DPT 610 FOUNDATIONS OF PHYSICAL THERAPY EVALUATION (3)
TIME
LOCATION
Instructor:
Office:
Office hours:
Phone:
E-mail:
Course Prerequisites
Acceptance into the DPT program.
Course Overview
This course is designed to give the physical therapy student: 1) basic problem solving and psychomotor skills necessary to perform a
general physical examination; and 2) the concepts, procedures, and techniques required to provide safe and effective patients care.
The psychomotor skills presented in this class include the basic assessment of cardiopulmonary function (peripheral pulses),
neurological function (reflexes, dermatomes, myotomes, balance), muscle function (muscle strength testing), joint mobility
(goniometry – range of motion), and soft tissue integrity and function (joint and soft tissue palpation as well as posture assessment).
Patient care skills presented in this class include infection control, body mechanics, patient/client positioning and draping, transfer
activities, wheelchair features and activities, and ambulation aids. The development of problem solving skills will be the central
focus of the course in addition to the attainment of important psychomotor and patient care skills. The material presented in this
course will serve as the foundation for second year course work in musculoskeletal, neurological, cardiopulmonary and
integumentary system evaluation and intervention.
Course Policies
Lab clothing is necessary during the laboratory portions of the course where palpation and/or observation of body parts is
necessary. Students should come prepared in the appropriate attire so as to expose the area of the body that is being studied. If
you should forget your lab clothes, patient gowns will be available for your use.
1. REQUIRED lab clothing includes: Men: Shorts, T-shirts, etc., Women: Shorts, Swim Suits, Halter tops, etc.
2. Class attendance will not be taken, but regular attendance is expected and considered essential to master the skills taught
in this course. It is impossible to gain mastery of the material presented in lab simply from your notes or a textbook. Please
be prepared for Lab and use your time wisely. You should also expect to devote significant time outside of the classroom to
practice the psychomotor skills that will be taught.
3. All lecture and laboratory sessions will start promptly at the designated time. If you are late, please take a seat quietly and
near the back of the classroom so you do not disrupt others when you come in.
4. It is expected that all reading assignments will be completed prior to the start of class.
5. Examinations must be taken on the day specified unless prior arrangements have been made with the instructor. No
make-up examinations will be given.
6. Plagiarism or any other form of cheating will result in a grade of Failure (F). Class activities in which students may work
together to complete assignments, will be specifically announced.
7. The Faculty is committed to treating you in a professional manner as well as making this course a meaningful experience for
you. If you need any help or further explanation of presented material, please see the faculty as soon as possible!
Student Learning Outcomes
 Synthesize available data on a patient/client expressed in terms of the International Classification of Function, Disability,
and Health (ICF) model to include body functions and structures, activities, and findings.
 Use available evidence in interpreting the examination of findings.
 Verbalize possible alternatives when interpreting the examination findings
 Cite the evidence (patient/client history, lab diagnostics, tests and measures and scientific literature) to support a clinical
decision.
1. Demonstrate proficiency in the use of a goniometer to measure active and passive joint range of motion for both upper and
lower extremity joints.
2. Describe and perform the procedures necessary to conduct a postural analysis.
3. Identify possible factors of the musculoskeletal system that contribute to postural abnormalities.
4. State the components of a normal postural alignment and indicate if structural asymmetries exist.
5. Demonstrate a basic neurological evaluation including peripheral sensation and tendon reflexes.
6. Utilize problem solving strategies to plan an effective and time efficient patient evaluation.
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Describe and properly perform the procedures necessary to conduct strength and manual muscle testing on the
musculature of the lower and upper extremity, including proper positioning of the patient as well as correct grading of the
muscle test.
Describe the possible clinical relevance of the findings obtained from strength/manual muscle testing, postural assessment,
and palpation examination.
Describe the application of active, passive, and resistive movements.
State the capsular patterns of each peripheral joint as well as basic descriptions of joint end-feel.
Accurately complete the measurement and monitoring of a patient’s vital signs.
Describe and perform the procedures necessary to assess muscle length as well as height, weight, and girth.
Describe and perform an assessment of the integumentary system including skin condition and color, hair growth, as well as
temperature.
Demonstrate proficiency in screening all the lower and upper extremity regions to determine if further examination or
referral is required.
Describe how to instruct health care professionals or family members on how to use proper body mechanics when lifting,
reaching, pushing, pulling and carrying objects.
Demonstrate correct hand-washing techniques, infection control using Standard Precautions, isolation precautions, as well
as the application and removal of protective garments.
Describe and demonstrate wheelchair functional activities with a person in the chair.
Demonstrate instruction and proper guarding as well as protect a person during various transfer techniques.
Demonstrate the proper technique for a patient to perform the functional activities appropriate for the person’s condition
using proper ambulation aids.
Demonstrate the use of equipment required for special patient needs.
State and demonstrate how to establish and maintain a clean (sterile) field.
Identify factors necessary to maintain a safe treatment environment.
Demonstrate the basic components for a safety assessment of a home, workplace and community.
Describe the need for and indentify those situations when pro bono service should be incorporated into clinical practice.
Course Materials
required
 Palmer ML, Epler ME: Fundamentals of Musculoskeletal Assessment Techniques. Ed 2, Philadelphia, Lippincott, 1998.
 Pierson FM, Fairchild SL: Principles and Techniques of Patient Care. Ed 4, Philadelphia, Saunders, 2007.
 Patient Case studies and Research articles from the professional journals may be used throughout the course to
supplement the student's readings.
optional
 Norkin CC, White DJ: Measurement of Joint Motion: A guide to goniometry.
 Hoppenfeld S: Physical Examination of the Spine and Extremities. New York, Appleton-Century-Crofts, 1976
 Hislop HJ, Montgomery J: Daniels and Worthingham’s Muscle Testing: Techniques of manual examination.
 Palmer and Toms: Manual for Functional Training.
 Kendall and Kendall: Muscles: Testing and Function.
Required journal readings
Beling, J., & Roller, M. (2009). Multifactorial intervention with balance training as a core component among fall-prone older adults. J
Geriatr Phys Ther, 32(3), 125-133.
Katsura, Y., Yoshikawa, T., Ueda, S. Y., Usui, T., Sotobayashi, D., Nakao, H., et al. Effects of aquatic exercise training using waterresistance equipment in elderly. Eur J Appl Physiol, 108(5), 957-964.
Kaya, A., Ozgocmen, S., Kamanli, A., Aydogan, R., Yildirim, A., & Ardicoglu, O. (2007). Evaluation of a quantitative scoring of enthesitis
in ankylosing spondylitis. J Clin Rheumatol, 13(6), 303-306.
Kibele, A., & Behm, D. G. (2009). Seven weeks of instability and traditional resistance training effects on strength, balance and
functional performance. J Strength Cond Res, 23(9), 2443-2450.
Lu, Y. M., Lin, J. H., Hsiao, S. F., Liu, M. F., Chen, S. M., & Lue, Y. J. The relative and absolute reliability of leg muscle strength testing
by a handheld dynamometer. J Strength Cond Res, 25(4), 1065-1071.
Robles, P. G., Mathur, S., Janaudis-Fereira, T., Dolmage, T. E., Goldstein, R. S., & Brooks, D. Measurement of peripheral muscle
strength in individuals with chronic obstructive pulmonary disease: a systematic review. J Cardiopulm Rehabil Prev, 31(1), 11-24.
Silva, E. M., Andrade, S. C., & Vilar, M. J. Evaluation of the effects of Global Postural Reeducation in patients with ankylosing
spondylitis. Rheumatol Int.
Sixel-Doring, F., Liepe, K., Mollenhauer, B., Trautmann, E., & Trenkwalder, C. The role of (123)I-FP-CIT-SPECT in the differential
diagnosis of Parkinson and tremor syndromes: a critical assessment of 125 cases. J Neurol.
Torpilliesi, T., Bellelli, G., Morghen, S., Gentile, S., Ricci, E., Turco, R., et al. Outcomes of Nonagenarian Patients After Rehabilitation
Following Hip Fracture Surgery. J Am Med Dir Assoc.
Westcott, W. L., Winett, R. A., Annesi, J. J., Wojcik, J. R., Anderson, E. S., & Madden, P. J. (2009). Prescribing physical activity:
applying the ACSM protocols for exercise type, intensity, and duration across 3 training frequencies. Phys Sportsmed, 37(2), 51-58.
Course Outline
1. TERMINOLOGY
a. Disability
b. Impairment
c. Functional Limitation
2. FUNDAMENTALS OF PATIENT/CLIENT MANAGEMENT
a. Examination
i. History Taking
ii. Tests and Measures
b. Evaluation
c. Diagnosis
d. Prognosis
e. Intervention
i. Coordination, Communication and Documentation
ii. Patient/Client-Related Instruction
f. Patient Care Activities
g. Direct Interventions
h. Outcomes
i. Patient Care Activities
3. TESTS AND MEASURES
a. Anthropometric Characteristics
i. Assessment of edema through palpation and girth measurements
ii. Measurement of height, weight, length, and girth
iii. Observation and palpation of trunk and extremities at rest and during and after activity
b. Integumentary Integrity
i. Assessment for presence of blistering
ii. Assessment for presence of hair growth
iii. Assessment of continuity of skin color
iv. Assessment of sensation (e.g. pain, temperature, tactile)
v. Assessment of skin temperature as compared with that of an adjacent area or an opposite extremity
c. Joint Integrity and Mobility
i. Analysis of the nature and quality of movement of the joint or body part during performance of specific
movement tasks
ii. Assessment of joint hyper mobility and hypo mobility
iii. Assessment of pain and soreness
iv. Assessment of response to manual provocation tests
v. Assessment of soft tissue swelling, inflammation, or restriction
d. Motor Function (Motor Control and Motor Learning)
i. Analysis of balance
ii. Analysis of posture during sitting, standing, and locomotor activities
iii. Analysis of head, trunk, and limb movement
e. Muscle Performance (Including Strength, Power, and Endurance)
i. Analysis of functional muscle strength, power, and endurance
ii. Analysis of muscle strength, power, and endurance, using manual muscle tests
iii. Assessment of muscle tone
iv. Assessment of pain and soreness
f. Posture
i. Analysis of resting posture in any position
ii. Analysis of static and dynamic postures
g.
4.
Range of Motion (Including Muscle Length)
i. Analysis of functional ROM
ii. Analysis of ROM using goniometer
iii. Assessment of muscle, joint or soft tissue characteristics
h. Reflex Integrity
i. Assessment of normal reflexes (e.g. stretch reflex)
ii. Assessment of pathological reflexes (e.g. Babinski reflex)
i. Sensory Integrity
i. Assessment of cutaneous sensation
PATIENT CARE MANAGEMENT
a. Approaches to Infection Control
i. Hand-washing techniques
ii. Isolation precautions
iii. Application & removal of protective garments
b. Body Mechanics
i. Principles and concepts of proper body mechanics
ii. Lifting principles and techniques
c. Positioning and Draping
i. General and preventative positioning
ii. Draping
d. Transfer Activities
i. Types of transfers
ii. Principles of mobility for the bed and mat
iii. Standing, sitting, and lifting transfers
iv. Mechanical equipment
e. Wheelchair Features and Activities
i. Evaluation of fit
ii. Wheelchair components and features
iii. Functional activities
f. Ambulation Aids, Patterns, and Activities
i. Measurement and fit
ii. Safety considerations and precautions
iii. Basic gait patterns
iv. Standing and sitting activities
Teaching Methods and Learning Experiences
The format of this course will be primarily the development of psychomotor and patient care skills through laboratory experiences.
Lectures will be used to present basic information on the topics prior to demonstration and practice. Although students will have an
opportunity to practice the skills taught during the laboratory, additional time outside of the classroom will be necessary for
students to gain entry-level proficiency. The use of patient case studies will be used to help reinforce the principles being taught.
Students may be called upon to demonstrate tests previously covered in a class or laboratory session.
Course Evaluation
Evaluation will be based upon six (6) examinations (3 practical and 3 written). Students will be tested and graded in groups of two
for the practical examinations. Each student will be given approximately 30 minutes to accurately demonstrate and answer any
questions concerning at least two upper extremity and two lower extremity psychomotor skills as well as two patient care skills
drawn at random. The grade for the practical examinations will be determined on the student’s psychomotor abilities as well as their
thoroughness, rationale and professionalism. The practical examination will be on both the upper and lower extremity skills.
Students must pass all three examinations in order to successfully pass the course. Students who are unable to adequately
demonstrate the skills chosen will need to re-take any or all three of the practical examinations at a later date determined by the
instructors. The following grading scale will be used for the written examinations: A= 90% - 100%, B = 80% - 89.9%, C = 70% - 79.9%,
F = Below 70%. Approximately 10% of the total points for the class are reserved for professional behavior and laboratory
participation. Finally, students will need to successfully complete a series of Wednesday afternoon rotations through the Physical
Therapy Clinic held at either the Fronske Student Health Center or in the Health Professions building. Laboratory participation
points will also be deducted for non-professional behavior associated with the Physical Therapy Clinic.
Written Exam 1
Written Exam 1
Written Exam 1
Practical Exam (UE Exam)
Practical Exam (LE Exam)
Practical Exam (Patient Care)
Laboratory Participation
Possible points
50
50
50
50
50
50
30
-----330
Class Schedule
Week
Topic
1
Course introduction
Terminology and overview of examination process
Fundamentals of muscle testing and goniometry
Overview of principles and techniques of patient care
2
Hip assessment
Infection control
3
Hip and knee assessment
Body mechanics
4
Written Exam 1
5
Knee assessment
Positioning and draping
6
Foot and ankle assessment
Transfer techniques
7
Posture assessment
8
Shoulder assessment
Transfer activities
9
Shoulder assessment
Wheelchair features and activities
10
Written Exam 2
Practical Exam 1 – Lower Extremity Case Studies
11
Elbow and forearm assessment
Ambulation aids
12
Hand and wrist assessment
Ambulation patterns
13
Hand and wrist assessment
Ambulation activities
14
Written Exam 3
Practical Exam 2 – Upper extremity case studies
15
Practical Exam 3 – Patient care
16
Practical Exam 3 – Patient care
Readings
Pierson ch 1-2
Palmer ch 12
Pierson ch 2
Palmer ch 12-13
Pierson ch 4
Palmer ch 13
Pierson ch 5
Palmer ch 14
Pierson ch 7
Palmer ch 4
Palmer ch 5
Pierson ch 7
Palmer ch 5
Pierson ch 8
Palmer ch 6
Pierson ch 9
Palmer ch 7
Pierson ch 9
Palmer ch 7
Pierson ch 9
Statement on Cheating and Plagiarism
Cheating is the actual or attempted practice of fraudulent or deceptive acts for the purpose of improving one’s grade or obtaining
course credit; such acts also include assisting another student to do so. Typically, such acts occur in relation to examinations.
However, it is the intent of this definition that the term ‘cheating’ not be limited to examination situations only, but that it include
any and all actions by a student that are intended to gain an unearned academic advantage by fraudulent or deceptive means.
Plagiarism is a specific form of cheating which consists of the misuse of the published and/or unpublished works of others by
misrepresenting the material (i.e., their intellectual property) so used as one’s own work. Penalties for cheating and plagiarism range
from a 0 or F on a particular assignment, through an F for the course, to expulsion from the University. For more information on the
University’s policy regarding cheating and plagiarism, refer to the Schedule of Courses (‘Legal Notices on Cheating and Plagiarism’) or
the University Catalog (‘Policies and Regulations’).
Students with Disabilities
The University is committed to providing reasonable academic accommodation to students with disabilities. The Student Disability
Services Office provides university academic support services and specialized assistance to students with disabilities. Individuals
with physical, perceptual, or learning disabilities as addressed by the Americans with Disabilities Act should contact Student
Disability Services office for information regarding accommodations at (619) 594-6473
(http://www.sa.sdsu.edu/dss/dss_home.html). Moreover, you should notify me so that reasonable efforts can be made to
accommodate you.
This syllabus and schedule are subject to change in the event of extenuating circumstances.