Universitat Internacional de Catalunya
Specific Methods of Intervention in Cardiorespiratory and Vascular Physiotherapy
Other languages of instruction: Catalan
Teaching staff
Theoretical block:
PhD. María Antonia Ramon Belmonte
maramon@uic.es
Practical block:
Mrs.Marta Amor
Mr. Raúl Carrión
Introduction
The cardio-respiratory physical therapy is a discipline that uses physical techniques, based on knowledge of respiratory pathophysiology, in order to prevent, cure or stabilize disorders affecting thoraco-pulmonary system.
The course is divided into two blocks, a theoretical one and a practical one. The theoretical block is dedicated to the various theoretical aspects of cardio-respiratory physiotherapy. The practical block consists of a cardio-respiratory evaluation seminar.
Theoretical block: Cardio-respiratory Physiotherapy
This block is intended to facilitate the student to acquire the knowledge necessary to face the physical therapy of major cardio-respiratory diseases.
It is therefore essential the knowledge of anatomy, biomechanics and physiology of the respiratory system, that will make possible to understand how certain diseases may disrupt the normal functioning of this system. The most important aspects will also be addressed for a complete evaluation (clinical, physical and functional) of cardio-respiratory patients and will teach the student to interpret the results from these evaluations. The physiological properties of the main techniques of respiratory physiotherapy will be examined. The student will be introduced into children's respiratory physiotherapy and effort retraining of the patient. Finally, the major cardio-respiratory diseases suitable to physiotherapy treatment will be reviewed. This block is closely related to the cardio-respiratory evaluation seminar and "physiotherapy matter applied to respiratory dysfunction".
Practical Block: Cardio-respiratory evaluation Seminar
The practical part of the course is intended to train students in the evaluation of patients with cardio-respiratory disease. Students will study and work on practical aspects of topographic anatomy of the chest, physical examination in respiratory therapy (with special emphasis on lung auscultation) and functional evaluation of cardiorespiratory patient.. The acquisition of this knowledge will guide the diagnosis in physiotherapy and thereby define the objectives of our treatment. This block is closely related to the theoretical part of the course and with the subject of physical therapy for respiratory dysfunctions, in which the main techniques of respiratory physiotherapy will be reviewed in a practical way.
Pre-course requirements
Not specified
Objectives
- Knowing the anatomy, biomechanics and the most important physical properties of the respiratory system; all of it is necessary to perform a good intervention in cardio-respiratory physiotherapy.
- Knowing the consequences that can produce physiological and structural changes caused by various respiratory diseases in the proper functioning of the respiratory system.
- Knowing the basic self-defense mechanisms that the respiratory system has.
- Acquire a complete training to carry out a comprehensive evaluation of patients with cardio-respiratory disease, which will enable the formulation of therapeutic goals.
- Knowing how to interpret the results of the main tests of cardiorespiratory functional evaluation.
- Knowing the characteristics and clinical symptoms of major cardio-respiratory diseases.
- Knowing the theoretical basis and physiological properties on which the main respiratory physiotherapy techniques, both manual and instrumental, are based.
- Knowing the scientific evidence supporting or otherwise disapproving the use of certain techniques for physiotherapy treatment of diseases of the cardio-respiratory system. Get a basic training of the most important aspects of infant respiratory physiotherapy.
Competences/Learning outcomes of the degree programme
- 01 - The ability to analysis and synthesis.
- 02 - The ability to organise and synthesize
- 05 - The ability to manage information.
- 09 - Demonstrate critical thinking skills.
- 10 - Develop autonomous learning skills.
- 15 - Demonstrate a concern for quality.
- 17 - The ability to work responsibly and autonomously, so as to handle job-related activities without the need for strict supervision.
- 29.1 - Demonstrate a committment to ongoing learning and self-improvement.
- 30.1 - Teamwork skills.
- 43 - Knowledge of physiotherapeutic procedures based on techniques and methods specific to physiotherapy interventions applied to the various disorders of all systems and medical and surgical specialisations, as well as health promotion and disease prevention.
- 48 - Ability to establish a physiotherapeutic diagnosis according to international norms and using internationally validated assessment tools.
- 48.2 - Ability to assess the patient's/client's needs in order to give priority to the ones that could compromise the rehabilitation process.
- 49 - Ability to design a physiotherapy treatment plan.
- 50 - Ability to execute, direct and coordinate a physiotherapy treatment plan while attending to the client's individual needs and using therapeutic tools specific to the physiotherapy profession.
- 50.1 - Ability to establish and implement physical therapy in treatments provided by all other medical and surgical specialties whenever it is deemed necessary.
- 53 - Capacity to participate within the areas of health promotion and disease prevention.
- 55 - Capacity to incorporate scientific research and an evidence-based practice within the professional culture.
Learning outcomes of the subject
Students:
- Understand physiotherapy procedures based on specific methods and techniques applicable in the pathology related to the specialty of medicine and surgery in Neurology.
- Know how to apply the diagnostic process in physical therapy, establishing a hierarchy of the patient's needs.
- Design physiotherapy intervention plans incorporating scientific research and evidence-based practice.
- Maintain an attitude of motivation and improvement in the learning proces.
- Have the necessary skills for teamwork and oral/written communication.
Syllabus
Theoretical block: Cardiorespiratory Physiotherapy
1. Anatomy and biomechanics of the respiratory system (SR)
1.1 Upper and lower airway
1.2 Ribcage
1.3 Respiratory muscles
2. Physical properties of SR
2.1. Compliance
2.2. Elasticity
2.3. Resistance
2.4. Time constant
2.5. Respiratory work
2.6. Muscular strength
2.7. Resistance and fatigue of the respiratory muscles
2.8. Equal pressure point (EPP)
2.9. Röhrer Equation
2.10. Pulmonary volume, ventilation and perfusion
2.11. Diaphragmatic movement
3. Self-defense mechanisms of the respiratory system
3.1. Physical barriers of the upper airway
3.2. Lower airway muco-ciliary system
3.3. Reflex mechanical systems
3.4. Immune system
4. Chest physiotherapy Evaluation
4.1. Clinical evaluation
4.2. Physical examination
4.3. Respiratory functional evaluation
4.4. Assessment of effort capacity
5. Respiratory physiotherapy techniques (physiological properties and indications / counterindications)
5.1. Breathing re-education techniques.
5.1.1. Proper use of the diaphragm
5.1.2. Guided breathing
5.1.3. Pursed-lip breathing
5.1.4. EDIC
5.2. Bronchospasm reduction techniques
5.2.1. Fragmented breathing
5.2.2. Staggered breathing
5.3. Bronchial hygiene techniques
5.3.1. Gravitational techniques: Autogenic Drainage
5.3.2. Shock waves
5.3.2.1. Percussion
5.3.2.2. Vibration
5.3.3. Airflow Modification
5.3.3.1. Low flow: ELTGOL, Prolonged Slow Expiration
5.3.3.2. High Flow: Cough, Forced Expiration Technique, Increased Expiratory Flow
5.4. Instrumental techniques
5.4.1. Incentive spirometer
5.4.2. Positive expiratory pressure (PEP-mask, flutter)
5.4.3. Assisted coughing (in-exsuflator)
6. Effort retraining of respiratory and cardiac patients
6.1. Factors limiting effort capacity
6.2. Effort retraining indications
6.3. Assessment of effort capacity
6.3.1. Maximum tests (incremental effort exercises)
6.3.2. Submaximal exercise (six minute walk)
6.3.3. Muscle strength tests (Upper Extremitiess, Lower Extremitiess, Respiratory M)
6.3.4. Quality of life Test
6.4. Training methods
6.4.1. Constant-load training
6.4.2. Interval training load
6.4.3. Muscle strength training (limbs and respiratory m.)
6.5. Training variables
6.5.1. Intensity
6.5.2. Duration
6.5.3. Frequency
6.5.4. Modality
6.6. Parts of a retraining session
6.7. Retraining of respiratory patients
6.8. Retraining of heart patients
7. Child Respiratory Physiotherapy (RP)
7.1. Lung development
7.2. Children RP Considerations
7.3. Evaluations in RP for children
7.4. Specific techniques of child FR
7.4.1. Prolonged Slow Expiration
7.4.2. Autogenous drainage
7.4.3. Provoked coughing
7.4.4. Glosso-pulsion retrograde
7.4.5. Désobstruction Rhinopharyngée Rétrograde
7.4.6. Periodic insufflation with cylinder
7.4.7. Pressures / Vibrations
8. Main pathologies
8.1. COPD
8.2. Asthma
8.3. Pneumonia
8.4. Bronchiectasis
8.5. Cystic fibrosis
8.6. Atelectasis
8.7. Pneumothorax
8.8. Pleural effusion
8.9. Bronchiolitis
8.10. Alterations of the ribcage
8.11. Neuromuscular diseases
8.12. Abdominal and thoracic surgery
Practical Block: Cardiorespiratory evaluation Seminar
1. Topographic anatomy of the chest.
1.1 Reference lines
1.2 Thoracic Regions
1.3 Airway
1.4 Ribcage
1.5 Lung Topography
1.5.1 Projections of the lung parenchyma in the chest
1.5.2 Lobes and sulci
1.5.3 Bronchial tree and pulmonary segments
1.5.4 Pleura
1.6 Respiratory muscles
1.7 Cardiac Topography
2. Physical examination
2.1 Inspection
2.2 Palpation of structures involved (extra-thoracic airway and rib cage)
2.3 Breathing rate
2.4 Heart rate
2.5 Blood Pressure
2.6 Thoracic perimeter
2.7 Percussion
2.8 Lung auscultation
3. Respiratory functional evaluation
3.1 Measurement and monitoring of peak flow
3.2 Evaluation of the effectiveness of cough (peak cough flow)
3.3 Gas analysis and pulse oximetry
4. Evaluation of effort functional capacity
4.1 Incremental exercise test
4.2 6 minute walking test
4.3 Shuttle test
4.4 Muscular strength test
4.5 Activities questionnaires of daily living and breathing quality life
Teaching and learning activities
In blended
Theoretical block:
This block will be done with the whole group.
There will be master exhibitions with audiovisual tools, videos and the theoretical content will be combined with real case studies.
Students will have to write articles or other documents in order to complete their training and continue with the professor's lectures.
Students will solve during the theoretical block various activities related to the contents of the subject.
Practical block:
This block will be held in small groups.
Thanks to a theoretical explanation and a practical demonstration by the teacher, students will be able to put into practice the cardiorespiratory physiotherapy techniques that make up the block.
Student participation through interventions during the course will be highly valued.
| lectures | oral presentation / master class case method |
01 02 05 30.1 43 48 48.2 | 1.2 |
| theoretical and practical workshops | cooperative learning oral presentation / master class problem-solving exercises |
09 10 49 50 50.1 | 0.8 |
| self-learning activities | apprenticeship contract | 15 17 29.1 53 | 1 |
| student's independant work-study | 43 55 | 2 |
| TRAINING ACTIVITY | METHODOLOGY | COMPETENCES | ECTS CREDITS |
|---|---|---|---|
| lectures | oral presentation / master class case method | 01 02 05 30.1 43 48 48.2 | 1.2 |
| theoretical and practical workshops | cooperative learning oral presentation / master class problem-solving exercises | 09 10 49 50 50.1 | 0.8 |
| self-learning activities | apprenticeship contract | 15 17 29.1 53 | 1 |
| student's independant work-study | 43 55 | 2 |
Bibliography and resources
Bibliografía Recomendada (disponible en la Biblioteca Campus Sant Cugat):
- Postiaux, G. Fisioterapia Respiratoria en el niño Ed McGraw-Hill, 2000.
- West J. Fisiopatoligía Pulmonar. Ed Médica Panamericana, 2004.
- Güell R. Rehabilitación Respiratoria. Ed M & M Communications,1999.
- Pryor JA. Physiotherapy for Respiratory & Cardiac Problems. Ed Churchill Livingstone,1998.
- Delplanque D, Antonello M. Fisioterapia y reanimación Respiratoria. Ed Masson, 1996.
- Smith, M. Ball, V. Rehabilitación Cardiovascular y Respiratoria. Ed. Harcourt, 2000.
- Cash JE. Kinesioterapia para trastornos torácicos, cardíacos y vasculares. Ed Panamericana.
- Vandevenne A. Reéducation Respiratoire des bronchopneumopaties chroniques obstructives. Ed Masson.
- Pneumokinesitherapie.Barthe, J. Ed Doin.
- Bases de datos de publicaciones científicas: PubMed, ISI Web of Knowledge, etc.
- Artículos/Lecturas científicas disponibles en la Web de la asignatura.
Recursos:
- Diapositivas de las clases teóricas
- Casos clínicos
- Ruidos Pulmonares en MP3
Evaluation period
- E1 18/05/2021 12:00h
- E2 22/06/2021 13:00h