EXSC632 - Clnical Assessment and Exercise for Neurological Conditions

Year

Credit points

Campus offering

Prerequisites

Teaching organisation

Unit rationale, description and aim

Injury to the nervous system is often devastating; however, extensive recovery of function within this system is possible with appropriate diagnosis and rehabilitation. Within their scope of practice, accredited exercise physiologists must be able to design and prescribe safe, evidence-based exercise interventions for individuals suffering a range of neurological disorders. This unit builds upon a framework of the human nervous system at gross anatomical and fundamental elemental levels, with a focus upon the sensory and motor components of movement control. This unit will extend the principles of physiology, motor control and biomechanics, and build upon skills gained during undergraduate studies. Students will explore the use of exercise in the rehabilitation of individuals with neurological disorders (including stroke, spinal cord injury, acquired brain injury, Parkinson's and multiple sclerosis). Specifically, pathophysiology of neural injury, general impairments commonly suffered as well as specific neurological disorders will be examined. The aim of this unit is for students to become proficient in the knowledge and techniques for the determination of neurologic injury and exercise-based rehabilitation of general neurological impairments, as well as specific neurological disorders.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Demonstrate advanced, coherent knowledge of anatomy, physiology, pathology and evidence-based clinical assessment and exercise interventions relevant to neurological conditions (GA5, GA8, GA9)

LO2 - Demonstrate critical thinking and clinical reasoning to design and justify safe and effective person-centred exercise interventions informed by advanced and coherent knowledge of holistic clinical management and evidence-based practice and the needs and goals of individuals with neurological conditions (GA1, GA4, GA5, GA8, GA9).

LO3 - Selectively apply evidence-based clinical assessments for individuals with neurological conditions and demonstrate critical thinking and clinical decision making to interpret findings, which informs subsequent holistic clinical management (GA1, GA3, GA4, GA5, GA8, GA9, GA10).

LO4 - Demonstrate the ability to design, deliver, monitor and adapt safe and effective person-centred exercise interventions for individuals with neurological conditions integrating advanced and coherent knowledge of holistic clinical management and evidence-based practice (GA1, GA3, GA4, GA5, GA6, GA8, GA9)

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

GA8 - locate, organise, analyse, synthesise and evaluate information 

GA9 - demonstrate effective communication in oral and written English language and visual media 

GA10 - utilise information and communication and other relevant technologies effectively.

Content

Topics will include: 

• Nervous system, its role in motor control, and responses to pathology
• Neurological disorders, with a focus on accredited exercise physiologist target pathologies
• pathophysiology, aetiology, classifications, associated risk factors, incidence, signs and symptoms
• common treatments, and effects on clinical status and exercise capacity
• Evaluation of neuromuscular accredited exercise physiologist target pathologies
• sensory, motor and functional (e.g. posture, balance, gait) evaluation and assessment 
• exercise capacity
• Principles of exercise prescription
• Assessment of clinical outcomes and their effects
• Appropriate design, implementation, monitoring, modifying and progression 
• Effects of commonly prescribed medications on the response to exercise 
• Current rehabilitation best practices
• application of current evidence
• Indications and contraindications of procedures during assessment and rehabilitation 
• monitoring and interpretation of physiological response at rest, exercise and recovery
• safety practices in recognition of adverse signs and symptoms of accredited exercise physiologist 
• Communication with patients and other health professionals
• communicating with patients with communication difficulties

Learning and teaching strategy and rationale

This unit is offered through multi-mode delivery and aims to facilitate learner centred activities and inquiry-based learning. Learning and teaching strategies within this Masters level unit are based on a blend of constructivism, social constructivism, and experiential learning. These strategies focus on active participation and developing a community of inquiry. Purposefully designed content and activities have been identified. This has led to the development of purposefully designed learning activities focusing on inquiry-based learning principles aimed at encouraging critical thinking, clinical decision-making, application of knowledge and skills, evidence for practice, collaborative peer learning, and critical self-reflection.

Students participate in individual and small group activities based on analysis of current practice, to assimilate application of acquired knowledge and facilitate translation of learning into practice. Engagement in extended dialogue is encouraged to guide change to a more interprofessional, person-centred practice. Unit activities include, but are not limited to: guided readings, synchronous on-line or face-to-face lectures, web-based activities and practical workshops, which include skill development, case-study simulations, work-based activities with reflection to enhance practice. To facilitate practical application of knowledge and skills, multi-mode delivery requires participation in weekly practical workshops. Where possible, workshop activities are designed as reusable learning objects. Activities are aimed to facilitate acquisition of advanced knowledge and skills in assessment and exercise intervention planning strategies.

Assessment strategy and rationale

Assessment tasks in this unit have been purposefully designed to prepare for and replicate authentic clinical practice, with an “assessment for learning” approach to provide evidence for judgement of learning and to reinforce, facilitate and support learning and its application. The assessment tasks have been designed to provide a broad range of tasks aligned to andragogic principles of adult learning, facilitating choice and self-direction for the post graduate student. The design enables timely judgement to ensure students have appropriate knowledge and skills prior to workplace application.

The first assessment task enables students to acquire and apply advanced knowledge and understanding of content delivered throughout the unit. The second assessment task enables students to assimilate this knowledge and develop clinical reasoning to interpret the findings of a clinical assessment and prescribe an exercise rehabilitation intervention, which is informed by holistic clinical management, evidence-based practice and based on individual needs and goals of a case study. The final assessment task enables students to develop the ability to apply critical thinking and clinical reasoning to selectively perform and justify the use of appropriate clinical assessments, which will then inform prescription, instruction and delivery of an exercise rehabilitation intervention for a case study with a neurological condition. This assessment tasks also enables students to apply knowledge and skills specific to evaluation and monitoring of the case study’s response to exercise and apply clinical decision making to modify the intervention where necessary. The final assessment task is also a hurdle requiring students to demonstrate, at a minimum, the essential clinical competencies needed to safely and effectively service a client with a neurological condition. Demonstration of these essential clinical competencies is necessary for safe and effective professional practice as an accredited exercise physiologist. Students will be given two opportunities to successful complete this assessment with space for provision of individual feedback between opportunities if required.

Overview of assessments

Representative texts and references

Carr, JH, & Shepherd, RB. (2010). Neurological Rehabilitation: Optimizing Motor Performance (2nd ed). Churchill Livingstone.

Shumway-Cook, A, & Woollacott, MH. (2011). Motor Control: Translating Research into Clinical Practice (4th ed.). Baltimore, MD: Lippincott Williams & Wilkins.