Subject Title:	Exercise Therapy – I
Total hours:	175
Theory:	75
Practical:	100
Total Hours/ Week:	6 hours
Lecture:	2 hours /week
Practical:	3 hours/ week
Seminars/ Tutorials:	1 Hour/ week
Method of Assessment:	Written, Oral, Practical

Course Description:
In this course, the students will learn the basic principles and effects of exercise as a therapeutic modality and will learn the techniques in the restoration of physical functions and basic biomechanics involves the study of basic concepts of human movements.

THEORY

SECTION – I

• History of Physiotherapy [1 hour]: Origin, Definition (IAP, American, Canadian, etc.), Scope of profession, Different branches of Physiotherapy.
• Introduction to Exercise therapy [2 hours]: Aims, Techniques, Approach to the patient’s problem, Assessment of the patient’s condition, planning treatment management (briefly), Physiological effects and uses of exercise, Psychological aspects of exercise.
• Terminologies and Basic Biomechanics [3 hours]: Introduction to movements, Types of muscle contraction, Types of muscle work, Group action of muscle, closed chain and open chain kinematics, Active and passive insufficiency, swing and shunt muscle.
• Nervous control of movement[1 hour]:
• Kinematics of movement [1 hour]: Joint movements, axis and plane. Direction of motion, Magnitude of motion, rate of motion.
• Kinetics of movement [3 hours]: Force- analysis of force (parallelogram law only), tension, gravity, center of gravity, line of gravity, base of support, Friction- types, Importance, effects and uses, Equilibrium, Fixation and stabilization, Potential energy, kinetic energy, work, power, speed, velocity, acceleration, mass, momentum, inertia, moment arm, torque.
• Simple machines [4 hours]: Lever- Definition, types and uses, anatomical levers, functional levers in physiotherapy, pulley- types and uses, mechanical advantage, anatomical pulley- Angle of pull, pendulum, Elasticity, springs—properties of springs, springs in series and parallel, Hooke’s law .
• Therapeutic gymnasium [2 hours]: Orientation to various equipments used in exercise therapy department with its principles, effect and uses – pulleys, springs, axillary crutches, elbow crutches, walker, finger ladder, theraband, dumbbells, weights, weight cuff, sand bags, therapeutic balls, parallel bars, shoulder wheel, shoulder ladder, pronator – supinator instrument, static cycle, rowing machine, ankle exerciser, balancing boards, springs etc and their biomechanical principles.
• Group, home and individual exercise [2 hours]: – advantages, disadvantages, criteria of selection of patients.
• Soft tissue manipulation [14 hours]:
  • Introduction, brief history, definition, classification
  • Physiological effects and therapeutic uses, indications and contraindications.
  • Preparation of patient, basic points to be considered prior, during and after the treatment procedure.
  • Techniques, effects and uses, indications and contraindications of each. Specific effects of the techniques
  • Massage for arm, leg, neck, back and face.
  • Massage for Oedema, scar, tendinitis, and fibrosis.
• Yoga [4 Hours]: – Principles of yoga, basic yogic postures and their physiological effects.

SECTION – II

• Starting and derived positions [5 hours]: All fundamental and derived positions with effect, uses and muscle work.
• Active movements [10 hours]:
  • Free exercise-Definition, classification, principles, technique, indication, contraindication, effects and uses.
  • Active assisted exercise: definition, principles, technique, indication, contraindication, effects and uses.
  • Assisted- resisted exercise: definition, principles, technique, indication, contraindication, effects and uses.
  • Resisted exercise: Definition, classification, principles, technique, indication, contraindication, effects and uses. Difference of manual and mechanical resistance, Specific regimes- delormes, oxford, macqeen, circuit weight training, Types of isometrics.
• Passive movements [3 hours]: Definition, classification, principles, technique, indication, contraindication, effects and uses.
• Goniometry [5 hours]: Definition, uses, R.O.M.- 0-180 ,180-0, 0- 360 system, active R.O.M., passive R.O.M., Types of Goniometer, principles, techniques, limitations, Technique of measurement for all peripheral joints, spine and TMJ, causes of restriction of motion, normal and abnormal end feel, distinguish between Skin, Muscle and capsular contractures.
• Trick movements and its types [1 hour]:
• Suspension therapy [2 hours]: Definition, point of suspension, types, uses for increase joint R.O.M. and muscle power in upper limb and lower limb, indication, contraindication, limitations and benefits.
• Posture [2 hours]: Definition, types, factors affecting posture, postural training.
• Ambulatory devices/Walking Aids [10 hours]:- Types – crutches, canes & frames, measurement of different devices, uses. Gait : Definition, stages of normal gait, limb length (Lower limb only- apparent, true, supratrochantric) and girth measurement, pelvic tilt, pathological gait (brief introduction), uses of parallel bar in pre crutch training phase, gait training with the help of different types of ambulatory assistive devices, progression, group of muscle responsible, walking on even surface, slope, climbing up and down stairs.

PRACTICAL: (100 Hours)
Skills required for above topics of the subject to be practiced on self and models.

Practical Exam Format:
PRACTICAL-80 marks, INT. ASSESSMENT-20 marks, TOTAL-100 MARKS

• Long case-based on Techniques of application of Massage/Goniometry/Suspension Therapy etc. [35 marks]
  • Principles, Indications, Contra-indications, Documentation Of findings etc [20 marks]
  • Psychomotor & affective-skills [15 marks]
• • Short Case – Any one of the following [20 marks] Passive movements / Limb length / Girth Measurement / Yoga / Posture / Group Exercises / Chest Expansion/ Starting OR Derived position/ Walking Aids etc.
  • Spots-Based on Therapeutic Gymnasium [Four] [5×4= 20 marks]
  • Journal [5 marks]

Recommended books:

• Principles of exercise therapy- Dena Gardiner
• Practical exercise therapy- Margaret Hollis
• Guide line for goniometry-Cynthia Norkin & Joyce White
• Principals of therapeutic soft tissue manipulation – A. G. Sinha

Reference Books:

• Therapeutic exercise – Carolyn Kisner and Colby
• Clinical Kinesiology – Brunnstrom
• Massage for Therapist- Margaret Hollis
• Physical Rehabilitation- Susan B. O’Sullivan
• Physiotherapy in Orthopaedic conditions-by Jayant Joshi [for the study of Basic Yogic postures]
• Yoga for Health & Peace – S. Nimbalkar