Universitat Internacional de Catalunya

Therapeutic Exercises for the Upper Extremities

Therapeutic Exercises for the Upper Extremities
3
13886
1
First semester
OB
Main language of instruction: Spanish

Other languages of instruction: Catalan, English

Teaching staff

Introduction

Physical activity for health is a fundamental element to prevent and treat pathologies and diseases and also to maintain the benefits achieved with multiple types of treatments. The physiotherapist is the professional responsible for prescribing and executing therapeutic physical exercise programs. In this subject, the student will be provided with knowledge and skills in order to achieve the necessary skills to develop a therapeutic exercise program applied to the upper extremity.

Pre-course requirements

No prerequisites are specified.

Objectives

  1. Know the indications, contraindications and objectives of training as a component of the OMPT multimodal intervention.
  2. Know the fundamental principles of exercise physiology applied to therapeutic exercise programs in the upper extremity.
  3. Integrate therapeutic exercise in the areas of prevention, treatment and training in OMPT of upper extremity dysfunctions.
  4. Execute and instruct self-treatment exercises and techniques for the upper extremity (joint self-management, self-stretching, functional self-massage and neural self-management).
  5. Execute and instruct active stabilization exercises of the regions of the upper extremity.

Competences/Learning outcomes of the degree programme

Basic and general skills

  • CB7: To develop the skills to apply the knowledge acquired and their ability to solve problems in new or little-known environments within broader (or multidisciplinary) contexts related to their area of study.
  • CB8: To have the skills to integrate knowledge and face the complexity of formulating judgments based on information that, being incomplete or limited, includes reflections on the social and ethical responsibilities linked to the application of their knowledge and judgments.
  • CB9: To have the skills to communicate their conclusions as well as the knowledge and ultimate reasons that support them, aimed at specialized and non-specialized audiences in a clear and unambiguous way.
  • CB10: To have the ability to develop learning skills that allow them to continue studying in a way that will be largely self-directed or autonomous.
  • CG1: That students demonstrate a critical, analytical, evaluative and evidence-based clinical practice of the OMPT area of specialization.
  • CG3: Knowing how to carry out specific evaluation and treatment procedures for arthro-neuro-muscular dysfunctions, establishing a diagnosis of Orthopedic Manual Physiotherapy based on the findings.
Transversal competencies: 
  • CT1: Being able to communicate effectively and to carry out an anamnesis, an evaluation and treatment of arthro-neuro-muscular dysfunctions, in interpersonal relationships so that they lead to enhancing the health status of the patient/user and the collaboration of the multidisciplinary team.
  • CT2: Show communication skills in interpersonal relationships that lead to enhancing the health status of the patient/user and the collaboration of the multidisciplinary team.
Specific competencies:
  • CE1: To determine and apply the most appropriate treatment, taking into account the indications, contraindications, precautions and effects of Manual Orthopedic Physiotherapy in the framework of the management of pain mechanisms and dysfunctions of the arthro-neuro-muscular system.
  • CE2: That students know the indications, contraindications, precautions and effects of OMPT in the framework of the management of pain mechanisms and dysfunctions of the arthro-neuro-muscular system.
  • CE4: To have the ability to specifically execute the principles of mobilization, manipulation, motor learning, exercise physiology, ergonomic strategies, among other therapeutic modalities, for the treatment of pain and function of the arthro-neuromuscular system specifically, such as multimodal elements of the therapeutic approach of Orthopedic Manual Physiotherapy.

Learning outcomes of the subject

Students will:

  • Demonstrate creativity, adaptability, and innovation in patient/user instruction, information, and training.
  • Demonstrate critical awareness of the need to motivate and encourage the patient in order to improve their adherence to a training program.
  • Plan and execute a therapeutic training program adapted to the physical diagnosis, functional situation and expectations of the patient/user.
  • Demonstrate abilities and skills in the execution and instruction of exercises and self-treatment techniques of the upper extremity (joint self-management, self-stretching, functional self-massage and neural self-management).
  • Demonstrate abilities and skills in the execution and instruction of active stabilization exercises of the upper extremity regions.

Syllabus

  • Psychological foundations of exercise and adherence to therapeutic exercise programs.
  • Types of therapeutic training.
  • Design, planning and programming of a therapeutic training session.
  • Training variables.
  • Calculation of the maximum force.
  • Perceived exertion scales.
  • Dosage of therapeutic training (series, repetitions, rest, sessions)
  • Self-treatment techniques for the treatment of hypomobility:
    • Joint self-mobilization
    • Neural automobilization
    • Muscle self-stretch
    • Functional self-massage
  • Specialized therapeutic active stabilization exercise for the treatment of hypermobility:
    • Joint centralization
    • Muscular strength, endurance and coordination training
    • Motor control
  • Therapeutic exercise specialized in the most frequent clinical subgroups of the upper extremity.

Teaching and learning activities

In person



  • TC (Theoretical classes): The teacher is the one who exposes in a systematic and orderly manner the information corresponding to the different subjects and the student has a role mainly as a receiver. The scenario in which the teacher transmits knowledge is the classroom and he does it to the entire group of students. The theoretical class format allows the introduction of group activities in the classroom and the development of strategies that encourage the active participation of students.
  • PC (Practical classes):  It includes any type of classroom and/or laboratory practice (practices among students, case studies, problems, activities in the computer room, search for information,...)
  • SLA (Self-learning activities: These activities are designed so that the student solves problems on their own with the help of the material provided and the information from the face-to-face activities and/or available in the virtual environment in which the online subjects are developed.
  • SIS (Student independent study): It is a process aimed at the formation of an autonomous student capable of learning to learn; It consists of developing study skills, establishing educational goals and objectives based on the recognition of the weaknesses and strengths of the individual, which will respond to the needs and expectations of each one. It implies the possibility that each student makes their own decisions in relation to the organization of their time and their learning pace, which is why it requires a high degree of responsibility to make the most of resources.Includes study of contents related to "theoretical classes" and "practices" (studying exams, carrying out individual and group theoretical work, library work, complementary reading, etc.).
  • MC (Master Class): Transmission of knowledge and activation of cognitive processes in the student.
  • CL (Cooperative learning): Development of active and significant learning cooperatively.
  • FL (Flipped learning): Systems based on new technologies as basic knowledge tools outside the classroom, so that when students arrive to class they put their ideas and impressions together, giving teachers the opportunity to personalize their instruction according to the needs of each one.
  • PBL (Problem based learning): Development of active learning through problem solving.
  • RP (Role playing): Transfer to the classroom of situations typical of reality that will serve the student to apply them in their future life.
  • CS (Case studies): Acquisition of learning through the analysis of clinical or professional cases, real or simulated.

Evaluation systems and criteria

In person



  • Theoretical evaluation: 20%
  • Practical evaluation: 40%
  • Self-assessment: 20%
  • Co-assessment: 20%

The grading system will be used in accordance with current legislation. Actually, according to RD 1.125/2003 del 5 de septiembre.

  • 0-4,9 Fail.
  • 5,0-6,9 Pass.
  • 7,0-8,9 Notable.
  • 9,0-10 Outstanding.

The Honor Roll mention may be awarded to students who have obtained a grade equal to or greater than 9.0. Their number may not exceed 5% of the students enrolled in a subject in the corresponding academic year, unless the number of students enrolled is less than 20, in which case a single Honors may be awarded.

Bibliography and resources

  • Freddy M. Kaltenborn. Movilización Manual de las Articulaciones. Volumen I Extremidades. 1ª Ed. Zaragoza. OMT España; 2011.
  • Freddy M. Kaltenborn. Fisioterapia Manual. Volumen III Manipulación – Tracción de las extremidades y la columna. 1ª Ed. Zaragoza. OMT España; 2009.
  • M. Tricás, César Hidalgo, Orosia Lucha, Olaf Evjenth. Estiramiento y Autoestiramiento muscular en Fisioterapia OMT. Volumen I: Extremidades. OMT-España, 2012.
  • G. Bucher-Dollenz, R. Wiesner, R. Blake, E. Hengeveld, P. Jeangros, V. Schöb Mezzanotte, H. Stam, H. von Piekartz, P. Westerhuis  El Concepto Maitland. Su aplicación en Fisioterapia Panamericana, 2010.
  • Renate Wiesner, dipl. Physiotherapeutin HF, Fachlehrerin Manuelle Therapie, OMT SVOMP, Teacher IMTA Ejercicios de fisioterapia Thieme 2009
  • Schomacher. Orthpedic Manual Therapy. Assesment and Management. Thieme 2014
  • Couppé C, Svensson RB, Silbernagel KG, Langberg H, Magnusson SP. Eccentric or concentric exercises for the treatment of tendinopathies? J Orthop Sports Phys Ther. 2015;45(11):853-863. doi:10.2519/jospt.2015.5910
  • Hernández-Sanchez S, Korakakis V, Malliaropoulos N, Moreno-Perez V. Validation study of the Functional Assessment Scale for Acute Hamstring injuries in Spanish professional soccer players. Clin Rehabil. 2019;33(4):711-723. doi:10.1177/0269215518815540
  • Hernández-Sánchez S, Poveda-Pagán EJ, Alakhdar-Mohmara Y, Hidalgo MD, Fernández-De-Las-Peñas C, Arias-Buría JL. Cross-cultural Adaptation of the Victorian Institute of Sport Assessment-Achilles (VISA-A) Questionnaire for Spanish Athletes With Achilles Tendinopathy. J Orthop Sports Phys Ther. 2018;48(2):111-120. doi:10.2519/jospt.2018.7402
  • Hertel J, Corbett RO. An updated model of chronic ankle instability. J Athl Train. 2019;54(6):572-588. doi:10.4085/1062-6050-344-18
  • Joseph MF, Denegar CR. Treating tendinopathy. Perspective on anti-inflammatory intervention and Therapeutic exercise. Clin Sports Med. 2015;34(2):363-374. doi:10.1016/j.csm.2014.12.006
  • Malliaras P, Barton CJ, Reeves ND, Langberg H. Achilles and patellar tendinopathy loading programmes: A systematic review comparing clinical outcomes and identifying potential mechanisms for effectiveness. Sport Med. 2013;43(4):267-286. doi:10.1007/s40279-013-0019-z
  • Martin RL, Chimenti R, Cuddeford T, et al. Achilles pain, stiffness, and muscle power deficits: Midportion achilles tendinopathy revision 2018. J Orthop Sports Phys Ther. 2018;48(5):A1-A38. doi:10.2519/jospt.2018.0302
  • Martin RL, Davenport TE, Paulseth S, Wukich DK, Godges JJ. Ankle stability and movement coordination impairments: Ankle ligament sprains. J Orthop Sports Phys Ther. 2013;43(9). doi:10.2519/jospt.2013.0305
  • Nielsen RO, Rønnow L, Rasmussen S, Lind M. A prospective study on time to recovery in 254 injured novice runners. PLoS One. 2014;9(6). doi:10.1371/journal.pone.0099877
  • Rees JD, Wolman RL, Wilson A. Eccentric exercises; why do they work, what are the problems and how can we improve them? Br J Sports Med. 2009;43(4):242-246. doi:10.1136/bjsm.2008.052910
  • Woodman R, Berghorn K, Underhill T, Wolanin M. Utilization of mobilization with movement for an apparent sprain of the posterior talofibular ligament: A case report. Man Ther. 2013;18(1). doi:10.1016/j.math.2012.03.014
  • Yasui Y, Tonogai I, Rosenbaum AJ, Shimozono Y, Kawano H, Kennedy JG. The Risk of Achilles Tendon Rupture in the Patients with Achilles Tendinopathy: Healthcare Database Analysis in the United States. In: BioMed Research International. Vol 2017. Hindawi Limited; 2017. doi:10.1155/2017/702186
  • Kongsgaard M, Kovanen V, Aagaard P, et al. Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. Scand J Med Sci Sports. 2009;19(6):790-802. doi:10.1111/J.1600-0838.2009.00949.X
  • Rio E, Van Ark M, Docking S, et al. Isometric contractions are more analgesic than isotonic contractions for patellar tendon pain: An in-season randomized clinical trial. Clin J Sport Med. 2017;27(3):253-259. doi:10.1097/JSM.0000000000000364
  • Stathopoulos N, Dimitriadis Z, Koumantakis GA. Effectiveness of Mulligan’s Mobilization With Movement Techniques on Range of Motion in Peripheral Joint Pathologies: A Systematic Review With Meta-analysis Between 2008 and 2018. J Manipulative Physiol Ther. 2019;42(6):439-449. doi:10.1016/j.jmpt.2019.04.001
  • Mascaró A, Cos MÀ, Morral A, Roig A, Purdam C, Cook J. Gestión de la carga en las tendinopatías: progresión clínica para tendinopatías de Aquiles y rotuliana. Apunt Med l’Esport. 2018;53(197):19-27. doi:10.1016/j.apunts.2017.11.005
  • Logerstedt DS, Scalzitti D, Risberg MA, et al. Knee stability and movement coordination impairments: Knee ligament sprain revision 2017. J Orthop Sports Phys Ther. 2017;47(11):A1-A47. doi:10.2519/jospt.2017.0303
  • Hernandez-Sanchez S, Abat F, Hidalgo MD, et al. Confirmatory factor analysis of VISA-P scale and measurement invariance across sexes in athletes with patellar tendinopathy. J Sport Heal Sci. 2017;6(3):365-371. doi:10.1016/j.jshs.2016.01.020
  • Kotsifaki A, Korakakis V, Whiteley R, Van Rossom S, Jonkers I. Measuring only hop distance during single leg hop testing is insufficient to detect deficits in knee function after ACL reconstruction: A systematic review and meta-analysis. Br J Sports Med. 2020;54(3):139-153. doi:10.1136/bjsports-2018-099918
  • Daman M, Shiravani F, Hemmati L, Taghizadeh S. The effect of combined exercise therapy on knee proprioception, pain intensity and quality of life in patients with hypermobility syndrome: A randomized clinical trial. J Bodyw Mov Ther. 2019;23(1):202-205. doi:10.1016/j.jbmt.2017.12.012
  • Filbay SR, Grindem H. Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture. Best Pract Res Clin Rheumatol. 2019;33(1):33-47. doi:10.1016/j.berh.2019.01.018
  • Hernandez-Sanchez S, Hidalgo MD, Gomez A. Cross-cultural adaptation of VISA-P score for patellar tendinopathy in Spanish population. J Orthop Sports Phys Ther. 2011;41(8):581-591. doi:10.2519/jospt.2011.3613
  • Vander Doelen T, Scott A. Multimodal management of patellar tendinopathy in basketball players: A retrospective chart review pilot study. J Bodyw Mov Ther. 2020;24(3):267-272. doi:10.1016/j.jbmt.2020.02.013
  • Arundale AJH, Bizzini M, Giordano A, et al. Exercise-based knee and anterior cruciate ligament injury prevention. J Orthop Sports Phys Ther. 2018;48(9):A1-A25. doi:10.2519/jospt.2018.0303
  • Rutherford D, Moreside J, Wong I. Hip joint motion and gluteal muscle activation differences between healthy controls and those with varying degrees of hip osteoarthritis during walking. J Electromyogr Kinesiol [Internet]. 2015 Dec 1;25(6):944–50. Available from: https://pubmed.ncbi.nlm.nih.gov/26542484/
  • Dobson F, Hinman R, Hall M, Terwee G, Roos E, Bennell K. Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis: a systematic review. Osteoarthr Cartil [Internet]. 2012 Dec;20(12):1548–62. Available from: https://pubmed.ncbi.nlm.nih.gov/22944525/
  • Ryan, DeBurca, Creesh M. Risk factors for groin/hip injuries in field-based sports: a systematic review. Br J Sports Med [Internet]. 2014;48(14):1089–96. Available from: https://pubmed.ncbi.nlm.nih.gov/24795341/
  • Bennell K, Hinman R, Wrigley T, Creaby M, Hodges P. Exercise and osteoarthritis: cause and effects. Compr Physiol [Internet]. 2011 Oct;1(4):1943–2008. Available from: https://pubmed.ncbi.nlm.nih.gov/23733694/
  • Thorborg K, Hölmich P, Christensen R, Petersen J, Roos E. The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist. Br J Sports Med [Internet]. 2011 May;45(6):478–91. Available from: https://pubmed.ncbi.nlm.nih.gov/21478502/
  • Zoga, Kavanagh, Omar, Morrison, Koulouris, Lopez, et al. Athletic pubalgia and the “sports hernia”: MR imaging findings. Radiology [Internet]. 2008 Jun 1;247(3):797–807. Available from: https://pubmed.ncbi.nlm.nih.gov/18487535/
  • Via, Frizziero, Finotti, Oliva, Randelli, Maffulli. Management of osteitis pubis in athletes: rehabilitation and return to training - a review of the most recent literature. Open access J Sport Med [Internet]. 2018 Dec;10:1–10. Available from: https://pubmed.ncbi.nlm.nih.gov/30613167/