This laboratory manual is a compilation of years of work developing the neurologic and geriatric rehabilitation laboratory course at the Ohio State University. It is a constantly evolving course, but we wanted to capture the essence of the course and share it so that other instructors could utilize the resources developed over the years. This manual is designed to be used in conjunction with the textbook Neurologic Rehabilitation: Neuroscience and Neuroplasticity in Physical Therapy Practice but could be used with other neurologic rehabilitation textbooks.
This lab manual does not function like a typical textbook. It is designed to be used as an electronic resource and for use within a laboratory course. We have written it with the goal that the learner is practicing the techniques described, rather than simply reading the manual. We have included resources for both the instructor and the learner. Instructions for how to use the lab manual are included below.
The practice of neurologic physical therapy requires the translation of best evidence on evaluation and treatment of clients with neurologic disorders to clinical practice through guided practice and skill development. In Chapters 1 and 2, students develop fundamental skills of movement analysis and application of motor learning principles for skill acquisition that apply across all clients with neurologic disorders. Students review cerebral circulation and apply their knowledge to stroke cases in Chapter 3. Chapters 4 through 6 focus on student development of examination and evaluation skills with practice of a basic neurologic examination (Chapter 4), selection and interpretation of outcome measures (Chapter 5), and evaluation of a neurologic client through application of the Framework for Examination Decision Making (Chapter 6). Chapters 7 to 13 focus on the management of the client with stroke and similar health conditions, including functional task training of sitting upright and trunk control (Chapter 7), respiratory management (Chapter 8), bed mobility, positioning and range of motion (Chapter 9), transfers (Chapter 10), gait training (Chapter 11), upper extremity training (Chapter 12), and management of perceptual deficits such as unilateral neglect and pusher syndrome (Chapter 13). Chapters 14 to 18 focus on management of the client with spinal cord injury with laboratories on foundational skills (Chapter 14), bed mobility (Chapter 15), transfer training (Chapter 16), wheelchair skills (Chapter 17), and ambulation skills (Chapter 18). In Chapter 19, students gain skills in evaluation and treatment of balance deficits. Chapters 20 to 24 focus on the management of clients with specific neurologic disorders, including vestibular system disorders (Chapter 20), lower motor neuron disorders (Chapter 21), Parkinson disease (Chapter 22), multiple sclerosis and cerebellar ataxia (Chapter 23), and traumatic brain injury (Chapter 24).
For Learners and Instructors
Outline: This provides an overview of the chapter for all users.
Worksheet: Learners and instructors have access to a worksheet that describes activities to be practiced in class. Along with the description of activities, it also provides the learner with some brief introductory material, and thought questions are asked throughout each worksheet. Learners should utilize the worksheet as a roadmap to the activities performed in each laboratory session. We suggest that the worksheet either be open on a device or printed out and brought to class. This allows learners to write or type answers to questions and have instructions for activities on hand during classroom activities. Some chapters provide pictures and/or links to videos of specific techniques to augment student learning.
Skills Check and Skills Check Key: Each laboratory session ends with a skills check that can be performed by the learner as a self-check or by the instructor as a competency evaluation on the students’ learning. We also include a skills check key so that learners can self-assess or instructors can evaluate the students’ performance on the skills check.
Instructor Guide: The instructor guide provides a timeline for each laboratory session based on three-hour block of time. If the instructor needs to use a shorter or longer block of time it will be easy to alter the setup of labs since each chapter includes a recommended minute-by-minute breakdown of the laboratory session. In addition, we provide instructors with guidance on ways to set up the session, including breaking out in groups, setting up stations, and suggestions for using volunteer patients in the classroom. We hope that these instructions are valuable to new instructors setting up a course for the first time and veteran instructors looking for fresh ideas.
Worksheet Key: Each chapter includes a key to the worksheet that is released only to instructors. We designed the worksheet key to be helpful to instructors while teaching the laboratory session as well as a key for students to self-check their individual learning. Instructors can release the key to students once the laboratory session is completed.
We would like to acknowledge all the contributions that our students and residents make to our teaching; their input has been invaluable in the creation of this lab manual. We would also like to thank our families and our co-workers without whom this lab manual would not have been possible.