Paper V: Elective – Rehabilitation: Basics, Assessment and Evaluation

Objectives:
At the end of the course, the candidate will:

• Acquired the in-depth understanding of the concept of general and community based rehabilitation.
• Be able to assist in planning and organization of camps at community level.
• Be able to impart services and training at the community level effectively with minimum resources.

The course shall enable the candidate to get expertise in the community health and function in the general set up as consultant. Such candidate shall attain ability as a consultant and mandatory member of the team of the health professionals, involved in the following headings:

• Sports sciences and health promotion
• Movement and psycho-somatic conditions.
• Cardio-pulmonary rehabilitation.
• Mother and child care.
• Industrial health
• Geriatrics.

Section-I: Rehabilitation- Basics

• Definition, Concept, principles & Scope of Rehabilitation, Community, Health care delivery system, Health Administration, Institutional based rehabilitation and community based rehabilitation – its principles and differences, multi-disciplinary approach, role of national institutes, District rehabilitation centre and primary health centre. Physiotherapist as a Master Trainer in CBR & IBR.
• Epidemiology of dysfunctions & advance skills of physical and functional assessment related to Community. Clinical decision-making skill in management of dysfunction
• Evidence Based Practice & Recent advances in Community Health. Indian Health statistics
• Fitness and health promotion – Principles of fitness for health promotion in community, Nutrition and Diet. Stress management through yoga and psychosomatic approaches.
• Natural calamity & disaster management – Role of P.T. in disaster management team.
• I.C.F. [Impairment, Disability, Handicapped and its implications] Evaluation of Disability & Compensation for Persons with disability Act – 1995 and related Government infrastructure.
• Physiotherapy Ethics – code of conduct, Regulatory Agencies and Legal Issues.
• W.H.O.`s policies-about rural health care -Role of P.T.-Principles of a team work of Medical person/P.T./O.T. audiologist/speech therapist /P.&O./vocational guide in C.B.R. of physically handicapped person.
• Public health education methods and appropriate media – Public awareness to the various disabilities, communications, message generation and dissipation.
• Role of Government & NGOs in CBR, inter-sectoral programs and co-ordination, Implementation of the Act.

Section-II: Rehabilitation –Assessment and Evaluation
Assistive Technology for mobility & Stability

• Orthotics & Prosthetics: definition, classification, biomechanical principles; assessment and evaluation, prescription & fabrication
• Designing & Training of UL, LL, trunk, neck Orthosis, footwear modifications in various conditions
• Designing & Training of UL, LL prosthesis in Amputees.
• Indications / Contraindications, psychological aspects of its application.
• Use of adaptive devices, design & construction e.g. canes, walkers, wheelchairs.

Industrial Health

• Applied anatomy, physiology and biomechanics related to Industrial health.
• Clinical decision making skill in assessment and management of dysfunction related to Industrial health.
• Industrial physiotherapy- prevention of injuries, physiological restoration, rehabilitation in industrial injuries, work station adaptations/ modifications.
• Environmental stress in the industrial area –Accidents due to
• • Physical agents- e.g.-Heat/cold, light, noise, Vibration, U.V. radiation, Ionizing radiation.
  • Chemical agents-Inhalation, local action, ingestion,
  • Mechanical hazards-overuse/fatigue injuries due to ergonomic alteration & ergonomic evaluation of work place-mechanical stresses as per hierarchy – Sedentary table work –executives, clerk, Inappropriate seating arrangement- vehicle drivers Constant standing- watchman- Defence forces, surgeons, Over-exertion in labourers – common accidents –Role of P.T.-Stress management,
  • Psychological hazards- e.g.-executives, monotony & dissatisfaction in job, anxiety of work completion with quality, Role of P.T. in Industrial setup & Stress management-relaxation modes. Physiotherapy role in industry – preventive, promotive, curative, intervention, ergonomic and rehabilitative services.Ergonomic considerations and health promotion in the industry
• job analysis, job description, job demand analysis, task analysis, Employee fitness, job modification, Employment acts.
• Vocational Rehabilitation; evaluation & management.

Paper VI: ELECTIVE – INTERVENTIONS IN CLINICAL REHABILITATION

CONDITIONS

Section-I: Clinical Rehabilitation conditions

• Rehabilitation in musculoskeletal conditions, sport sciences and health promotion
• Rehabilitation in cardio-pulmonary conditions, and health promotion
• Rehabilitation in neurological conditions, movement & psycho-somatic disorders, paediatric conditions
• General fitness strategies- body mass composition, assessment, obesity and weight control

Section-II: Mother & Child Care, Geriatrics & Health Promotion

Mother and Child Care

• Applied anatomy, physiology and biomechanics related to Women’s health, mother and child care.
• Clinical decision making skill in assessment and management of dysfunction related to mother & child.
• Anatomy of Pelvic floor-Physiological changes occurring in female during pregnancy, Physical exercises during pregnancy. -Clinical reasoning for care to be taken while performing exercises during pregnancy.
• Prenatal /antenatal programme-Clinical reasoning for specific breathing exercises/ relaxation/ postural training/ Pelvic floor stretching & strengthening exercises.
• Physiotherapy during labor -Post-natal exercise programme after normal labour / labour with invasive procedures, pain – musculoskeletal pain during pregnancy, pain during delivery and pain relief.
• Maintenance of posture during pregnancy-fitness programmes and breast feeding
• Psychological and emotional changes and coping with demands of new born.
• Uro-genital dysfunction – P.T. management -Menopause-De-conditioning – P.T. management –Common Gynaecological surgeries- role of P.T.-Clinical reasoning for application of Electro- therapeutic measures in Obstetrics / Gynaecology.

Geriatrics & Health Promotion

• Applied anatomy, physiology and biomechanics related to Aging / degenerative changes-Musculoskeletal / Neuromotor/ cardio respiratory / Metabolic/ integumentary / sensory
• Clinical decision making skill in assessment and management of dysfunction related to geriatric health.
• Role of Physiotherapy in a Home for the aged- geriatric care/physiotherapy, holistic approach.
• Fitness and Health promotion in elderly.
• Psychosomatic approaches in management of disorders of stress, change in life-style to reduce risk factors for disability. Drug dependence and iatrogenic disorders.
• Assistive Technology used for Stability & mobility to enhance function.

Recommended Books:

• Textbook of community medicine and community health-by Bhaskar Rao
• Industrial therapy—Glenda Key
• Community based rehabilitation for person with disability- S. Pruthuvish
• Community based rehabilitation for person with disability- Malcolm Peat
• Developing cultural competence in physical therapy practice, Jill black lattanzi, Larry D. Purnell (2006 F.A. Davis).
• Disability 2000- RCI
• Physiotherapy in the community , Gibson, Ann. 1988, Woodhead-Faulkner 72 (Cambridge, Wolfeboro, N.H., USA)
• Community Rehabilitation in Neurology, Michael P. Barnes, Harriet Radermacher, Cambridge University Press 2009
• Community Care for Health Professionals, Ann Crompton and Mary Ashwin, (Butterworth – Heinemann 2000)
• Legal rights of disabled in India- Gautam Banerjee
• Disabled village children by David Werner
• Physical rehabilitation- Sussan O Sullivan
• ICF- WHO 2001 publications
• Preventive and social medicine- K.Park
• Mural K F –Ergonomics: Man in his working environment
• Exercise Physiology-by McArdle
• Musculoskeletal Disorders in work place: Principle & Practice-by Nordin Andersons Pope
• Chorin C& M Desai, C Gonsalves, 1999, Women & the Law, Vol. I & II Socio – legal Information Centre Mumbai
• Geriatrics Physiotherapy – By Andrew Guccione,2nd Edition (Mosby 2000)
• Physical Therapy of the geriatric patient by Jackson Osa. Churchill Livingstone. New York.
• Geriatric Physical Therapy: A Clinical Approach by Carole B. Lewis and Jennifer Bottomley (1993)
• Training in the Community for the people with disability –by Hallender Padmini Mendes
• Occupational Therapy and Physical disfunction: Principles, Skills & Practices – Turner, Foster & Johnson – Churchill Livingstone
• Orthotics and Prosthetics in Rehabilitation by Michelle M. Lusardi PhD PT and Caroline C. Nielsen PhD (Jun 30, 2006)
• Prosthetics and Orthotics: Lower Limb and Spine by Ron Seymour PhD (Feb 14, 2002)
• Lower-Limb Prosthetics and Orthotics: Clinical Concepts by Joan Edelstein and Alex Moroz (Dec 15, 2010)
• Orthotics: A Comprehensive Clinical Approach by Joan Edelstein MA PT FISPO and Jan Bruckner PhD PT (Jan 1, 2002)
• Orthotics in Functional Rehabilitation of the Lower Limb by Deborah A. Nawoczenski PhD PT and Marcia E. Epler PhD PT ATC (Jan 15, 1997)
• Ergonomics for Beginners: A Quick Reference Guide, Third Edition by Jan Dul and
• Weerdmeester (May 28, 2008)
• Ergonomic Living : How to Create a User-Friendly Home & Office by Gordon Inkeles and Iris Schencke (Nov 1, 1994)
• Ergonomics for Therapists by Karen Jacobs EdD OTR/L CPE FAOTA (Jul 30, 2007)
• Ergonomics In Computerized Offices by E. Grandjean (Dec 18, 1986)
• Action Plan for Community-Based Rehabilitation (CBR) in India:: focus on Culture and Participation by Kamaraj