate treatment and rehabilitation and to evaluate readiness to return to the
appropriate level of activity. This includes the ability to:
Describe and interpret appropriate measurement and assessment procedures as they relate to the selection and application of
therapeutic modalities.
Interpret objective measurement results as a basis for developing individualized therapeutic modality application and set-up
(parameters).
Interpret the results of injury assessment and determine an appropriate therapeutic modality program to return the patient to
physical activity.
Determine the appropriate therapeutic modality program and appropriate therapeutic goals and objectives based on the initial
assessment and frequent reassessments.
TM-C9e
Determine the criteria for progression and return to activity based on the level of functional outcomes.
TM-C9f
Describe appropriate methods of assessing progress when using therapeutic modalities and interpret the results.
TM-C9g
Interpret physician notes, postoperative notes, and physician prescriptions as they pertain to a treatment plan.
TM-C9h
Describe appropriate medical documentation for recording progress in a therapeutic modality program.
TM-C10
Identify manufacturer’s, institutional, state, and federal standards for the operation and safe application of therapeutic modalities.
TM-C11
Identify manufacturer’s, institutional, state and federal guidelines for the inspection and maintenance of therapeutic modalities.
TM-P1
Assess patient to identify indications, contraindications, and precautions applicable to the application of therapeutic modalities.
TM-P2
Obtain and interpret baseline and posttreatment objective physical measurements to evaluate and interpret results.
TM-P3
Inspect the therapeutic modalities and treatment environment for potential safety hazards.
TM-P4
Position and prepare the patient for the application of therapeutic modalities.
TM-P5
Select and apply appropriate therapeutic modalities according to evidence-based guidelines.
TM-P6
Document treatment goals, expectations, and treatment outcomes.
TM-CP1
Synthesize information obtained in a patient interview and physical examination to determine the indications, contraindications
and precautions for the selection, patient set-up, and evidence-based application of therapeutic modalities for acute and chronic
injuries. The student will formulate a progressive treatment and rehabilitation plan and appropriately apply the modalities.
Effective lines of communication should be established to elicit and convey information about the patient’s status and the
prescribed modality(s). While maintaining patient confidentiality, all aspects of the treatment plan should be documented using
standardized record-keeping methods.
TM-CP1.1
Infrared Modalities
TM-CP1.2
Electrical Stimulation Modalities
TM-CP1.3
Therapuetic Ultrasound
TM-CP1.4
Mechanical Modalities
TM-CP1.5
Massage and other Manual Techniques
PH-C1
Explain the laws, regulations, and procedures that govern storing, transporting, dispensing, and recording prescription and
nonprescription medications (Controlled Substance Act, scheduled drug classification, and state statutes).
PH-C2
Identify appropriate pharmaceutical terminology and abbreviations used in the prescription, administration, and dispensing of
medications.
PH-C3
Identify information about the indications, contraindications, precautions, and adverse reactions for common prescription and
nonprescription medications (including herbal medications) using current pharmacy resources.
PH-C4
Explain the concepts of pharmacokinetics (absorption, distribution, metabolism, and elimination) and the suspected influence that
exercise might have on these processes.
8
PH-C5
Explain the concepts related to bioavailability, half-life, and bioequivalence.
PH-C6
Explain the general pharmacodynamic principles as they relate to the mechanism of drug action and therapeutic effectiveness
(e.g. receptor theory, dose-response relationship, potency, and drug interactions).
PH-C7
Describe the common routes used to administer medications (e.g., oral, inhalation, and injection) and their advantages and
disadvantages.
PH-C8
Explain the relationship between generic or brand name pharmaceuticals.
PH-C9
Identify medications that might cause possible poisoning, and describe how to activate and follow the locally established poison
control protocols.
PH-C10
Explain the known usage patterns, general effects, and short- and long-term adverse effects for the commonly used performanceenhancing substances.
PH-C11
Identify which therapeutic drugs and nontherapeutic substances are banned by sport and/or workplace organizations in order to
properly advise patients about possible disqualification and other consequences.
PH-P1
Obtain and communicate patient education materials regarding physician-prescribed medications, over-the-counter drugs, and
performance-enhancing substances using appropriate references.
PH-P2
Abide by federal, state, and local regulations for the proper storage, transportation, dispensing (administering where appropriate),
and documentation of commonly used medications.
PH-P3
Activate and effectively follow locally established poison control protocols.
PS-C2
Explain the stress-response model and the psychological and emotional responses to trauma and forced inactivity.
PS-C11
Identify and describe the sociological, biological and psychological influences toward substance abuse, addictive personality
traits, the commonly abused substances, the signs and symptoms associated with the abuse of these substances, and their
impact on an individual’s health and physical performance
PS-C15
Describe the psychosocial factors that affect persistent pain perception (i.e., emotional state, locus of control, psychodynamic
issues, sociocultural factors, and personal values and beliefs) and identify multidisciplinary approaches for managing patients with
persistent pain.
NU-C4
Identify nutritional considerations in rehabilitation, including nutrients involved in healing and nutritional risk factors (e.g., reduced
activity with the same dietary regimen and others).
NU-C10
Explain implications of FDA regulation of nutritional products.
PD-C14
Interpret the current research in athletic training and other related medical and health areas and apply the results to the daily
practice of athletic training.
9