Foundations of Rehabilitation Science Case Review

Course Information

• Course Title: Foundations of Rehabilitation Science
• University: Western University
• Days: Mondays
• Time: 6:30-9:30
• Location: FNB 1270

Course Faculty

• Jen Van Bussel (PT)
• JP Raman (PT)
• Josh Campbell (OT)
• David Sindrey (CSD)

Course Structure and Assessments

• Three blocks (each 3 weeks long)
• PT, OT, CSD
• Each block followed by an MCQ (20% each)
• MCQs completed on Brightspace (CSD MCQ scheduled during final exam period)
• Individual Assignment (20%): Case Review
• Group Assignment (20%): Knowledge Translation Video

Individual Assignment: Case Review

• Opportunity to practice reflective writing and demonstrate understanding of clinical roles, scope of practice, common therapeutic approaches of PT, OT, SLP, and Audiology.
• Students demonstrate understanding in application to a clinical case study.
• Tasks:
  • Meet Jay (review case information)
  • Describe the role and scope of practice for each profession.
  • Describe one assessment or treatment each profession may perform for Jay's care needs or to prepare him for discharge home.

Group Assignment: Knowledge Translation Video

• Collaborate in small groups (maximum 5 students)
• Demonstrate their knowledge of a chosen topic from the course.
• Choose any topic learned in the course.
• Summarize knowledge through a short video (<5 minutes)
• Demonstrate time management, teamwork, oral communication skills, and knowledge of course content.
• Develop, practice or refine teaching skills through instructional video technology.
• Email group details to course manager by February 7th.

Rehabilitation Process

• Identify problems and needs
• Assess effects.
• Relate problems to modifiable and limiting factors.
• Define target problems and target mediators, select appropriate measures.
• Plan, implement, and coordinate interventions

Rehabilitation Outcomes/Goals

• Goals vary based on the condition being treated, patient's age, and available resources/psychosocial factors.
• General goals include preventing loss of function, improving/restoring function, slowing the rate of loss of function, compensating for lost function, and maintaining current function.

Rehabilitation Categories

• Rehabilitation medicine
• Therapy
• Assistive technologies

Rehabilitation Medicine

• Improves function through diagnosis and treatment of health conditions, reducing impairments, and preventing/treating complications.
• Specialists include physiatrists, rehabilitation doctors, and physical and rehabilitation specialists, as well as psychiatrists, geriatricians, paediatricians, ophthalmologists, neurosurgeons, and orthopaedic surgeons.

Assistive Technologies

• Any item or equipment/product that improves or maintains functional capabilities of individuals.
• Examples include crutches, prostheses, orthoses, wheelchairs, canes, walkers, hearing aids, cochlear implants, ocular devices, talking books, communication boards, and speech synthesizers.

Therapy

• Concerned with preventing/slowing decline in functioning, restoring and compensating for loss of function, and maintaining current level of functioning.
• Personnel include physical therapists, occupational therapists, orthotists, prosthetists, psychologists, rehabilitation and technical assistants, social workers, and speech and language therapists.
• Therapy measures include training, exercises, compensatory strategies, education, support and counselling, modifications to environment, provision of resources, and assistive technologies.

Physical Therapy (or Physiotherapy)

• Primary care, autonomous, and client-focused health profession dedicated to improving quality of life.
• Focuses on promoting optimal mobility, physical activity, and overall health and wellness.
• Also includes preventing disease, injury, and disability, managing conditions (acute and chronic), activity limitations, and participation restrictions.
• Involved in improving and maintaining optimal functional independence and physical performance, rehabilitating injury, effects of diseases and disability, and educating/planning programs for maintenance/support to prevent re-occurrence/re-injury/functional decline.
• Uses physical agents like mechanical force and movements (bio-mechanics/kinesiology), manual therapy, exercise therapy, electrotherapy, and other modalities (like hydrotherapy).
• Applies examination, diagnosis, physical intervention, and patient education to improving a patient's quality of life.

International Classifications of Functioning, Disability, and Health (ICF)

• WHO framework for measuring health and disability at individual and population levels.
• Complements the 10th revision of ICD.
• Includes health condition, body functions and structure, activities, participation, environmental factors, and personal factors

International Statistical Classification of Diseases and Related Health Problems (ICD-11)

• International standard diagnostic tool for epidemiology, health management, and clinical purposes.
• Global health data, documentation, and aggregation.
• Scientifically up-to-date and multilingual.
• Includes 17000+ categories, 80000+ concepts, 120000+ terms, and >1.6 million clinical terms.

International Classification of Health Interventions (ICHI)

• Being developed to offer a common tool for reporting and analyzing health interventions (statistical purposes).
• Includes interventions carried out by a diverse range of providers (across the full scope of health systems).
• Covers diagnostic, medical, surgical, mental health, primary care, allied health, and functioning support

Scope of Practice

• RHPA: The Regulated Health Professions Act, 1991
  • Governing framework for health professions in Ontario
  • Amended in 2009
• RHPA Purpose: To better protect and serve public interest, be more open/accountable system of self-governance, provide a modern framework for health professionals, provide consumers with freedoms of choice, provide mechanisms to improve care quality.
• RHPA Features: Scope of practice statement, Controlled acts (procedures/activities risky if not performed by qualified practitioner), Health regulatory colleges, Health Professions Regulatory Advisory Council, Health Professions Appeal and Review Board
• List of Regulated Health Professions (29): Audiology, Chiropody, Chiropractic, Dental Hygiene, Dental Technology, Dentistry, Denturism, Dietetics, Homeopathy, Kinesiology, Massage Therapy, Medical Lab Technology, Medical Radiation Technology, Midwifery, Naturopathy, Nursing, Occupational Therapy, Opticians, Optometry, Pharmacy, Pharmacy Technicians, Physicians, Physiotherapy, Podiatrists, Psychology, Psychotherapy, Respiratory Therapy, Speech-Language Pathologists, and Traditional Chinese Medicine and Acupuncture
• Physiotherapy Act (1991): Relevant aspects for discussion: Authorized (Controlled) acts, Scope of practice for PTs, rights/responsibilities of regulatory college

PT Scope of Practice (Details)

• Musculoskeletal system, expertise in treatment of musculoskeletal (muscle and joint) conditions, diagnosis, treatment, and prevention
• Neuromuscular system, assessment and treatment of pain/dysfunction associated with conditions (low back pain, osteoporosis etc)
• Cardiorespiratory system, prevention, rehabilitation, and compensation of conditions affecting heart/lungs (such as shortness of breath, persistent cough), increased work of breathing

Physiotherapy Expertise

• Employ a client-centered approach
• Ensure physical and emotional safety of client
• Conduct client assessment
• Diagnose and prognosticate
• Develop, implement, monitor, and evaluate intervention plan
• Complete or transition care
• Plan, deliver, and evaluate programs

Communication Skills

• Effective use of oral and non-verbal communication
• Effective written communication
• Adapt communication to different contexts
• Effective use of communication tools and technologies

Collaboration

• Promote the integrated approach to client services
• Facilitate collaborative relationships and contribute to effective teamwork
• Contribute to conflict resolution

Management

• Support organizational excellence
• Utilize resources efficiently and effectively
• Ensure a safe practice environment
• Engage in quality improvement activities
• Supervise others
• Manage practice information safely and effectively

Leadership

• Champion the health needs of clients
• Promote innovations in healthcare
• Contribute to leadership in the profession

Scholarship

• Use evidence-informed approach in practice
• Engage in scholarly inquiry
• Integrate self-reflection and external feedback to improve personal practice
• Maintain currency with developments relevant to area of practice
• Contribute to learning of others

Professionalism

• Comply with legal and regulatory requirements
• Behave ethically
• Embrace social responsibility as health professional
• Act with professional integrity
• Maintain personal wellness consistent with the needs of practice

Physiotherapy Code of Ethics

• Physiotherapists are responsible for conducting themselves ethically in all professional practice situations.
• Ethical values for physiotherapists in Ontario spell out the acronym R.E.A.C.H (Respect, Excellence, Autonomy and Well being, Communication, Collaboration and Advocacy, Honesty and Integrity).
• These values should be applied in professional practice, especially in the patient-physiotherapist relationship and when facing ethical dilemmas.
• While a consistent process is followed, decisions and outcomes can vary and different opinions can exist.

Employment Outlook

• Number of PTs (as of 2023): 29,153 (increase from 2022)
• PTs employed in physiotherapy: 27,964
• Employment in other professions but seeking employment in PT: 79
• Employed in other professions but not seeking employment in PT: 214
• Unemployed but seeking employment: 170
• Unemployed and not seeking employment: 65
• Job postings for physiotherapists (as of Dec 2024): 24 on CPA website, 395 on Govt job bank.
• Importance of tailoring resume, using education and experience help at Western, and volunteering

Next Week

• Licensure and registration requirements
• Areas of practice
• Therapeutic interventions
• Outcome measures
• Charting approaches

Additional Notes

• The pages contain tables and pie charts (visual information) providing information on PTs by province, by age, gender, and employment forecast. Various institutions, acts, and organizations (WHO, ICD, ICF, etc.) are mentioned.
• The information covers the foundations of rehabilitation science, including the historical context and current employment status of the profession.

This quiz focuses on the Case Review assignment for the Foundations of Rehabilitation Science course. It emphasizes reflective writing and understanding the clinical roles of PT, OT, SLP, and Audiology through a clinical case study. Students will demonstrate their grasp of therapeutic approaches and professional scopes of practice.