module specification

This module develops students’ ability in a range of core knowledge, skills and attitudes required for the assessment, communication, problem identification, goal setting, treatment, management, and evaluation of effective Physiotherapy practice when working with individuals with long term conditions affecting musculoskeletal, cardiorespiratory, and neurological conditions.

Its emphasis will be on evidence-based clinical reasoning and problem solving, which is developed through critical engagement with theoretical evaluation of human movement and functioning and practical skills development. It will consider physiotherapy within contemporary healthcare frameworks as part of the multidisciplinary approach to ensuring recovery, rehabilitation, re-ablement and self-management of individuals with long term conditions. Students will learn and practice effective and contemporary clinical hands-on skills required to optimise outcomes for individuals with long-term conditions commonly encountered in practice. It will also develop the skills and understanding, including public health approaches to support continuing health and wellbeing in this population.

The module will run alongside applied sciences (PT7001) and physiotherapy theory and practice 2 (PT7004) to allow students to utilise human science as the basis of their evidence-based Physiotherapy management of commonly encountered problems in clinical practice.

This course runs alongside PT7001, PT7004
Available for Study Abroad? NO

Knowledge

• Contextual frameworks for healthcare: e.g., biopsychosocial, ICF, NHS and adult social care frameworks, national service framework for LTC, intermediate care and rehabilitation services, self-management, health informatics, digitally enhanced care
• Long term conditions including stroke / Parkinson’s disease / Multiple Sclerosis / polyneuropathy/ chronic obstructive pulmonary disease (COPD) / asthma / cystic fibrosis/ heart failure/ congenital heart disease/ bronchiectasis/ long covid/ osteoarthritis (OA) / rheumatoid arthritis (RA) / spinal pain/ persistent pain,
• Use of pharmacology and medication for long term conditions including for: altered muscle tone, extrapyramidal symptoms, anxiety, depression, asthma, COPD, inflammation, and pain; impact of polypharmacy, medication review in the management of long-term conditions
• Multi-disciplinary management of common conditions focusing on care pathways (e.g., at-home and community outreach for COPD), and the basis of specific physiotherapeutic interventions and rehabilitation programmes e.g., task specific training, mirror therapy, exercise therapy Parkinson’s, cardiac and pulmonary rehabilitation, exercise prescription for long term conditions, pain management etc.
• Self-management, health promotion and long-term management, progression of rehabilitation to include return to work / sport, promoting physical activity and reducing sedentary behaviour, health coaching etc.
• Evidence based physiotherapy management with emphasis on rehabilitation and exercise

Skills

• Clinical assessment skills including subjective & objective assessments – for a variety of long-term conditions affecting musculoskeletal, cardiorespiratory, and neurological systems
• Comprehensive neurological assessment
• Functional assessment
• Cardiorespiratory assessment of chest
• Interpretation of CXR
• Auscultation
• Musculoskeletal assessments in long term conditions affecting lower limb and gait
• E-health technologies for delivery of treatment and monitoring including telephone triage, and telerehabilitation
• Manual therapy for spinal rehabilitation
• Exercise prescription for spinal pain
• Clinical reasoning - (procedural, interactive, collaborative, teaching, predictive, ethical reasoning)
• Record keeping
• Therapeutic handling and positioning 
• Motor control rehabilitation
• Balance and gait rehabilitation
• Functional rehabilitation (gait, stairs, transfers) 
• Exercise prescription and progression
• Promoting self-management, health promotion, health coaching for living well
• Management of breathlessness (including positioning) & impaired gas exchange
• Long term oxygen therapy
• Thermotherapy
• Cardiac and Pulmonary Rehabilitation
• Approaches to optimise participation for people with dementia, anxiety, and depression (fluctuating consent, family involvement, CBT, ACT, exercise etc)

Attitudes

• Empathy, cultural competence, problem-solving for clinical reasoning
• Biopsychosocial approach (problem identification, plan, review)
• Person focussed care and population awareness
• Societal and global health awareness
• Health promotion

The teaching methods will include didactic teaching, guided self-study, blended learning, small group case study exploration, practical skills development sessions, and case-based teaching.

Practical teaching will be a significant part of this module and students will be able to work in groups and receive feedback from practical tutors to use to continue their skills development.

At the end of this module, students will be able to:

1. Apply sound knowledge and understanding of human functioning to formulate appropriate assessment, problem list and person-centred treatment goals for individuals with long term and related conditions seen by physiotherapists in a variety of clinical contexts using a biopsychosocial framework.
2. Deliver and evaluate safe and effective physiotherapeutic treatment and management including face to face, digital interventions, risk management interventions appropriate to individuals with long term and related conditions, their changing problems, environment, psychosocial needs, family/carer and other service providers.
3. Demonstrate the ability to work safely and effectively within your own scope of practice in collaboration with others and refer appropriately when necessary.
4. Systematically analyse and justify the role for physiotherapy within a multidisciplinary approach to recovery, rehabilitation and reablement services for individuals with long term and related conditions seen by physiotherapists in different contexts.

The module will be assessed by an objective structured clinical examination (OSCE) and a problem-solving essay.

Problem solving essay
This 2000-word essay will explore student’s ability to plan evidenced based management for an individual with long term conditions using a biopsychosocial framework. The essay will require students to explore all possible management approaches including multi-disciplinary strategies to optimise patient functioning in both short and longer terms. This assessment will account for 50% of module marks and assess LO 1,4. Students will have an opportunity to practice planning evidence-based management for clinical case studies throughout the module and be given a formative opportunity to practice writing a short essay and receive feedback before the actual assessment.

Objective Structure Clinical Examination (OSCE)
The OSCE will account for 50% of the module mark and will examine student’s practical and clinical reasoning skills for the assessment and delivery of physiotherapy interventions to optimise functioning in individuals with long term conditions within a multidisciplinary context. This assessment will account for 50% of module marks and assess LO 2,3. A formative practice OSCE will be scheduled before students do the actual assessment.

Electronic reading list:
https://rl.talis.com/3/londonmet/lists/170F7133-92AA-1DD4-5182-C17A6D097FF9.html

1. Greenhalgh, Susan, James Selfe. Red Flags: a guide to identifying serious pathology of the spine Elsevier 2006. 
2. Jenkins, P. 2005. Making sense of the chest x-ray: a hands-on guide. Hodder Arnold
3. Jones, M. 2019. Clinical reasoning in Musculoskeletal Practice. Elsevier.
4. Lennon, Sheila, Ramdharry, Gita, and Verheyden, Geert. Physical Management for Neurological Conditions. Fourth ed. 2018.
5. Main, Eleanor, and Denehy, Linda. Cardiorespiratory Physiotherapy: Adults and Paediatrics. Fifth Edition / Edited by Eleanor Main, Linda Denehy. ed. 2016.  
6. Petty, Nicola J. Neuromusculoskeletal Examination and Assessment: A Handbook for Therapists. Fourth ed. 2013.
7. Shumway-cook, A and Woollacott, M. 2012. Motor control: translating research into clinical practice.
8. Van Griensven, Hubert. Pain in Practice: Theory and Treatment Strategies for Manual Therapists. Edinburgh: Elsevier, 2005.
9. Tidy, Noel M., Porter, Stuart B, and VLeBooks. Tidy's Physiotherapy. 15th ed. Oxford: Churchill Livingstone, 2012. Physiotherapy Essentials