Learning objectives
The training objectives of the integrated course are to provide students with knowledge on instrumental and manual physiotherapeutic techniques and their biological effects. <br />
The student is also expected to be able to assess the patient’s objective and subjective data in the planning of the physiotherapeutic and nursing care process and be able to identify the most important preventive measures, as regards ergonomics and nursing practices, in patient handling. <br />
Course unit content
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Physical Medicine and Principles of Massotherapy (SSD MED/34) 1 Credit <br />
Prof. Giovanni Soncini <br />
<br />
Physical treatment methods: general introduction <br />
Thermotherapy; Electric currents; Microwaves; Phototherapy; Ultrasound; Laser therapy; Mesotherapy; Magnetotherapy <br />
Vertebral traction <br />
The application of physical treatment methods in orthopaedic diseases: indications and contraindications <br />
Hydrotherapy <br />
<br />
Module “Instrumental Assessment and Innovation in Physical Medicine and Rehabilitation”, Prof. Cosimo Costantino <br />
Massotherapy, Surface electromyography; Baropodometric evaluation; Hyperthermia; T.E.CA.R.therapy; Nd:YAG Laser; Cryo-ultrasound; SEQEX cold therapy. <br />
General assessment of the patient (SSD MED/48) 0.8 Credits <br />
Physiotherapist Annalisa Cavaldonati (PR), Physiotherapist Annarita Molinari (PC) <br />
THEORETICAL SECTION <br />
MOVEMENT / POSTURE connected with the disease; examples <br />
WHAT CAN WE SEE: what to do/how to do it! <br />
It is not really a question of disease; types of patient: what to look for and how to act <br />
WHAT HAPPENS: primary signs /secondary signs <br />
WHAT SHOULD WE LOOK OUT FOR: observation and assessment of the signs <br />
Observing and assessing the patient, the student should be able to evaluate the residual power to be exploited, in accordance with the signs <br />
GENERAL ERGONOMIC CONCEPTS / KNOWLEDGE OF DISABILITY. How to perform workplace actions correctly: Art. 49 of section V, Legislative Decree 626/94 <br />
CORRECT MANOEUVRES for helping the patient maintain the correct postures: in bed/sitting in the wheelchair <br />
CORRECT MANOEUVRES for helping the patient to move: positioning/transfer <br />
SPECIFIC EQUIPMENT AND INTERIORS; their characteristics; how to use them correctly; how to teach the patient and/or parent to use them correctly <br />
OBJECTIVE: independence for the individual <br />
PRACTICAL SECTION <br />
Based on: Seeing / Trying / Reflecting / Reasoning <br />
Workshop (group work: presentation, discussion, hands-on) <br />
Visit to the rehabilitation department: gym, rooms, bathrooms <br />
Visit to an admitted patient <br />
Use of/practice with a wheelchair <br />
How patients prefer to move, and why <br />
Correct position in bed <br />
Transfer <br />
Practice in their presence <br />
Practice with a patient <br />
<br />
Massotherapy Techniques (SSD MED/48) 1,1 Credits <br />
Historical overview and definition of massage. <br />
Preliminary standards: Environment, Materials, Patient, Masseur <br />
Massage characteristics <br />
Fundamental manoeuvres: Effleurage, Friction, Pressure, Kneading, Vibration, Percussion <br />
Examination of the patient (theory and practice): Skin, Muscular tissue, Tendons, Joints, Circulation, Nervous system <br />
Massaging the various regions (theory and practice): Cervical, Dorsal, Lumbar, Lower limbs, Upper limbs, Abdomen, Chest, Face <br />
Introductory Overview of Deep Transverse Friction Massage (Cyriax) <br />
Introductory Overview of Connective Tissue Massage (Dicke) <br />
Introductory Overview of Fascial Manipulation (Stecco) <br />
Introductory Overview of Shiatsu <br />
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<br />
Physical Therapy (SSD MED/48) 0.6 Credits <br />
Ultrasound Therapy and Sonophoresis (practical applications) <br />
Laser therapy (practical applications) <br />
Antalgic electrotherapy (TENS, Interferential) (practical applications) <br />
Electrotherapy (Galvanic Current, Ionophoresis, Diadynamic Current (practical applications) <br />
Electrostimulation: Square, Triangular, Triangular-Exponential waves, Kotz Current, Biphasic square waves (practical applications) <br />
Hyperthermia (practical applications) <br />
TECAR (resistive capacitive energy transfer) therapy (practical applications) <br />
<br />
Objective examination of the patient (SSD MED/48) 0.5 Credits <br />
Physiotherapist Antonella Tambini <br />
Observation: patient’s attitude, normal alignment, symmetries, asymmetries of the trunk and limbs, analysis of body weight distribution during rest and during certain functional activities. Demonstration and student practice workshop. <br />
Palpation of the soft tissue, bone contours, knowledge of the main bone landmarks. Demonstration and student practice workshop. <br />
Active joint range. Demonstration and student practice workshop. <br />
Passive joint range. Demonstration and student practice workshop. <br />
Measuring and recording of active and passive joint range. Demonstration and student practice workshop. <br />
<br />
Elements of Clinical Nursing (SSD MED/45) 1 Credit <br />
D.A.I. Antonella Dovani (PR), D.A.I. Belinda Riboni (PC) <br />
<br />
Role and profile of the nurse (Presentation of Nurse’s professional profile, as per Ministerial Decree 739/94) <br />
Maslow's Hierarchy of Needs <br />
Nursing assistance according to V. Henderson’s conceptual model with regard to Needs, and N. Roper’s model with regard to Living Activities. <br />
The Nursing process. Phases of the Nursing process (assessment, planning, implementation, evaluation) <br />
Nursing information tools: <br />
From the Nursing Record to the Consolidated Record (multiprofessional) <br />
Graphic records, principal written notes: PA- PO- FR- parameters -Diuresis - Temperature - Therapeutic prescription. <br />
Definition of vital parameters: PA - PO (normal values and their main alterations) <br />
Practice in measuring PA - PO parameters. <br />
Hospital Infections: <br />
Main Precautions for Measuring HIs: hand washing (types of washing) <br />
Localisation of the HI. <br />
Urinary tract infections: sources of infection, the most frequent causes, urinary drainage, precautions to be adopted for patients with indwelling bladder catheters and in order to avoid Urinary Tract Infections. <br />
Infections of the lower respiratory tract: causes of onset. Measures for the prevention of hospital-acquired pneumonia (correct use of probes for bronchoaspiration and pneumonia ab ingestis) <br />
Bacteraemia: Intravascular infections ( from C.V.Cs., C.V.P. catheters), sources of infection <br />
Other localisations: staphylococcus skin infections (Burns department) <br />
Other Hospital Risk Areas: <br />
High risk for patients and staff <br />
Moderate risk <br />
Low risk <br />
Classification of medical devices: <br />
Critical, semi-critical and non-critical <br />
Personal protection equipment or barrier clothing: masks, protective glasses and visors, gloves (guidelines for correct use), overgowns, overshoes <br />
Precautions to be adopted : standard precautions (S) + <br />
Additional precautions for airborne diseases <br />
Additional precautions for pulmonary TB <br />
Precautions for contact transmitted diseases <br />
Definitions of: Antisepsis, Antiseptic, Asepsis, Bactericide, Bacteriostatic. Contamination, Detergent, Disinfectant, Disinfection, High-Level-Disinfection, Sterility, Sterilisation, Aseptic Techniques <br />
Disinfectants <br />
Principles for the correct use of disinfectants (Warnings for use) <br />
Principal disinfectants used in the health sector: Glutaraldehyde, Alcohol, Chlorhexidine, Chlorine and its derivatives, Compounds made from Quaternary ammonium , Iodophores, Hydrogent Peroxide <br />
Elimination: <br />
Urinary and Faecal (standard, colour and any alterations to be reported) <br />
The Bladder catheter: <br />
Precautions to be adopted for patients with indwelling catheters during positioning or moving <br />
External urine collectors (Pen Flo, condom) <br />
Gastrointestinal tract: precautions to be adopted for patients with <br />
Nasogastric tubes (e.g. Post-operative, for Enteral Nutrition), <br />
Stomies (care and hygiene) <br />
Brief Observation. The Casualty Department. Handling a patient with a Cardiac Arrest, correct activation of the survival chain, practice of BLS (Basic Life Support) according to I.R.C. guidelines (A-B-C of cardiopulmonary resuscitation) <br />
Bibliography
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<br />
Recommended texts: <br />
COMPENDIO DI MEDICINA RIABILITATIVA - Authors: M.Pizzetti, I. Caruso - Edizioni Mediche Scientifiche Internazionali <br />
Fisioterapia clinica pratica, authors: Cisari, Severini, published by Edi Ermes <br />
Course material <br />
Teaching methods
<br />Classroom lectures<br />Practical activities.<br />Oral test
