Universitat Internacional de Catalunya
Physiotherapy Applied to Circulatory, Cardiac and Respiratory Dysfunctions
Other languages of instruction: Catalan
Teaching staff
Make an appointment by email:
Marta Amor
Laura García Rueda
Sonia Subías Blas
Eloi Arias
Raúl Carrión
Laura Franco
- Assessment period
(E) exam date (R) revision date (1) examination session 1 (2) examination session 2 (E2) 04/07/2023 12 p.m.
Introduction
Cardiorespiratory physiotherapy involves a set of physical techniques that often complement medical treatment. These techniques help to improve breathing function, promote bronchial hygiene, reduce dyspnea and make breathing re-education possible for patients with cardiorespiratory diseases. Understanding these techniques is essential in order to adapt physiotherapy treatment to physiological changes in the body of these patients.
This subject involves a theoretical and practical seminar where students will learn about the main treatment techniques for respiratory physiotherapy.
Oedema Treatment Seminar
Oedema is a common clinical sign in our daily practice, but it requires specific analysis to determine its cause.
The physical treatment of oedema involves a set of interrelated techniques, which can help us improve oedema caused by a failure in return circulation.
Cardiac Rehabilitation Seminar
Atherosclerosis is the leading cause of death in developed countries, causing about 20 million deaths per year worldwide, and 3,500 in Catalonia. In addition, progressive increases in life expectancy means a significant increase in morbidity due to cardiovascular diseases.
Since the launch of the Framingham Heart Study in 1948, which associates physical activity with lower mortality rates among both men and women at any age, and also thanks to Taylor’s meta-analysis published in the American Journal of Medicine in 2004, which stated that there was a very significant decline in cardiovascular and total mortality, total cholesterol, triglycerides and systolic blood pressure, training programmes specifically designed for people whose relatives have suffered a cardiovascular-related death have been included as part of treatment protocols (secondary prevention) and as a primary prevention mechanism.
Pre-course requirements
Not specified, although it is advised to have passed the Cardiorespiratory Assessment Seminar from the subject Specific Intervention Methods in Cardiorespiratory Physiotherapy, since treatment techniques in respiratory physiotherapy are closely related to the examination.
Objectives
- To understand the practical foundations of the different treatment techniques available to physiotherapists in order to treat patients with cardiorespiratory diseases.
- To acquire a comprehensive education in physiotherapy and administer comprehensive physiotherapy treatment to patients with cardiorespiratory diseases, which will make it possible to achieve the therapeutic goals set.
- To identify treatment priorities in each stage of patient recovery.
- To offer the most appropriate therapeutic indications for respiratory therapy guided by patient assessment (mainly lung auscultation)
- To understand how to identify potential complications as the process evolves.
- To know how to plan a breathing re-education programme for patients with respiratory problems.
- To acquire basic training in the most important aspects of respiratory physiotherapy for infants.
- To acquire the basic knowledge about inhalation and nebulised therapies.
- To recognise and be able to differentiate between the different types of oedemas.
- To understand the anatomy of the Lymphatic System well enough to perform Manual Lymphatic Drainage correctly.
- To master manual lymphatic drainage depending on the source and type of oedema.
- To identify possible complications throughout a patient's treatment.
- To plan complex decongestant therapy.
- To use complementary therapies appropriately.
- To acquire the training necessary to differentiate between the indications and counter-indications of the technique.
- To understand the methodological basis for training.
- To provide students with basic knowledge of the different physiological responses and adaptations of patients with heart conditions to acute and chronic exercise.
- To understand the most effective strategies for promoting the take-up and maintenance of physical exercise in patients with heart conditions.
- To understand the methodological basis of cardiac rehabilitation programmes (RC).
Competences/Learning outcomes of the degree programme
- 01 - The ability to analysis and synthesis.
- 02 - The ability to organise and synthesize
- 06 - To have comprehensive problem-solving skills.
- 10 - Develop autonomous learning skills.
- 14 - Demonstrate initiative and an entrepreneurial spirit.
- 15 - Demonstrate a concern for quality.
- 21 - Knowledge of the physiological and structural changes that can occur after physiotherapeutic interventions.
- 28.1 - Capacity for oral and written communication in the native language.
- 28.3 - Show respect, appreciation and sensitivity towards the work of others.
- 30.1 - Teamwork skills.
- 37.1 - Use discretion, use available information appropriately and respect patient dignity and confidentiality
- 37.5 - knowledge of the profession's deontological ethics codes
- 38.1 - Respect for the rights of the patient and their family.
- 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.
- 48.1 - Knowledge of the internationally accepted norms and 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.
- 49.1 - Ability to develop a specific physiotherapy treatment plan through clinical thinking and problem-solving skills.
- 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.
- 50.10 - Ability to establish a scheduled plan to follow during treatment.
- 50.2 - Ability to design and apply therapeutic exercises specifically designed for cardiorespiratory, orthopedic, traumatologic, pediatric, rheumatologic, geriatric, neurologic, pulmonary, and sport-related diseases and injuries, as well as those for spine defects, urinary and fecal incontinence and pre/post-partum exercises.
- 50.8 - Ability to encourage the client and family to participate in the rehabilitation process.
- 51 - Ability to assess the outcomes of the physiotherapy treatment against the initial goals set and the established outcome criteria.
- 51.1 - Ability to design and set up activities related to disease prevention and health promotion.
- 51.2 - Ability to assess the patient's /client's progress.
- 51.3 - Ability to re-assess and modify treatment goals if necessary, and to adjust the intervention or treatment plan according to the new goals.
- 52.2 - Capacity to prepare a comfortable environment in which physiotherapy will be provided.
- 52.3 - Ability to keep the patient informed about the treatment by explaining the tests and techniques that are involved, the preparation they require, to ensure the patient's collaboration at all times.
- 53.1 - Ability to design and set up activities related to health promotion and disease prevention.
- 57 - Ability to keep up-to-date on knowledge, skills and attitudes related to professional competencies through continuous education.
- 61 - Ability to motivate others, through the capacity to generate a desire and enthusiasm for active participation in any kind of project or task.
Learning outcomes of the subject
After completing this subject, students will be able to:
Respiratory Techniques Seminar:
- Understand how to correctly apply the main treatment techniques for cardio respiratory pathologies.
- Design a specific physiotherapy intervention plan, using problem-solving skills and clinical reasoning, according to criteria of adequacy, validity and efficiency.
- Identify the most appropriate treatment techniques based on a previous patient assessment and evaluate the evolution of the results.
- Adapt a beathing re-education plan for cardiac patients.
- Use the main respiratory physiotherapy treatment techniques for children.
- Identify the structural, physiological, functional and behavioural changes that occur as a result of using cardiorespiratory physiotherapy.
- Adapt respiratory physiotherapy treatment to children.
- Assimilate basic knowledge of inhalation and nebulised therapies.
- Give practical information to patients on their rehabilitation and prevention.
- Differentiate between the different types of oedema and apply the correct techniques according.
- Identify oedemas that can be treated by complex decongestive therapy.
- Properly use MLD and the various complementary techniques.
- Be aware of new developments in lymphatic pathology.
- Stimulate students’ interest in a specialised, comprehensive and forward-thinking outlook, not only by discussing cardiac rehabilitation programmes (PRC), but also what it means for the training and rehabilitation of chronic diseases.
Syllabus
1. Breathing re-education techniques
1.1 Breathing control by correctly using the diaphragm
1.2 Guided abdominal-diaphragmatic breathing
1.3 Guided costal breathing
1.4 Pursed-lip breathing
1.5 EDIC: Deep breathing exercises
1.6 Postures that facilitate breathing
1.7 Postural changes for pleural effusion
1.8 Movements of the ribcage
1.9 Protecting surgical wounds
2. Bronchial hygiene techniques
2.1. Gravitational techniques: Postural drainage
2.2. Shockwaves: Percussion and vibration
2.3. Expiratory flow modification:
- LOW FLOW:
2.3.1. ELTGOL
2.3.2. Prolonged slow expiration
- HIGH FLOW:
2.3.3. Forced expiration technique
2.3.4. Increased expiratory flow
2.3.5. Cough
3. Respiratory physiotherapy techniques for children
3.1 ELPR (Prolonged slow expiration)
3.2 Glosso-Pulsion retrograde
3.3 retrograde rhinopharyngeal clearance
3.4 Provoked coughing
4. Instrumental techniques
4.1 Instrumental airway clearance techniques (inhalation): Incentive spirometer
4.2 Expiratory instrumental techniques (exhalation):
4.2.1 Continuous positive airway pressure: Pep-mask, Thera-pep
4.2.2 Discontinuous positive pressure: Flutter, Acapela
4.3 Insufflator-exsufflator (cough assist machine)
5. Oxygen therapy
5.1 Indications
5.2 Sources of oxygen: Compressed gas, concentrators and liquid oxygen
5.3 Management systems: Nasal cannula, masks, saving systems
5.4 Oxygen therapy
6. Inhaled therapy
6.1 Nature
6.2 Indications
6.3 Inhalation systems
6.4 Use procedures
Oedema Treatment Seminar:
1. Introduction
2. Lymphatic system
2.1. Lymphatic system components
2.2. Lymphatic system physiology
2.3. Anatomy of the lymphatic system
2.3.1. Upper extremity anatomy
2.3.2. Lower extremity anatomy
3. Oedema
3.1. Oedema grading
3.1.1. Venous Oedema
3.1.2. Lymphedema
3.1.2.1. Primary lymphedema
3.1.2.2. Secondary lymphedema
3.1.3. Lipoedema
3.1.4. Lipo-lymphedema
4. Manual lymphatic drainage
4.1. Definition
4.2. Lymphatic drainage
4.3. Appeal manoeuvres
4.4. Resorption manoeuvres
4.5. Bypass or replacement
4.6. Physiological and therapeutic effects
4.7. Indications
4.8. Contraindications
4.8.1. Absolutes
4.8.2. Relative
5. Complementary techniques
5.1. Pressure therapy
5.2. Multilayer bandaging
5.3. Containment or compression garments
5.4. Kinesiotherapy
6. Surgical techniques
7. Prevention and general recommendations
Cardiac Rehabilitation Seminar:
1. Cardiac rehabilitation (CR)
- Historical evolution of CR
- CR concept
- Configuration of a cardiac rehabilitation programme (CRP)
- Human resources and material resources
2. Training load
- Parameters defining training load
- Volume
- Intensity
- Density
3. General principles of physical training
- Theories on adaptation in physical exercise General Adaptation Syndrome
Schulz-Arndt principle
Principle of overcompensation
- Biological principles of adaptation Principles to initiate adaptation Principles to ensure adaptation Principles for specific adaptation
4. Cardiac patients’ phenomena of response and adaptation to exercise
- Muscle response and adaptation to exercise Response and adaptation of muscle fibre Response and adaptation of motor units
- Adaptation of the energy systems Adaptation of the aerobic system Adaptation and lactic anaerobic system
- Cardiovascular response and adaptation to exercise of cardiac patients
Heart flow
Systolic execution volume Pharmacological conditioning
5. Methodological basis for strength training in cardiac patient
- Types of strength training Concentric method
Eccentric method
Isometric method
- Strength-resistance training
6. Methodological basis for resistance training in cardiac patients
- Physiological adaptations related to training energy systems VO2 Max
Anaerobic verge Aerobic system training Training zones
Anaerobic system training Training zones
7. Cardiac patient training programme planning
- Training planning Interpretation of the PE and HC Risk stratification
Diagnosis of current level of risk Training plan
Monitoring training
- Planning structures The session
Microcycle
Macrocycle
Teaching and learning activities
In person
This subject will be carried out in small groups.
After a theoretical explanation and a practical demonstration by the teacher, students will be able to put into practice the cardiorespiratory physiotherapy treatment techniques learned during this subject.
Students will have to solve some practical problems/cases during the seminar. Student participation through interventions during the subject will be highly valued.
|
TRAINING ACTIVITY |
METHODOLOGY |
COMPETENCES |
ECTS CREDITS |
|
Theoretical and practical workshops |
Case method problem-solving exercises |
06 21 28.1 28.3 30.1 38.1 43 48.2 49 49.1 50 50.1 50.2 50.8 51 51.1 51.2 51.3 61 |
2 |
|
Autonomous learning activities |
Work placement contract |
01 02 14 15 37.1 37.5 48.1 50.10 53.1 57 |
1 |
|
Independent work- study |
|
37.5 43 48.1 53.1 |
2 |
| TRAINING ACTIVITY | METHODOLOGY | COMPETENCES | ECTS CREDITS |
| independent study | cooperative learning | 37.5 43 48.1 53.1 | 2 |
| theoretical and practical seminars | cooperative learning case method problem-solving exercises | 06 21 28.1 28.3 30.1 38.1 43 48.2 49 49.1 50 50.1 50.2 50.8 51 51.1 51.2 51.3 61 | 2 |
| autonomous learning activities | learning contract | 01 02 14 15 37.1 37.5 48.1 50.10 53.2 57 | 1 |
Evaluation systems and criteria
In person
Respiratory Techniques Seminar (40%):
Students will be mainly assessed on their ability to implement practical procedures based on real tasks and problem solving by presenting clinical cases.
- Continuous assessment (30%)
- Practical exam (70%): Planning objectives, treatment and execution of respiratory physiotherapy techniques from a clinical case
The mark will be calculated from continuous assessment activities (30%) and a theoretical-practical exam (70%). If students achieve less that a 5.0, they will have to re-take the theoretical-practical exam in a second call.
Oedema Treatment Seminar (30%):
This subject will be assessment in two phases: Theoretical block (50%):
- Multiple-choice exam Practical block (50%)
- Practical/oral exam (35%)
- Practical case (15%)
Cardiac Rehabilitation Seminar (30%):
The mark following this seminar will be based on a theoretical exam (70% of the total mark) and practical activities (30%) that will involve exercises, clinical cases and participation in forums.
Students must submit all assignments in order to fulfil the 30% needed for the practice activities.
The marking system is set in accordance with current regulations, namely Royal Decree 1.125/2003 of 5 September:
0 to 4.9: Fail/F (Suspenso in Spanish)
5.0 to 6.9: Pass/C (Aprobado in Spanish).
7.0 to 8.9: B (Notable in Spanish)
9.0 to 10 A (Sobresaliente in Spanish)
An "Honourable" mark may be granted to students whose mark is equal to or higher than 9.0. Their mark may not exceed that of 5% of the students who are enrolled in a subject in the corresponding academic year, unless the number of students is less than 20, in which case it may be granted only to one student.
Attendance regulations
All subjects on the Bachelor’s Degree in Physiotherapy include theoretical and practical content whereby the main objective is to acquire and develop procedures and technical skills that are directly related to professional practice. These classes are taught in small groups which are continuously guided and supervised by a teacher. Therefore, attendance is essential and necessary to ensure students acquire these skills. Absences will only be excused in extraordinary circumstances, and even then, if students miss more than 30% of their classes, they will have to retake the subject in the next academic year, without the possibility of a resit. The consequences of failing to comply with this regulation may have very negative effects on the enrolment process (overlapping and/or academic incompatibilities), as well as the completion of the bachelor’s degree.
Bibliography and resources
Recommended bibliography (available from the Sant Cugat Campus library):
- Postiaux, G. Fisioterapia Respiratoria en el niño. Ed McGraw-Hill, 2000.
- 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 J. E. Kinesioterapia para trastornos torácicos, cardíacos y vasculares. Ed Panamericana.
- Vandevenne A. Reéducation Respiratoire des bronchopneumopaties chroniques obstructives. Ed Masson.
- Pneumokinesitherapie. Barthe, J. Ed Doin.
- Scientific publication databases: PubMed, ISI Web of Knowledge, etc.
Oedema Treatment Seminar:
- Wittlinger H., Wittlinger D., Wittlinger A., Wittlinger M. Drenaje Manual según el Método del Dr. Vodder. Ed. Medica Panamericana, 2012
- Leduc A. Leduc O. D.L.M. Teoría y Práctica. Ed Masson, 2003
- Francesc Viñas. La Linfa y su drenaje, 2000
- Serra Escorihuela. Tratamiento braquiedema en el cáncer de mama, 2002
- Ferrandez J-C S. Theys, J-Y Bouchet. Reeducación de los edemas de los miembros inferiores. Ed Masson, 2002
- Ferrandez J-C Theys, S. Actualizaciones del DLM en el Linfedema secundario a cáncer de mama. De la anatomía al gesto pasando por la fisiopatología, 2003
Cardiac Rehabilitation Seminar:
Basic training theories
- Bompa, T. Theory and methodology of training. Kendall-Hunt. Iowa. 1990.
- García Manso, J. M. Navarro, M.; Ruiz, J. A.: Bases teóricas del entrenamiento deportivo. Principios y apliaciones. Gymnos. Madrid. 1996.
- García Manso, J. M. Navarro, M.; Ruiz, J. A.: Planificación del entrenamiento deportivo. Gymnos. Madrid. 1996.
- García Manso, J. M. Navarro, M.; Ruiz, J. A.: Pruebas para la valoración de la capacidad motriz en el deporte. Evaluación de la condición física. Gymnos. Madrid. 1996.
- García Manso, J.M. La fuerza. Gymnos. Madrid. 1999.
- Matveiev, L. El proceso del entrenamiento deportivo. Stadium. Buenos Aires. 1982.
- Navarro, F. La resistencia. Gymnos. Madrid. 1998.
- Platonov, V. N. El entrenamiento deportivo. Teoría y metodología. Paidotribo. Barcelona. 1988.
- Platonov, V. N. La adaptación en el deporte. Paidotribo. Barcelona. 1991.
- Verjoshanski, I.V. Entrenamiento deportivo. Planificación y programación. Martinez Roca. Barcelona.1990.
- Volkov, M.V. Los procesos de recuperación en el deporte. Stadium. Buenos Aires. 1984.
- Zintl, F. Entrenamiento de la resistencia. Martinez Roca. Barcelona 1991.
- Barbany, J. R. Fisiología del esfuerzo. Barcelona. Generalitat de Catalunya. Institut Nacional d’Educació Física de Catalunya. 1stedition. 1986.
- López Chicharro, J. L.; Fernández Vaquero, A. Fisiología del ejercicio. Madrid. Editorial Médica Panamericana, 2008.
- López Chicharro, J. L.; López Mojares, L. M. Fisiología clínica del ejercicio. Madrid. Editorial Médica Panamericana, 2008.
- McArdle, W. D.; Katch, F. I.; Katch, V.L. Fundamentos de fisiología del ejercicio. Madrid. McGraw- Hill/Interamericana de España, 2004.
Cardiac rehabilitation
- AMERICAN COLLEGE OF SPORTS MEDICINE, (2010). Manual de consulta para el control y la prescripción de ejercicio. Barcelona. Paidotribo.
- AMERICAN COLLEGE OF SPORTS MEDICINE, (1990). The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in henny adults. (Position Stand of the American College of Sport Medicine). Medicine and Science Exercise. 22:265271.
- Fardy, S. P.; Franklin, B. A.; Porcaro, P. J.; Verril, E.D. Training Techniques in Cardiac Rehabilitation. Human Kinetics Monograph nº3 1998.
- Raudal J. Thomas, M. D., M. S. IGAKU. The Heart and Exercise. A Practical Guide for the Clinic. SHOIN Medical Publishers, Inc. 1996.
- W. Scheider et al. Fitness Movilidad. Fuerza. Resistencia. Teoría y prácticas. Ediciones Scriba, S.A. Barcelona. 1993.
- Manual Hurst. Alexander SCHLANT. FUSTER. O'ROURKE. Robert ROBERTS. Edmund
- H. SONNENBLICK. El Corazón. McGraw-Hill. INTERAMERICANA. 2000.
- Dr LINDAK HALL. Desarrollo y administración de programas de rehabilitación cardíaca. Ed. Paidotribo. 1997.
- Vivian H Heyward, PhD. Evaluación y Prescripción del Ejercicio. Ed. Paidotribo. 1997.
Evaluation period
- E2 04/07/2023 A14 12:00h
- E2 04/07/2023 G2 12:00h