Kingsborough Community College of the
City University of New York
Physical Therapy Assistant Program
Course Syllabus
PTA 7
Modalities and Procedures
Course Description:
This course includes the physical basis of physical therapy modalities of electricity along
With physiological principles, indications, and contra-indications and precautions. The
Course also introduces the student to pulmonary toilet, mechanical traction,
Phototherapy and therapeutic massage.
Textbook Requirements: Physical Agents: L. Michlovitz, Theory and Practice
For the Physical Therapist Assistant, F.A. Davis,
Philadelphia,1996
Kisner Carolyn, Therapeutic Exercise Foundations and
Techniques, F.A. Davis Company,Philadelphia,1996
Pre-requisites: PTA 1, PTA 2, PTA 10, PTA 20, PTA 3, PTA 4, PTA 5, PTA 6,
BIO 11, BIO 12.
Co-requisities: PTA 8.
Student Learning Objectives
As evidenced by successful performance and completion of written and practical
Examinations, assignments, research article reviews, lab presentations, and the role
Playing and analysis of clinical scenarios, the student will:
1.0. Implement electrotherapy treatments (including high/low voltage,
interferential, and TENS ).
1.1. State the historical use of electrical stimulation in rehabilitation.
1.2. Define the therapeutic goals of electrical therapy.
1.3. Define the concepts of electrophysics including: voltage, resistance,
impedance and capacitance.
1.4. Identify the difference between direct current and alternating current.
1.5. Identify the differences between low voltage and high voltage current.
1.6. Define electrical current in terms of pulse and wave forms, amplitude,
duration, frequency and duty cycle
1.7. Identify the physiological events associated with electrical stimulation.
1.8. Define the distinguishing characteristic and indications and contraindications of electrical stimulation.
1.9. Describe the uses and benefits of electrical stimulation in the treatment of
pathology ( loss of ROM, weakness, pain, open wounds).
1.10. Distinguish the physiological effects of various parameters of electrical
stimulation (voltage, type, dosage, duty cycle, etc.).
1.11. Discuss the therapeutic relationship of electrotherapy with other
therapeutic procedures.
1.12. Demonstrate safe administration of electrical stimulation including
low and high volt current, TENS and interferential current, in the management of pain, weakness, open wounds, and other common conditions treated with physical therapy.
2. 0. Implement EMG biofeedback treatments.
2.1. Define the distinguishing characteristics and indications and
contraindications of EMG biofeedback.
2.2. Describe the uses of EMG biofeedback in physical therapy treatment.
2.3. Discuss the therapeutic relationship of EMG biofeedback with other
therapeutic procedures.
2.4. Demonstrate the safe use of EMG biofeedback while considering
indications and contraindications.
2.0. Implement ionophoresis treatment
3.1. Define the distinguishing characteristics and indications and
contraindications of iontophoresis.
3.2. Explain the concepts of ion transfer related to iontophoresis.
3.3. Discuss the therapeutic relationship of iontophoresis with other
therapeutic procedures.
3.4. Demonstrate safe administration of iontophoresis, while considering
patient comfort, dosage, agent, indications and contraindications and physiological effects.
3.0. Implement ultraviolet treatments.
4.1. Define the distinguishing characteristic and indications and
contraindications of ultraviolet therapy.
4.2. Discuss pathologies of the integumentary system treated with ultraviolet
therapy.
4.3. Discuss the therapeutic relationship of ultraviolet therapy with other
therapeutic procedures.
4.4. Demonstrate safe use and assistance in ultraviolet therapy.
4.0. Implement edema control activities utilizing air compression, external
Wrapping, and elevation.
5.1. Define the distinguishing characteristics and indications and
contraindications of air compression, external wrapping, and elevation
activities.
5.2. Define mechanisms of edema control.
5.3. Demonstrate safe and appropriate administration of mechanical compression, external wrapping, and elevation activities.
5.0. Implement pulmonary toilet treatment
6.1. Describe the anatomical organization of the respiratory system.
6.2. Discuss the importance of pulmonary hygiene in the prevention and
treatment of disease.
6.3. Describe postural drainage, vibration and percussion techniques.
6.4. Describe pathological conditions treated with postural drainage and
pulmonary hygiene techniques.
6.5. Demonstrate safe and appropriate performance of auscultation,
postural drainage, vibration, percussion, and pulmonary hygiene techniques.
6.6. Teach pulmonary hygiene activities.
6.7. Demonstrate appropriate documentation of pulmonary toileting.
6.8. Analyze the effectiveness of pulmonary hygiene techniques.
6.9. Discuss the therapeutic relationship of pulmonary toileting with other
therapeutic procedures (therapeutic exercise, range of motion,
functional activities, etc.)
6.0. Implement therapeutic massage treatment .
7.1. Discuss the uses, precautions, and applications of therapeutic massage.
7.2. Describe specific massage techniques including, effleurage,petrissage,
Tapotement and myofascial release.
7.3. Discuss the therapeutic relationship of massage with other therapeutic
Procedures (therapeytic exercises, rande of motion, functional activities,etc)
7.4. Demonstrate safe and appropriate performance of therapeutic massage
Techniques.
7.5. Demonstrate appropriate documentation of therapeutic massage.
7.6. Teach the benefits of therapeutic massage
7.0. Given patient scenarios, implement comprehensive physical therapy treatment.
8.1. Perform therapeutic techniques demonstrating an understanding of the role
Of the physical therapist assistant in rehabilitation.
8.2. Perform therapeutic techniques appropriately employing universal
Precautions and sound body mechanics.
8.3. Perform therapeutic techniques demonstrating an understanding of
Organizational structure, levels of authority, and fiscal considerations
Of the health care delivery system.
8.4. Teach the uses, applications and responses of modalities and
Procedures with emphasis on safety and rationale.
8.5. Demonstrate the adjunctive nature of modalities and procedures by
Integrating their use in complete treatment applications.
8.6. Implement therapeutic interventions within the plan of treatment
Utilizing knowledge of assessment and measurement,functional
Activities, modality,and therapeutic exercises skills.
8.7. Implement therapeutic intervations within the plan of treatment
Demonstrating consideration of time management,therapeutic sequence and
Procedure selection issues.
8.8 Demonstrate appropriate documentation of modality and procedure use,
Considering patient response, treatment parameters, long/short term goals,
And effectiveness.
8.8. Perform physical therapy treatment considering influencing factors
(psychosocial, economic, legal /ethical, etc.).
8.9. Assist in discharge planning and alternative levels of care decision making.
8.11.Communicate patient response to supervising physical therapist.
8.12. Identify clinical responses and situations that require the attention of the
supervising physical therapist.
8.13. Analyze the effectiveness of modalities and procedures in specific
clinical situations.
8.14. Assess patient response to treatment and appropriately alter therapeutic
intervention within the plan of treatment .
8.15. Delineate beneficial and untoward effects of electrotherapy, ultraviolet,
pulmonary toileting and therapeutic massage.
8.16. Analyze the relationship of all physical modalities with other therapeutic
procedures (therapeutic exercise, range of motion, functional activities )
8.17. Verify effectiveness of teaching behavior by analyzing patient
performance.
9.0. Demonstrate appropriate professional behavior
9.1. Attend and be on time for class, lab, and scheduled appointments.
9.2. Be prepared for lab activities, attend to tasks assigned.
9.3. Accept constructive criticism and respond and/or follows through
Appropriately.
9.4. Express self in a clear and easily understood manner.
9.5. Maintain appropriate personal hygiene.
9.6. Treat others with positive regard, dignity and respect.
9.7. Analyze and examine professional literature considering: specific
Scientific methods, interpretation of results, and clinical significance
In order to foster further personal investigation and clinical effectiveness.
9.8. Explain the importance of life long learning.
9.9. Describe how professional development can occur..
Student Assessment
As indicated in the student handbook, to receive a passing grade in this course the student
Must successfully complete all comprehensive examinations and assignments with a grade
Of “C” or better. Additionally , the instructor assesses student competencies in skills
Critical to this course using the standardized skills checklists, located in the laboratory
Requiring a passind score of at least 90%. Critical skills in this course include:
1. Application of the following modalities: low voltage galvanic and faradic stimulation,
High voltage galvanic stimulation, interferential stimulation, iontophoresis,TENS,
EMG biofeedback, ultraviolet, and mechanical compression.
2. Instruction of effects and uses of the following modalities: low voltage galvanic and
Faradic stimulation, high voltage galvanic stimulation, interferential stimulation,
Iontophoresis, TENS , EMG biofeedback, ultraviolet, and mechanical compression.
3. Performance of postural drainage .
4. Performance of vibration and percussion techniques.
5. Instruction of breathing exercises.
6. Performance of basic therapeutic massage techniques.
7. Reporting to supervising physical therapist.
Grade Determination
Assigned Research Papers 10%
Weekly Quizzes 20%
Mid- Term Examination 15%
Group Presentation 10%
Laboratory Practical Examination 25%
Final Examination 20%
100%
Assigned research Paper
Each student submits two written papers summarizing and critiquing pertinent research
Article. Topics are assigned by the instructor . Each assignment is worth five percentage
Points for ten percent of total grade. Missed assignment are accepted without penalty
Up to one week after the due date. After that the assignment are accepted for no more
Than 2.5 percentage points.
Weekly Quizzes
Student must take weekly quizzes specifically related to assigned readings. Quiz type
Includes both “ take home” and “in class” .Quizzes are mainly composed of short essay
Questions. Quizzes are graded and returned within one week. Weekly quizzes are
Worth twenty percent of the final grade.
The student takes a cumulative examination covering the first six weeks of the course.
The examination include mainly short essay and fill in type questions. The mid-term
Examination is worth fifteen percent of the final grade.
Students are divided into study groups of 3-5 students. Each group is assigned a relevant
Clinical scenario. The group will be responsible for making a comprehensive presentation . Presentation are made from the sixth week through the twelfth week of the course. The presentation is worth ten percent of the final grade.
All students are required to take a comprehensive practical examination. This examination tests the student”s proficiency in modality application and documentation. The laboratory examination will be scheduled during final week and is worth twenty-five percent of the final grade.
The student takes a cumulative final examination. The examination includes mainly short essay and fill in type questions . The final examination is worth twenty percent of the final; grade.
Course Outline
Week # 1 ~Introduction to Electrical Therapy
Lecture
Assignment: Behrens pp. 226-234
This initial week introduces the student to electrical stimulation. The history of electrical
Stimulation as well as therapeutic goals and electrophysics are explored.
Assignment: Behrens lab manual Chapter 4, pp. 45-54
The introduction to electrical therapy continues. Student study and experience the
Parameters, responses, and sensations of electrical stimulation. Student are oriented to
And indentify commom characteristics of electrical stimulation equipment (on/off switches,intensity, electrodes, etc.
Week # 2 ~ Electrical Therapy con”t.
Lecture
Assignment: Behrens pp. 234-260
Current classifications including DC vc. AC ,and HV vc. LV are studied in referance to: pulses and waveforms , amplitude and duration, and frequency and duty cycle.
Assignments: Behrens lab manual Chapter 4 continued.
Student practice proper electrode placement and use different size and type of
Eletrodes. Waveforms produced by common electrical current generators are viewed on
An oscilloscope. Student continue to experience and describe the sensation and visible
Physical effects of electrical current.
Week # 3 ~ Physiological Effects of Electrical Stimulation
Lecture
Assignment: Behrens Chapter 11.
The physiological effect of electric stimulation is studied. Membrane potentials,
Peripheral nerves and the motor unit are reviewed ( previously learned in Bio 11 ).
Laboratory
Assignment: Behrens lab manual Chapter 5, pp 55-62.
Specific indications and contraindications, and procedures for low and high voltage
Galvanic stimulation (LVGS, HVGS ) are presented. Student perform LVGS and HVGS treatment . Student consider therapeutic parameters as they relate to pathological
Conditions and effectiveness.
Treatment Application Activity
Student exhibit critical thinking and sound technical skills in the management of a
Cervical radiculopathy case as presented by the instructor and implement the
Prescribed plan of treatment. Student perform pain and sensation assessment, range of motion activities,thermal modalities and electrical stimulation appropriate to the scenerio. While performing treatments, students consider additional factors influencing patient care and the contemporary practice of physical therapy including: psycho-socjal issues and other issues impacting the health care delivery system. Student practice reporting and documenting consequences of treatment to supervising physical therapist. Students perform discharge planning activities including suggestions for home equipment and discharge alternatives. Following this treatment application activity, students discuss patient management and therapeutic techniques.
Week # 4 ~ Therapeutic Aplications of Electrical Stimulation.
Lecture
Assignement: Behrens Chapter 12 ,pp.283-305
Electrical stimulation application is studied. The effect of electrical stimulation on range of motion, muscle strengthening and edema reduction is discussed in relationship to pathological conditions.
Laboratory
Assignment: Behrens lab manual Chapter 7, pp. 75-86
Specific indication and contraindication of interferential current are reviewed. Given
Patient scenarios student perform treatments using, interferential, LVGS, and HVGS to
Produce specific motor responses.
Treatment Application Activity.
Students exhibit critical thinking and sound technikal skills in the management of a status
Post removal of a long leg cast case as presented by the instructor and implement the
Prescribed plan of treatment. Students perform pain and sensation assessment, rage of
Motion activities, goniometry, manual muscle testing , therapeutic exercise, and electrical
Stimulation appropriate to the scenario. While performing treatments, students consider
Additional factors influencing patient care and the contemporary practice of physical
Therapy including: psycho-social issues and other issues impacting the health care delivery
System. Students practice reporting and documenting consequences of treatment to
Supervising physical therapist. Students perform discharge planning activities including
Suggestions for home equipment and discharge alternatives. Following this treatment application activity ,students discuss patient management and therapeutic techniques.
Week # 5 ~ Therapeutic applications of Electrical Stimulation con”t
Lecture
Assignment : Behrens Chapter 14, pp.329-345.
Pain management is discussed in relation to the application of electrical stimulation.
Specifically, the uses and indications of transcutaneous electrical nerve stimulation
(TENS) are introduced. The applications of EMG biofeedback in pain management
and motor re- education are explored.
Laboratory
Assignment : Behrens, lab manual, Chapter 6, pp.63-86.
Given patient scenarios students apply TENS , and EMG biofeedback techniques.
Students practice the teaching of home application of TENS.
Treatment Application Activity.
Students exhibit critical thinking and sound technical skills in the management of
A lumbar periferal neuropathy case as presented by the instructor and implement the prescibed
Plan of treatment. Students perform pain and sensation assessments, range of motion
Activities, goniometry , manual muscle testing, electrical stimulation and EMG biofeedback
While performing treatments, students consider additional factors influencing patient care
And the contemporary practice of physical therapy including, psycho-social issues and
Other issues impacting the health care delivery system. Student practice reporting and
Documenting consequences of treatment to supervising physical therapist. Students perform
Discharge planning activities including suggestion for home equipment and discharge
Alternatives. Following this treatment application activity, student discuss patient
Management and therapeutic techniques.
Week # 6 ~ Electrical Stimulation for Wound Healing and Ion Transfer
Lecture
Assignment : Behrens, Chapter 13, pp.306-328.
The student is introduced to the application of electrical stimulation to enhance wound
Healing. Iontophoresis is also introduced.
Laboratory / Treatment Application Activity
Assignment : Behrens, lab manual, Chapter 4,pp.51-52,
Chapter 15,pp.163-172.
Students apply iontophoresis utilizing their knowledge of dosage, agent and pathology
Indications and contraindications. Given patient scenarios students practice integrating the
Use of all modalities with therapeutic exercise. Student document integrated treatments.
Week # 7 ~ Edema Management and Phototherapy
Lecture: Behrens, Chapter 9 ,pp.199-221.
Chapter 5 ,pp.118-126.
The student is introduced to ultraviolet therapy. Emphasis is placed on indications and
Containdications, safety ,and establishment of minimal erythemal dosage. The student is
Also introduced to the various mechanisms of edema control (external compression,
Elevation, etc.). Edema is defined and causes explored..
Laboratory
Assignment: Behrens, lab manual, Chapter 11, pp. 127-131.
Chapter 14, pp.153-162.
Students practice in procedures to establish minimal erythemal dose. Students practice
Applying ultraviolet rays to the body . Given patient scenarios students apply ace
Wrapping, Coban, and mechanical compression devices to upper and lower extremities.
Treatment Application Activity.
Student exhibit critical thinking and sound technical skills in the management of
A lymphodema case as presented by the instructor and implement the prescribed plan
Of treatment. Students perform pain and sensation assessment ,ciurcumferential and
Volumetric measurement ,range of motion, goniometry, manual muscle testing,
Therapeutic exercise ,and external compression activities appropriate to the scenerio.
While performing treatments, students consider additional factors influencing patient
Care and the contemporary practice of physical therapy including,psycho-social
Issues and other issues impacting the health care delivery system. Student practice
Reporting and documenting consequences of treatment to supervising physical therapist.
Students perform discharge