75302 - Advanced Physiotherapy - (IM)

Learning outcomes

At the end of the module the student possesses the knowledge and the ability to understand about the alterations of the peripheral nervous system and the degenerative alterations of the 1st and 2nd motor neurons susceptible to physiotherapy treatment. He is able to formulate rehabilitation hypotheses on the basis of the analysis of the neurological deficit and to plan, program, and perform a physiotherapy intervention.

Course contents

General elements of the neuroanatomy of the SNP

MOTOR UNIT AND INNERVATION RATIO: temporal summation, spatial recruitment, synchronization; strength gradation, discharge frequency, theory applied to strengthening exercise through proprioceptive neuromuscular facilitations and with the use of correct proprioceptivity; Different types of muscle contractionPrinciples of physiotherapeutic treatment of peripheral nerve lesions: recovery and maintenance of muscle trophism; recovery of sensitive components. Therapeutic exercise, neuromuscular facilitation, proprioceptive exercise, occupational therapy, choice of aid and classification of orthoses

· CLASSIFICATION OF THE PATHOLOGIES OF THE PNS: topographic: mono-, multi- or polyneuropathies, plexopathy and rhizopathy; qualitative (neuroapraxia, neurotmesis, axonotmesis); principles of axonal and myelin regeneration

CLINIC OF PNS NEUROLESIONS and etiopathogenesis (motor, sensory and autonomic semeiotics)

STUPOR FROM THE OPERATING ROOM: INSIGHTS ON CAUSES AND PROGNOSIS.

INSTRUMENTAL DIAGNOSTICS: EMG, ENG, Curve I / t, V.d.C, in relation to functional restoration.

ANATOMY AND CLINIC OF CRANIAL NERVES: principles of semeiotics referred to pathology of the c.n.

PATHOLOGIES OF PHYSIOTHERAPY INTEREST OF CRANIAL NERVES: clinical and rehabilitative treatment in neuropathies of III, IV, VI, VII, VIII n.c.

 PATHOLOGIES OF PHYSIOTHERAPY INTEREST OF THE CERVICAL SPINE AND BRACHIAL PLEXUS Review of the anatomy of the brachial plexus: roots, collaterals and terminal branchesMotor innervation and sensory territory of the cervical roots: myotomes, dermatomes and sclerotomes.Clinical correlations between cuff injuries and neck pain.Evaluation of the PNS of the upper limb; principles of neurodynamics: decompression, sliding, peripheral nerve tension; R.O.T., their course and palpation, evocative orthopedic tests, Tinel testThoracic Outlet Syndrome: description, evaluation (Adson's test, Eden's test, Wright's test), clinical indications and treatment principles

PATHOLOGIES OF PHYSIOTHERAPY INTEREST OF THE LUMBOSACRAL SPINE AND OF THE LUMBAR AND SACRAL PLEXUSES Review of the anatomy of the lumbar and sacral plexus: roots, collaterals and terminal branchesMotor innervation and sensory territory of the lumbar and sacral roots: Myotomes, dermatomes and sclerotomesEvaluation of the terminal branches of the lumbar and sacral plexus: stretch positions, R.O.T., their course and palpation, evocative orthopedic tests, Lasegue test, Straight Leg Raise test Wasserman testFocus on herniated disc compressions and narrowed vertebral canal compressions

THE AUTONOMOUS NERVOUS SYSTEM: anatomical description of the Orthosympathetic, Parasympathetic and MetasympatheticSemeiotics and clinical studies of the ANS: dysautonomies and the main clinical correlations with pathologies of physiotherapeutic interest

POLINEUROPATHIES: Guillan-Barrè syndrome: etiopathogenesis, clinical course (prodromal, extension, state and recovery phase), evaluation (motor and sensory balance), indications for the physiotherapeutic treatment of the various, auxiliary principles

· Critical illness myophaty and neuropathy: classifications, pathophysiology, risk factors, semeiotics. Rehabilitation: taking charge, evaluation, treatment in the various phases. ·

HEREDITARY DEGENERATIVE NEUROPATHIES: Charcot Marie-Tooth; etiopathogenesis and indications of physiotherapeutic treatment

· VIRAL NEUROPATHIES: Acute Anterior Poliomyelitis: etiopathogenesis and indications of rehabilitation treatment in the different ages of the patient and possible clinical complications.· Principles of physiotherapeutic treatment of peripheral nerve lesions: recovery and maintenance of muscle trophism; recovery of sensitive components. Therapeutic exercise, neuromuscular facilitation, proprioceptive exercise, occupational therapy and the choice of aid

1st AND 2nd MNS: ALS: etiopathogenesis, incidence, symptoms, differential diagnosis, ALSSS scale

Readings/Bibliography

Cyriax J., Medicina ortopedica: diagnosi clinica e trattamento appropriato, Piccin Nuova Libraria, Padova.

Formica M. M. et al., Trattato di neurologia riabilitativa, Marrapese Editore, Roma.

Kandel E. R., Schwartz J. H., Jessell T. M., Principi di neuroscienze, Casa Editrice Ambrosiana, Milano.

Kendall H. O., Kendall F. P., Wadsworth G. E., I muscoli: esame e studio funzionale, Piccin Nuova Libraria.

Knott M, Voss D. E., Facilitazione neuromuscolare propriocettiva, Piccin Editore, Padova.

Mumenthaler M., Schliack H., Lesioni dei nervi periferici, Piccin Nuova Libraria, Padova.

Prencipe R., Le neuropatie periferiche, Lombardo Editore, Roma.

Sorrentino G., Neurologia: principi di fisiopatologia, Idelson-Gnocchi editori, Napoli.

Stein J. H., Medicina interna, Art Servizi Editoriali, Milano.

Upledger J. E., Terapia Cranio-Sacrale: oltre la dura madre, Marrapese Editore, Roma.

Pieter Westerhuis, Renate Wiesner, Modelli clinici in Terapia Manuale, Thieme.

G. Maitland, E Hengeveld, K. Banks, K. English, Manipolazioni vertebrali di Mkaitland, seconda edizione Elsevier

Elly Hengeveld, Kevin Banks, Manipolazioni periferiche di Maitland, quarta edizione Elsevier

Adam Fisch MD, Neuroanatomy: Draw It to Know It, Oxford University press 2009 Martini, Fondamenti di anatomia e fisiologia, EdiSES

Teaching methods

Lectures on site supported by practical exercises

Assessment methods

The learning assessment procedure will be carried out through a written test. The candidate will have the opportunity to articulate what they have learned during the lessons and through their internship experiences.

Teaching tools

The lessons will be supported by slides and practical exercises

Office hours

See the website of Simone Rodio