39184 - Physiotherapy in Rheumathology and Geriatrics (RN)

Learning outcomes

At the end of the module, the student has the ability to apply knowledge and understanding about physiotherapy in the geriatric and rheumatological fields, knows the basic principles of the design and execution of interventions aimed at satisfying the needs of the subject with rheumatic and geriatric diseases .

Course contents

CLINICAL REASONING IN THE GERIATRIC AND RHEUMATOLOGICAL AREA:

Definition

The phases that make up the clinical reasoning: anamnestic collection with the relative clinical diagnosis made by the doctor, functional evaluation, identification of therapeutic objectives, rehabilitation intervention planning (project, physiotherapy program), re-evaluation

1.THE FRAGILITY OF THE ELDERLY PATIENT

Problems occurring in the rehabilitation of the geriatric patient: cognitive impairment, comorbidities.

Immobility and immobilization syndrome in the elderly

2. PARKINSON DISEASE

Diagnostic-functional process in physiotherapy:

Assessment of impairment performed through observation, inspection, palpation, mobilization and administration of tests, outcome measures. E.g. Scale: Hoehn and Yahr scale, Unified Parkinson's Disease Rating Scales, Webster ScoreVAS, mini mental test, water test

Assessment of disability through observation, interview with the caregiver, administration of scales (Barthel scale, FIM, Berg Balance test, Tinetti, Time Walking test), outcome measures.

Evaluation of participation in social life through observation, interview with the caregiver, administration of tests, outcome measures

Therapeutic goals

Therapeutic process

Evidence of efficacy available in scientific literature

Strategies and physiotherapy treatment: individual, group neuromotor treatment, occupational therapy)

Main aids and orthoses and training for use

The rehabilitation setting

Care giver training

The new intervention strategies:

functional surgery and botulinum toxin

3. THE ELDERLY FEMALE FRACTURE

Diagnostic-functional process in physiotherapy:

Assessment of impairment performed through observation, inspection, palpation, mobilization and administration of tests, outcome measures.

Fracture types and loading times

Assessment of disability by observation, interview with the caregiver, administration of tests, outcome measures.

Therapeutic goals

Therapeutic process

Evidence of efficacy available in scientific literature

Strategies and physiotherapy treatment

Main aids and orthoses and training for use

The rehabilitation setting

4. THE ELDERLY PERSON WITH A LOWER LIMB

Diagnostic-functional process in physiotherapy:

Assessment of impairment performed through observation, inspection, palpation, mobilization and administration of tests, outcome measures.

Assessment of disability by observation, interview with the caregiver, administration of tests, outcome measures.

Evaluation of participation in social life through observation, interview with the caregiver, administration of tests, outcome measures

Therapeutic goals

Therapeutic process

Evidence of efficacy available in scientific literature

Strategies and physiotherapy treatment: stump care, autonomy training in ADL without prosthesis, rehabilitation of walking with prosthesis

The rehabilitation setting

5. THE RISK OF FALLING IN THE ELDERLY

Diagnostic-functional process in physiotherapy

evaluation via the Berg Balance Scale, Tinetti and Conley scales

Therapeutic process

Physiotherapy strategies and treatment, indications for prophylaxis.

6. THE ROLE OF THE PHYSIOTHERAPIST IN RESIDENTIAL STRUCTURES FOR THE ELDERLY

Hints to regional legislation, main areas of intervention, integration with other professional figures: the PAI (individualized care plans)

The restraints

The patient with dementia: ROT, maintaining ADL skills.

7. INFLAMMATORY TYPE PAIN and MECHANICAL TYPE PAIN

Diagnostic-functional process

differential assessment of rheumatological pain through anamnesis and physical examination and using the appropriate measurement scales (VAS; Short-form McGill pain Assessment questionnaire, painad scale)

Therapeutic process

Strategies and physiotherapy treatment in the different phases and stages of rheumatic diseases

7. Rheumatoid arthritis

Diagnostic-functional process in physiotherapy:

Assessment of impairment performed through observation, inspection, palpation, mobilization and administration of tests, out measures such as (Outcome measures: assessment of pain by interview and administration of VAS scale; assessment of edema by perimetry and sign of the fovea; assessment of thermotact by palpation of the affected area and comparison with the contralateral district; evaluation of joint excursion by joint test, evaluation of muscle strength by muscle test (MRC Medical Research Council)

Assessment of disability by observation, interview with the caregiver, administration of scales (WOMAC, ACR - American College of Rheumatism - Classification criteria for osteoarthritis and rheumatoid arthritis, Arthritis Impact measurement scale), outcome measures.

Evaluation of participation in social life through observation, interview with the caregiver, administration of tests, outcome measures

Therapeutic goals

Therapeutic process

Evidence of efficacy available in scientific literature

Strategies and physiotherapy treatment

Main aids and orthoses and training for use

The rehabilitation setting

8. ANCHYLOSANT SPONDYLITIS

Diagnostic-functional process in physiotherapy:

Assessment of impairment performed through observation, inspection, palpation, mobilization and administration of tests (e.g. finger-to-ground distance (Bending), occiput wall distance, Schober test and BASMI evaluation scales (Bash Ankylosing Spondylitis Metrology Index) (anthropometric index proposed for the evaluation of the motility of the spine and the hip), outcome measures.

Assessment of disability by observation, interview with the caregiver administration of scales (BASFI (Bath Ankylosing Spondylitis functional Index) questionnaire which explores the degree of difficulty encountered in carrying out specific activities of daily life. BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) Bas-G (Bath Ankylosing Spondylitis Patient Global Score), outcome measures.

Evaluation of participation in social life through observation, interview with the caregiver, administration of tests, outcome measures

Therapeutic goals

Therapeutic process

Evidence of efficacy available in scientific literature

Strategies and physiotherapy treatment: individual treatment, self-treatment, group treatment

Main aids and training for use

The rehabilitation setting

9. SPINE AND CERVICALGIA

Diagnostic-functional process in physiotherapy: Assessment of impairment performed through observation, inspection, palpation, mobilization and administration of tests (Lasegue test, Wassermann test, Bob Elvey test),, outcome measures. Disability assessment by observation, interview with the caregiver, administration of scales (BacK Ill, Oswestry Low bach pain disability questionnaire, Roland Morris - Disability questionnaire, SF36) outcome measures.

Evaluation of participation in social life through observation, interview with the caregiver, administration of tests, outcome measures

Therapeutic goals

Therapeutic process

Evidence of efficacy available in scientific literature

Strategies and physiotherapy treatment: individual treatment, self-treatment, group gymnastics, back school, the AFA project. Main orthoses and use training

The rehabilitation setting

10 FIBROMYALGIA

Assessment of impairment performed through observation, inspection, palpation, mobilization and administration of tests, out measures such as.

The tender points

Therapeutic goals

Therapeutic process

Mutidisciplinary approach to fibromyalgia.

1. OSTEOPOROSIS: Diagnostic-functional process and therapeutic process)

2. CONNECTIVITIES: Diagnostic-functional process and therapeutic process)

3. SOFT TISSUE PATHOLOGIES (periarthritis, tendinitis, bursitis, myalgias, fasciitis, fibromyalgia) Diagnostic-functional process and therapeutic process

4. ALGODYSTROPHY: Diagnostic-functional process and therapeutic process

Teaching methods

Frontal lesson, work group, bibliographic research.

Assessment methods

Written test

Teaching tools

Biomedical databases

Office hours

See the website of Amanda Nardi