Foundations of Rehabilitation Science Quiz

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, MSc, FCAMPT)
• JP Raman (PT, PhD)
• Josh Campbell (OT)
• David Sindrey (CSD)

Course Structure and Assessments

• Three blocks (each 3 weeks long) for PT, OT, and CSD
• Each block followed by a multiple-choice quiz (20% each)
• Quizzes completed on Brightspace
• CSD multiple-choice quiz scheduled during final exam period
• Individual Assignment (Case Review) (20%)
• Group Assignment (Knowledge Translation Video) (20%)
• Additional assignments/assessments are not detailed, but exist

Individual Assignment (Case Review) Details

• Reflect on clinical roles, scope of practice, therapeutic approaches
• PT, OT, SLP, and Audiology perspectives
• Clinical case study application required
• The case study is of a client named "Jay"

Individual Assignment (Case Review) Tasks

• Review Jay's case information
• Describe role/scope of practice for each profession (PT, OT, SLP. Audiology)
• Describe one assessment/treatment for Jay's care needs/discharge

Group Assignment (Knowledge Translation Video) Details

• Small groups (maximum 5 students)
• Choosing a topic from the course
• Creating a short (under 5 minutes) video summarizing knowledge
• Demonstrating time management, teamwork, and oral communication skills
• Developing/practicing/refining teaching skills through instructional video technology
• Submission deadline: February 7th

Group Assignment (Knowledge Translation Video) Additional Details

• Form a group of 5 students maximum
• Email group details to course manager by February 7th
• Choose a discipline (PT, OT, CSD) and a topic
• Complete a short (<5 minutes) video instructional video
• Topic selection examples are available in Brightspace

Learning Objectives

• Foundational definitions and frameworks in rehabilitation sciences
• Introduction to the ICD, ICF model of disability from a physical therapy perspective
• Scope of physical therapy practice
• Evaluation of essential physical therapist competencies
• Review of the physiotherapy code of ethics
• Discussion of the current employment market for physical therapists
• The learning objectives are detailed

Health - Definition

• Health defined by WHO as "a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity."

Rehabilitation - Definition

• Rehabilitation is a set of measures assisting individuals with disabilities to achieve and maintain optimal functioning within their environments.

Rehabilitation Process

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

Rehabilitation Outcomes/Goals

• Goals dependent on various factors (condition, age, psychosocial factors)
• General goals include:
  • Prevention of loss of function
  • Improvement/restoration of function
  • Slowing the rate of loss of function
  • Compensation for lost function
  • Maintenance of current function

Rehabilitation Categories

• Rehabilitation medicine
• Therapy
• Assistive technologies

Rehabilitation Medicine

• Improves function through diagnosis/treatment of health conditions, reduction of impairments, and preventing/treating complications
• Doctors specializing in Medical Rehabilitation are known as physiatrists, rehabilitation doctors or physical and rehabilitation specialists
• Other specialists involved include psychiatrists, geriatricians, paediatricians, ophthalmologists, neurosurgeons, and orthopaedic surgeons

Assistive Technologies

• Any item or equipment improving or maintaining 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

• Focuses on preventing/slowing decline in functioning, restoring/compensating for loss of function, and maintaining current functioning levels
• Personnel in therapy include physical therapists, occupational therapists, orthotists, prosthetists, psychologists, rehabilitation/technical assistants, social workers, and speech-language therapists

Therapy Measures

• Training, exercises and compensatory strategies
• Education
• Support and counselling
• Modifications to environment
• Provision of resources and assistive technologies

Physical Therapy/Physiotherapy

• Primary care, autonomous, client-focused health profession dedicated to improving quality of life, promoting mobility, physical activity, and overall health and wellness by preventing disease, injury, and disability while managing acute/chronic conditions, activity limitations and participation.
• Improving and maintaining optimal functional independence and physical performance
• Rehabilitating injuries/effects of diseases/disabilities with therapeutic exercise programs and support.

Physical Therapy - What do we use?

• Physical agents like mechanical force and movements (bio-mechanics or kinesiology)
• Manual therapy
• Exercise therapy
• Electrotherapy
• Other modalities (like hydrotherapy)

Physical Therapy - How do we apply?

• Examination
• Diagnosis
• Physical intervention
• Patient education

ICF

• The World Health Organization's Family of International Classifications (FIC) provides a common language for health information globally
• Reference classifications are important in understanding the framework of rehabilitation
• International Classifications (ICF) complements the International Statistical Classification of Diseases and Related Health Problems (ICD), which provides information on diagnoses and health conditions, but not on functional status.
• ICF includes a list of environmental factors as the functioning and disability of an individual occurs within a context.

Model of ICF

• Health condition
• Body functions and structures
• Activity
• Participation
• Environmental factors
• Personal factors as contextual factors

ICF Explanation with Example

• The ICF model is explained with an example of osteoarthritis or rheumatoid arthritis (degenerative joint conditions)

Health Condition

• An umbrella term for disease, disorder, injury, trauma, or other circumstances (like aging, stress, congenital anomaly, or genetic predisposition).
• Includes information on pathogenesis and/or etiology

Body Functions and Structures

• Physiological functions of body systems – e.g. pain, range of motion, muscle weakness, coordination and sleep disturbances
• Anatomical parts like organs, limbs, and components

Activities

• Execution of tasks or actions
• Daily living activities (ADLs) – e.g.. washing, dressing, walking, handling objects

Participation

• Involvement in everyday situations and society
• e.g. vocational performance, family relations, recreation/leisure, and social life

Environmental Factors

• Workplace
• Housing
• Transportation facilities
• Family and friends
• Health services and insurance
• Societal attitudes

Personal Factors

• Health behavior
• Coping strategies
• Multi-morbidity
• Age and gender
• Contextual factors representing the entire background of a person's life and living situation – physical, social, and attitudinal environmental factors external to the person that can serve as facilitators or barriers to functioning

ICHI

• The International Classification of Health Interventions (ICHI) is being developed to provide a common tool for reporting and analysing health interventions for statistical purposes
• A health intervention is an act performed for/with/on behalf of a person or population to assess, improve, maintain, promote or modify health, functioning, or health conditions
• Covers interventions across the full scope of health systems, including those in diagnostic, medical, surgical, mental health, primary care, allied health, functioning support, rehabilitation, traditional medicine, and public health

Scope of Practice (RHPA)

• The Regulated Health Professions Act, 1991 (RHPA) and its associated acts, govern the regulatory framework for health professions in Ontario.

RHPA Purpose

• Better protect and serve public interest
• More open and accountable system of self-governance
• More modern framework for the work of health professionals
• Provide consumers with choice
• Provide mechanisms to improve quality of care

RHPA Features

• Scope of practice
• Controlled acts
• Health regulatory colleges
• Health Professions Regulatory Advisory Council
• Health Professions Appeal and Review Board

29 Regulated Health Professions

• Specific professions regulated (e.g., Audiology, Chiropody, Chiropractic, Dental Hygiene, Dentistry, Denturism, Dietetics, Homeopathy, Kinesiology, Massage Therapy, Medical Laboratory Technology, Medical Radiation Technology, Midwifery...) - 29 in total

Physiotherapy Act and Scope of Practice

• Details on authorised (controlled) acts, scope of practice, and rights/responsibilities of the regulatory colleges

Authorised Acts for Physiotherapists

• Tracheal suctioning
• Spinal manipulation
• Acupuncture (including dry needling)
• Wound treatment below the dermis
• Pelvic internal exams
• Administering substances by inhalation

Scope of Practice for Physiotherapists

• Assessment of musculoskeletal, neuromuscular, and cardiorespiratory systems
• Diagnosis of diseases/disorders associated with physical dysfunction, injury, or pain
• Treatment, rehabilitation, and prevention/relief of physical dysfunction, injury, or pain using various therapies, interventions, and approaches, including development, maintain, rehabilitation and augmenting function while promoting mobility.

PT Scope of Practice (Musculoskeletal, Neuromuscular, Cardiorespiratory)

• Musculoskeletal expertise in treating muscle and joint conditions, diagnosing/treating/preventing muscle/joint problems
• Neuromuscular assessment/treatment of pain/dysfunction related to diverse conditions: low back pain, osteoporosis, arthritis, fibromyalgia, sciatica, scoliosis, heart disease, Parkinson's disease, fractures, head/spinal injuries, multiple sclerosis, and cerebral palsy.
• Cardiorespiratory specializes in prevention/rehabilitation/compensation of heart/lung conditions such as shortness of breath, persistent cough, increased work of breathing, or reduced ability to exercise

Canadian Physiotherapy Association (CPA) Practice Divisions

• 14 different practice divisions (acupuncture, animal rehab, cardiorespiratory, global health, leadership, neurosciences, oncology, orthopedic, pediatrics, pain science, private practice, seniors health, sports, and women's health; specified)

Regulatory College of Physiotherapists (Ontario)

• Regulates physical therapists
• Aims for ongoing practice improvement and public interest

Essential Competencies for Physical Therapists

• Skills required in PT practice, including psychotherapy expertise, communication, collaboration, management, leadership, scholarship, and professionalism

Physiotherapy Expertise

• Client-centered approach, client safety, client assessment, diagnosis/prognosis, intervention plan development/implementation/monitor/evaluation, and transition/complete care, plan/deliver/evaluate programs

Communication

• Effective oral/nonverbal and written communication, adapted to context and using tools/technologies effectively

Collaboration

• Promote an integrated approach to client services, facilitate collaborative relationships, contribute to effective teamwork, and resolve conflicts

Management

• Supports organizational excellence, utilizes resources efficiently and effectively, ensures a safe practice environment, engages in quality improvement activities, supervises others, and manages practice information safely and effectively

Leadership

• Champions the needs of clients, promotes innovation in healthcare, contributes to leadership in the profession

Scholarship

• Evidence-informed practice
• Scholarly inquiry, integrates self-reflection/external feedback to improve personal practice
• Maintains currency with developments relevant to practice area
• Contributes to the learning of others

Professionalism

• Comply with legal/regulatory requirements, behave ethically, embrace social responsibility as a health professional, act with professional integrity, and maintain personal wellness consistent with practice.

Physiotherapy Code of Ethics

• Physiotherapists are responsible for ethical conduct in professional practice situations.
• Ethical values (R.E.A.C.H.)
  • Respect for differing individual needs and rights to privacy, confidentiality, dignity and treatment.
  • Excellence in professional practice
  • Autonomy and well-being, guided by a concern for the patient's well-being.
  • Communication, collaboration, and advocacy to achieve best outcomes.
  • Honesty and integrity in delivering high-quality, safe, and professional services.

Employment Outlook

• Number of PTs (as of 2023)

• PTs employed in physiotherapy

• Employed in other professions but seeking PT employment

• Employed in other professions but not seeking PT employment

• Unemployed but seeking PT employment

• Unemployed but not seeking PT employment

• Number of PTs per province in 2023 - specified

• Average age of PTs in Canada in 2023 - specified

• Number of PTs by gender - specified

• Employment forecast - job postings for 2024

  • 24 job postings on CPA website (https://physiotherapy.ca/career-centre/).
  • 395 job listings on Govt of Canada Job bank via (https://on.jobbank.gc.ca/jobsearch/jobsearch?searchstring=physiotherapist& locationstring=&sort=M/)

• Additional advice for improving resumes to tailor for specific roles/employers/settings, and for improving chance of employment by volunteering within hospitals and other health settings.

Next Week Topics

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

References

• List of cited sources (URLs for websites, files) - specified.