Outline

Overview

This unit of study will include three modules: advanced musculoskeletal, neurological and cardiopulmonary modules incorporating advanced clinical reasoning addressing complex patient-centred healthcare. The modules will enable students to develop their skills in analysing and planning management of patients with complex musculoskeletal, neurological and cardiopulmonary problems. The musculoskeletal module will include advanced manual therapy assessment and treatment including high velocity manipulative techniques. The neurological module will focus on management of spinal cord injuries. Students are required to source and integrate material from core areas of musculoskeletal, cardiopulmonary, and neurological physiotherapy as well as background sciences. Specific emphasis will be placed on fostering development of independent and eLearning skills as well as development of critical analysis skills to improve healthcare provision. Students will be expected to evaluate the scientific basis and ethical, legal and practical implications of physiotherapy interventions within the context of interprofessional team care and global health priorities.

Unit details and rules

Unit code	PHTY5208
Academic unit	Movement Sciences
Credit points	6
Prohibitions ?	None
Prerequisites ?	PHTY5206 and PHTY5197 and PHTY5201
Corequisites ?	None
Assumed knowledge ?	None
Available to study abroad and exchange students	No

Teaching staff

Coordinator	Justin Sullivan, justin.sullivan@sydney.edu.au

Type	Description	Weight	Due	Length
Final exam (Record+)	Musculoskeletal and Neurological Assessment Short answer and MCQ	55%	Formal exam period Due date: 02 Dec 2021 at 17:00	2 hours
Outcomes assessed:
Skills-based evaluation	Musculoskeletal assessment Assessment of clinical problem solving and use of advanced clinical skills	20%	Week 08	10 minutes
Outcomes assessed:
Assignment	Cardiopulmonary assessment Online case study	25%	Week 13 Due date: 08 Nov 2021 at 09:00	Friday 5pm to Monday 5pm
Outcomes assessed:
= hurdle task ? = group assignment ? = Type B final exam ?

Assessment summary

Musculoskeletal assessment: Students must demonstrate performance of selected practical techniques.
Cardiopulmonary assessment: Students will work in pairs to submit an assignment on-line addressing a question related to whether they will perform an intervention for a complex case. Literature will also be used to justify the decision made.
Musculoskeletal and Neurological Assessment: Written Exam

Detailed information for each assessment can be found on Canvas.

Important Note: All 3 modules must be passed to pass this unit ie the Musculoskeletal Practical Exam plus the Musculoskeletal section of the written exam, the Cardiopulmonary Assessment and the Neurological section of the written exam
Also note that the weeks each assessment is due is described relative to the weeks within each 7-week intensive session.

Assessment criteria

The University awards common result grades, set out in the Coursework Policy 2014 (Schedule 1).

As a general guide, a high distinction indicates work of an exceptional standard, a distinction a very high standard, a credit a good standard, and a pass an acceptable standard.

Result name	Mark range	Description
High distinction	85 - 100
Distinction	75 - 84
Credit	65 - 74
Pass	50 - 64
Fail	0 - 49	When you don’t meet the learning outcomes of the unit to a satisfactory standard.

For more information see sydney.edu.au/students/guide-to-grades.

For more information see guide to grades.

Late submission

In accordance with University policy, these penalties apply when written work is submitted after 11:59pm on the due date:

Deduction of 5% of the maximum mark for each calendar day after the due date.
After ten calendar days late, a mark of zero will be awarded.

Academic integrity

The Current Student website provides information on academic integrity and the resources available to all students. The University expects students and staff to act ethically and honestly and will treat all allegations of academic integrity breaches seriously.

We use similarity detection software to detect potential instances of plagiarism or other forms of academic integrity breach. If such matches indicate evidence of plagiarism or other forms of academic integrity breaches, your teacher is required to report your work for further investigation.

You may only use artificial intelligence and writing assistance tools in assessment tasks if you are permitted to by your unit coordinator, and if you do use them, you must also acknowledge this in your work, either in a footnote or an acknowledgement section.

Studiosity is permitted for postgraduate units unless otherwise indicated by the unit coordinator. The use of this service must be acknowledged in your submission.

Learning support

Simple extensions

If you encounter a problem submitting your work on time, you may be able to apply for an extension of five calendar days through a simple extension.  The application process will be different depending on the type of assessment and extensions cannot be granted for some assessment types like exams.

Special consideration

If exceptional circumstances mean you can’t complete an assessment, you need consideration for a longer period of time, or if you have essential commitments which impact your performance in an assessment, you may be eligible for special consideration or special arrangements.

Special consideration applications will not be affected by a simple extension application.

Using AI responsibly

Co-created with students, AI in Education includes lots of helpful examples of how students use generative AI tools to support their learning. It explains how generative AI works, the different tools available and how to use them responsibly and productively.

Weekly schedule

WK	Topic	Learning activity
Week 01	1. Musculoskeletal: manipulation indications and contra-indications and effects	Online class (1 hr)
	2. Musculoskeletal: clinical application of manipulation	Online class (1 hr)
	5. Musculoskeletal: Introduction to principles of MDT 6. MS: Incorporating MDT into musculoskeletal practice	Online class (2 hr)
	Application of MDT: case study	Online class (2 hr)
Week 02	Musculoskeletal: Cervical Spine and complex case Differentiation of Headache/Dizziness	Online class (4 hr)
Week 02	Musculoskeletal: Complex case: upper limb	Online class (2 hr)
Week 03	1. Cardiopulmonary: advanced clinical reasoning; 2. Cardiopulmonary impairment: analysis of gas movement problems in the cystic fibrosis; 3. Cardiopulmonary impairment: analysis of secretion movement, gas movement movement, and respiratory load in cystic fibrosis; 4. Cardiopulmonary: evidence-based interventions to improve gas movement problems	Online class (4 hr)
Week 03	2. Cardiopulmonary: techniques to improve secretion movement	Tutorial (2 hr)
Week 04	1. Cardiopulmonary: ventilation perfusion matching; 2. Cardiopulmonary: exercise prescription for cystic fibrosis; 3. Cardiopulmonary: sleep disordered breathing; 4. Professional practice and social issues in cystic fibrosis	Online class (4 hr)
Week 04	Cardiopulmonary: case conference and debate	Tutorial (2 hr)
Week 05	Neurological physiotherapy: physiotherapy management of people with spinal cord injury	Online class (4 hr)
Week 05	Neurological physiotherapy: impairment and activity in spinal cord injury;	Tutorial (2 hr)
Week 06	Musculoskeletal: screening for manipulation and manipulation performance TBC	Tutorial (2 hr)
	1. Neurological physiotherapy: living with spinal cord injury; 2. Neurological physiotherapy: management of spinal cord injury	Online class (3 hr)
	1. Neurological physiotherapy: impairment and activity in spinal cord injury;	Tutorial (2 hr)
Week 07	3. Musculoskeletal: Complex regional pain syndrome (CRPS) 4. Musculoskeletal: CRPS case study	Online class (2 hr)
	1. Neurological physiotherapy: incomplete spinal cord injury case study and wheelchair mobility in spinal cord injury	Tutorial (2 hr)
	24 and 25. Musculoskeletal: Complex clinical case: Differentiation lumbar spine, hip and pelvis	Online class (2 hr)
	Musculoskeletal: Using evidence to guide practice. Key concepts and Q&A discussion.	Online class (2 hr)
	Musculoskeletal: incorporating cervical spine clinical skills into practice TBC	Tutorial (2 hr)

Attendance and class requirements

Attendance: There are 25 hours of lectures and 22 hours of supervised tutorials across the 7 weeks. Students are expected to attend a minimum of 80% of tutorials for a unit of study (including 80% of the Musculoskeletal tutorials), unless granted exemption by the dean, head of school, or professor most concerned. The dean, head of school, or professor most concerned may determine that a student fails a unit of study because of inadequate tutorial attendance. Alternatively, at their discretion, they may set additional assessment items where attendance is lower than 80%. Students are expected to attend all lectures in this unit of study. Lecture recordings will be made available where possible to assist with revision and study but should not be considered a substitute for physically attending the lecture.

Study commitment

Typically, there is a minimum expectation of 1.5-2 hours of student effort per week per credit point for units of study offered over a full semester. For a 6 credit point unit, this equates to roughly 120-150 hours of student effort in total.

Required readings

Recommended textbook for neurological module:

Harvey L (2008) Management of Spinal Cord Injuries. Edinburgh; New York: Butterworth-Heinemann.

Recommended reading for Musculoskeletal module

Maitland GD, Hengeveld E, Banks K, English K. Maitland’s Vertebral Manipulation. Seventh Edition. London: Elsevier 2005.
Monaghan M. Spinal Manipulation- A manual for physiotherapists. The Copy Press Ltd, Nelson, New Zealand. 2001.
Jull G, Sterling M, Falla D, Treleaven J, O’Leary S. Whiplash Headache and neck pain, research directions for physical therapists. © 2008 Elsevier.

Learning outcomes

Learning outcomes are what students know, understand and are able to do on completion of a unit of study. They are aligned with the University's graduate qualities and are assessed as part of the curriculum.

At the completion of this unit, you should be able to:

LO1. Safely and competently perform advanced manual therapy techniques including selected high velocity manipulation procedures.
LO2. 2. Demonstrate advanced clinical reasoning for patients with complex problems by being able to: a. analyse the nature of the patient’s problems and the pathological mechanisms proposed for the problems. b. discuss and evaluate the effects of interactions between the pathological mechanisms and predict likely consequences c. propose intervention(s) for the patient’s problems. d. discuss the theoretical rationale(s) for intervention(s) and evaluate evidence for their effectiveness. e. identify how interventions would need to be modified in light of the patient’s multisystem problems and provide rationale for the modification(s). f. discuss how and when effects of intervention would be evaluated, the rationale underlying the evaluation and how results of evaluation might then modify intervention. g. identify and justify other health care services to which the patient should be referred.

Graduate qualities

The graduate qualities are the qualities and skills that all University of Sydney graduates must demonstrate on successful completion of an award course. As a future Sydney graduate, the set of qualities have been designed to equip you for the contemporary world.

GQ1	Depth of disciplinary expertise Deep disciplinary expertise is the ability to integrate and rigorously apply knowledge, understanding and skills of a recognised discipline defined by scholarly activity, as well as familiarity with evolving practice of the discipline.
GQ2	Critical thinking and problem solving Critical thinking and problem solving are the questioning of ideas, evidence and assumptions in order to propose and evaluate hypotheses or alternative arguments before formulating a conclusion or a solution to an identified problem.
GQ3	Oral and written communication Effective communication, in both oral and written form, is the clear exchange of meaning in a manner that is appropriate to audience and context.
GQ4	Information and digital literacy Information and digital literacy is the ability to locate, interpret, evaluate, manage, adapt, integrate, create and convey information using appropriate resources, tools and strategies.
GQ5	Inventiveness Generating novel ideas and solutions.
GQ6	Cultural competence Cultural Competence is the ability to actively, ethically, respectfully, and successfully engage across and between cultures. In the Australian context, this includes and celebrates Aboriginal and Torres Strait Islander cultures, knowledge systems, and a mature understanding of contemporary issues.
GQ7	Interdisciplinary effectiveness Interdisciplinary effectiveness is the integration and synthesis of multiple viewpoints and practices, working effectively across disciplinary boundaries.
GQ8	Integrated professional, ethical, and personal identity An integrated professional, ethical and personal identity is understanding the interaction between one’s personal and professional selves in an ethical context.
GQ9	Influence Engaging others in a process, idea or vision.

Outcome map

Learning outcomes	Graduate qualities
Learning outcomes

Alignment with Competency standards

Outcomes	Competency standards
	Physiotherapy Practice Threshold Statements - 1.1. plan and implement an efficient, effective, culturally responsive and client-centred physiotherapy assessment 1.2. involve the client and relevant others in the planning and implementation of safe and effective physiotherapy using evidence-based practice to inform decision-making 1.3. review the continuation of physiotherapy and facilitate the client’s optimal participation in their everyday life 3.2. record and effectively communicate physiotherapy assessment findings, outcomes and decisions 8.A. knowledge of relevant anatomy, physiology, pathology, other biomedical sciences relevant to human health and function, and psychosocial and other determinants of health encompassing cardiorespiratory, musculoskeletal, neurological and other body systems within the context of physiotherapy and best available research evidence 8.B. knowledge and understanding of theoretical concepts and principles relevant to physiotherapy practice including evidence-based practice
	Physiotherapy Practice Threshold Statements - 1. Physiotherapy practitioner 1.1. plan and implement an efficient, effective, culturally responsive and client-centred physiotherapy assessment 1.2. involve the client and relevant others in the planning and implementation of safe and effective physiotherapy using evidence-based practice to inform decision-making 1.3. review the continuation of physiotherapy and facilitate the client’s optimal participation in their everyday life 3.2. record and effectively communicate physiotherapy assessment findings, outcomes and decisions 8.A. knowledge of relevant anatomy, physiology, pathology, other biomedical sciences relevant to human health and function, and psychosocial and other determinants of health encompassing cardiorespiratory, musculoskeletal, neurological and other body systems within the context of physiotherapy and best available research evidence 8.B. knowledge and understanding of theoretical concepts and principles relevant to physiotherapy practice including evidence-based practice 8.C. knowledge and understanding of theoretical concepts and principles relevant to physiotherapy practice with clients across the lifespan, from birth to end of life care, who present with one or more problems such as pain and/or impairment or dysfunction contributing to impairment, activity limitations and participation restriction 8.D. knowledge and understanding of theoretical concepts and principles relevant to physiotherapy practice across acute, rehabilitation and community practice in a range of environments and settings 8.E. competence to practise as a physiotherapist autonomously as well as a member of an interprofessional team in relevant clinical situations 8.F. knowledge and understanding of theoretical concepts and principles relevant to physiotherapy practice in health promotion and facilitation of client self-management strategies to enhance their health and well-being

Physiotherapy Practice Threshold Statements -

Competency code	Taught, Practiced or Assessed	Competency standard
1.1		plan and implement an efficient, effective, culturally responsive and client-centred physiotherapy assessment
1.2		involve the client and relevant others in the planning and implementation of safe and effective physiotherapy using evidence-based practice to inform decision-making
1.3		review the continuation of physiotherapy and facilitate the client’s optimal participation in their everyday life
2.1		comply with legal, professional, ethical and other relevant standards, codes and guidelines
2.2		make and act on informed and appropriate decisions about acceptable professional and ethical behaviours
3.1		use clear, accurate, sensitive and effective communication to support the development of trust and rapport in professional relationships with the client and relevant others
3.2		record and effectively communicate physiotherapy assessment findings, outcomes and decisions
4.1		assess their practice against relevant professional benchmarks and take action to continually improve their practice
4.3		efficiently consume and effectively apply research and commit to practice informed by best available research evidence and new knowledge
4.5		recognise situations that are outside their scope of expertise or competence and take appropriate and timely action
5.1		engage in an inclusive, collaborative, consultative, culturally responsive and client-centred model of practice
5.2		engage in safe, effective and collaborative interprofessional practice
6.1		use education to empower themselves and provide knowledge to themselves and others.
7.1		organise and prioritise their workload and resources to provide safe, effective and efficient physiotherapy autonomously and, where relevant, as a team member
8.A		knowledge of relevant anatomy, physiology, pathology, other biomedical sciences relevant to human health and function, and psychosocial and other determinants of health encompassing cardiorespiratory, musculoskeletal, neurological and other body systems within the context of physiotherapy and best available research evidence
8.B		knowledge and understanding of theoretical concepts and principles relevant to physiotherapy practice including evidence-based practice
8.C		knowledge and understanding of theoretical concepts and principles relevant to physiotherapy practice with clients across the lifespan, from birth to end of life care, who present with one or more problems such as pain and/or impairment or dysfunction contributing to impairment, activity limitations and participation restriction
8.D		knowledge and understanding of theoretical concepts and principles relevant to physiotherapy practice across acute, rehabilitation and community practice in a range of environments and settings
8.E		competence to practise as a physiotherapist autonomously as well as a member of an interprofessional team in relevant clinical situations
8.F		knowledge and understanding of theoretical concepts and principles relevant to physiotherapy practice in health promotion and facilitation of client self-management strategies to enhance their health and well-being

Responding to student feedback

This section outlines changes made to this unit following staff and student reviews.

In general the students liked the number of practical classes and interactive case study lectures to explore clinical reasoning. Students preferred face to face lectures to prerecorded lectures. Unfortunately, due to COVID-19 all of the lectures will be online but where they are interactive case studies we will present them live online to facilitate interaction. All of the musculoskeletal and neurological tutorials will be face to face.

Additional information

Weekly schedule

Please note that the weeks listed for each learning activity and for the assessment are described in the weeks of the 7-week intensive (ie, week 1 = week -1 of semester for Sem 2a cohort and week 9 for Intensive November cohort).

Musculoskeletal Module

This unit of study aims to advance and consolidate students’ abilities to apply evidence-based practice to the assessment, differentiation, and management of various musculoskeletal conditions. Using a variety of case studies, students will study practical and theoretical aspects of musculoskeletal physiotherapy to encourage integration of selected manual therapy and exercise based interventions into the overall management of patients with complex problems. Students will be encouraged to consider the interaction between diagnosis and mechanisms of treatment effects.

Students will also be introduced to selected manipulative procedures for the spine and the use of such techniques in the overall management of mechanical pain in the spine. Other practical content includes upper cervical assessment and treatment techniques. Thus, students will practice and evaluate a range of strategies to decrease pain and impairments, and to improve function in patients with acute, sub-acute and chronic pain of musculoskeletal origin.

Work, health and safety

IMPORTANT SAFETY INFORMATION

The demonstration and practice of spinal manipulation forms part of the musculoskeletal component of this unit of study.

Manipulation involves the application of a high velocity, low amplitude thrust to selected joints and tissues, and can be associated with an audible click. These techniques are thought to increase range of movement and decrease pain in patients complaining of symptoms of spinal origin. Therefore, the ability to perform these manipulative techniques is highly desirable for physiotherapists treating patients with musculoskeletal disorders. Participation in these manipulation sessions will equip you with a range of advanced skills that will be useful in providing effective treatment for patients with lumbar, thoracic spine and ankle disorders.

Complications following manipulation are rare but potentially serious. Estimates of incidence ranging from approximately 1 in 20,000 to 1 in 500,000 are frequently cited and most complications involve manipulation of the cervical spine. In this subject we will be performing manipulation to the thoracic and lumbar spine. If you have a medical condition which might exclude you from being manipulated, for example a history of neurological signs or symptoms, or significant back pain, you should discuss this with your tutor, and if necessary, seek appropriate medical advice.

You must complete the student screening questionnaire (available online in Canvas ) prior to being the ‘patient’ for manipulation. Please complete this before your first tutorial class in week 1.

Some students may experience discomfort following repeated manipulation. If this does not resolve within 24-48 hours you should contact your tutor. If you have more serious symptoms, please contact the tutor immediately or your family doctor as soon as possible.

Practice of manipulative techniques is essential. However, you are advised not to practice these techniques until they have been demonstrated in class. Furthermore, you are advised to only practice the application of the high velocity manipulative thrust on fellow students under your tutor’s supervision. All other aspects of examinable techniques can be performed without tutor supervision.

Disclaimer

The University reserves the right to amend units of study or no longer offer certain units, including where there are low enrolment numbers.

To help you understand common terms that we use at the University, we offer an online glossary.

Current students

Overview

Overview

Unit details and rules

Teaching staff

Assessment

Assessment

Assessment summary

Assessment criteria

Late submission

Academic integrity

Learning support

Learning support

Simple extensions

Special consideration

Using AI responsibly

Weekly schedule

Weekly schedule

Attendance and class requirements

Study commitment

Required readings

Learning outcomes

Learning outcomes

Graduate qualities

Outcome map

Alignment with Competency standards

Responding to student feedback

Responding to student feedback

Additional information

Additional information

Work, health and safety

Disclaimer

On this page

Useful links

Media

Student links

About us

Connect

Current students

PHTY5208: Advanced Physiotherapy Practice

Intensive November, 2021 [Normal day] - Camperdown/Darlington, Sydney

Overview

Overview

Unit details and rules

Teaching staff

Assessment

Assessment

Assessment summary

Assessment criteria

Late submission

Academic integrity

Learning support

Learning support

Simple extensions

Special consideration

Using AI responsibly

Weekly schedule

Weekly schedule

Attendance and class requirements

Study commitment

Required readings

Learning outcomes

Learning outcomes

Graduate qualities

Outcome map

Alignment with Competency standards

Responding to student feedback

Responding to student feedback

Additional information

Additional information

Work, health and safety

Disclaimer

On this page

Useful links

Media

Student links

About us

Connect