PTA 210LW - Neurological Rehabilitation Techniques Lab

1. Demonstrate entry level treatment skills during the rehabilitation process of an individual with a spinal cord injury within the plan of care of the physical therapist.
   1. Demonstrate competency in developing activities utilizing a functional progression including supine, supine on elbows, prone, prone on elbows, sitting, quadruped, and tall kneel positions for strengthening in a patient with a SCI.
   2. Utilize various sensory inputs to assist in strengthening functioning muscles including resistance, quick stretch, and joint compression.
   3. Demonstrate competency in utilizing appropriate transfer techniques with a patient with a SCI including two-person lift, sit pivot, dependent lateral slide board, and assisted lateral slide board.
   4. Demonstrate competency in utilizing the head-to-hip ratio and discuss the role it plays in enhancing a patient's mobility during transfers.
   5. Demonstrate competency in performing standing activities and gait training with a person with a SCI including but not limited to the following: swing through, quarter turns, 4-point gait pattern, 2-point gait pattern, utilization of loftstrand crutches, and standing with orthoses from a wheelchair.
   6. Implement MMT testing assessments utilizing the key muscles to determine any changes in a patient’s neurological condition.
   7. Practice light touch sensation testing assessments utilizing nerve roots to determine any changes in a patient’s neurological status.
   8. Monitor a patient’s response to treatment activities to assess any changes in neurological status.
   9. Demonstrate entry-level skills in performing chest wall stretches to improve mobility and overall respiratory function.
   10. Demonstrate entry-level skills in performing cough assist techniques to assist in clearance of secretions in the airway.
   11. Examine various structural barriers a person with a SCI may encounter during community mobility.
   12. Recognize situations that require further clarification, supervision, or action by the supervising physical therapist. 
2. Demonstrate effective communication skills during treatment with a patient with a spinal cord injury (SCI).
   1. Educate accurately and effeciently the patient/caregiver on the signs and symptoms of autonomic dysreflexia and orthostatic hypotension.
   2. Educate accurately and efficiently the patient/caregiver on appropriate pressure relief techniques.
   3. Educate accurately and efficiently the patient/caregiver on appropriate self-ROM techniques for the LE.
   4. Educate accurately and efficiently the patient/caregiver on appropriate breathing exercises and cough assist techniques to enhance the respiratory function of a patient with a SCI.
3. Demonstrate entry-level skills in performing neuromuscular reeducation techniques to enhance the recovery process of a patient with neurological dysfunction under the plan of care of the supervising physical therapist.
   1. Demonstrate PROM/AAROM/AROM utilizing the PNF diagonals for the UE/LE correctly.
   2. Demonstrate competency in performing PNF techniques. 
   3. Demonstrate competency in utilizing developmental positions and the developmental sequence to enhance motor recovery.
   4. Demonstrate competency in utilizing sensory inputs to enhance motor recovery including massage, stretch, pressure, touch, ice, warmth, and resistance.
   5. Demonstrate competency in utilizing basic facilitatory and handling techniques to enhance motor recovery and normal movement.
   6. Demonstrate competency in incorporating the UE during functional activities.
   7. Demonstrate competency in opening the high toned hand in preparation for weight bearing.
   8. Implement strategies to treat Pusher syndrome.
   9. Identify abnormal movement patterns during functional activities often seen after a neurological insult including sit to stand, ambulation, rolling, sitting, and standing.
   10. Design and demonstrate a 30-45 minute treatment session on a mock patient with a neurological insult based on a plan of care by the physical therapist.
   11. Adjust treatment interventions based on patient response and determine when to consult with the supervising physical therapist.
   12. Implement treatment activities to improve the balance of patients with neurological dysfunction based on a plan of care by a physical therapist.
   13. Adjust balance activities and treatment based on patient response to the activities and report any changes to the supervising physical therapist.
   14. Maintain proper body mechanics throughout a patient treatment session given a case scenario.
   15. Calculate target heart rate max and heart rate reserve to optimize neuroplastic changes during treatment.
   16. Practice body weight supported treadmill training.
   17. Execute high intensity gait training with a mock patient.
4. Complete thorough documentation of neurological interventions.
5. Demonstrate an introductory understanding of vestibular rehabilitation.
   1. Practice basic vestibular exercises based on a plan of care developed by a physical therapist.
   2. Adjust treatment interventions based on patient response to treatment and identify any changes to report to the supervising physical therapist.
   3. Discuss how patients with vestibular dysfunction may respond to vestibular exercises and how that response may differ from other neurological dysfunctions.
6. Use appropriate action in emergency situations.
   1. Participate in mock emergency situations.