SPECIALITY PAPER

Speciality: Physiotherapy in Cardio Respiratory Conditions

UNIT-I Introduction to medical conditions

Common cardiac and respiratory conditions that need physiotherapy management,

(emphasis on congenital ad Ischemic Heart diseases, Cardiac failure, Valvular diseases,
Bronchectasis, Lung abscess, Empyema, COPD, Restrictive airway disease, Respiratory
filure). Tests for cardiac and Respiratory function, Clinical signs of these cardiac and
Respiratory function, Clinical signs of these diseases, Identifying complications,
prevetion/ avoiding complications (including DVT, pressure sore, neuropathy).

Unit-II introduction to Surgical conditions

Common surgeries done in Heart and Lung, their indicatios (emphasis an an

coronary by-pass graft. Valvotomy, valve replacements, Lobectomy, Pulmonectomy)
trauma to chest and its consequences, Tests of function, clinical signs,
identifying/preventing complications.

UNIT – III Medical Supervision and Physiotherapy.

Physician’s liability in Cardio-respiratory conditions seeking and intertreting

physician’s/physiatrist’s opinion, Physio-therapist’s liability, Reporting and referral to
physicians/physiatrist/hospital. Ethical issues.

UNIT – IV Basic care in Cardio – respiratory physiotherapy.

Special needs of a patient with cardiac/respiratory disease. Types of emergency,

consequences of emergency situation, communication skills in interacting with
patient/caregiver, Managing patient under sedation, care of equipment/iv line/ intubations
etc. connected to the patient.

UNIT – V Emergencies in Cardio – respiratory conditions.

Clinical feature of dyspnea, syncope, cyanosis, and shock. Bronchial and cardiac
asthma, protecting the airway, Resuscitation procedures/techniques, artificaial respiration,
Cardiac massage.

UNIT – VI Special test for Cardiac & pulmonary conditions.

Principles of exercise testing, Indication, contra – indications. Medical opinion on
testing precautions & setting for stress tests. Methods , Equipment, Test protocols,
reporting: spirometry, Respiratory Function Test.

UNIT – VII Physiotherapy in Pulmonary conditions.

Evaluation, goals of physiotherapy, Types of Breathing exercises, Breating Retraining,
Loclised expansion exercise, purse lip, paced abdominal and diaphragmatic breathing,
Shortness of breath and recovery. Postural Drainage, Methods of thinning secretions, use
of humidifiers, nebulisers, inhalers. General exercises, Adaptation to with exercise,
Aerobic exercises, Inspiratory exercises, Exercises to accessory respiratory muscles.

UNIT – VIII Strength and endurance exercise in chest conditions

Principles of physical training, Uses and results of strength and endurance training.
Methods of exerscises. Respiratory muscle therapy. Fatigue in Respiratory muscles.
Exercises in COPD dyspnea spiral, pulmonary exercises in children.

UNIT – IX Relaxation exercises in chest conditions

Principles of Relaxation, Methods of Relaxation, Yoga, Transcedental Meditation and

other forms or Relaxation; Anxiety/panic and respiratory function, progressive muscle
relaxation; Desensitisation, Music & Imagery as Relaxation therapy, Biofeedback in
Relaxation.

UNIT – X Pulmonary therapy in special situations.

Spinal cord injury, and chest physiotherapy, Bronchial asthma, Obesity, Geriatrics and
Physiotherapy, Physioptherapy in the unconscious patient.

UNIT – XI Support systems and Equipment.

Different types of ventilatory supports, Tracheostomy care. Chronic mechanical
ventilation, rocking bed and Pneumowrap, oxygen supports, Caring for patient with
Cardiac pacemaker.

UNIT – XII Physiotherapy in Cardiac conditions.

Types of Exercises in Cardiac problem, indications, contra-indications and
precautions. Aerobic exercises, Exercises for improving cardiac function and
Methodology, monitoring and evaluation (including identifying complications).

UNIT – XIII Principles of Rehabilitation.

Rehabilitation of Cardiac and pulmonary conditions, Awareness of risk factors,
environmental/genetic/infective/behavioural/, ADL analysis, modification of activity,
energy saving adaptations, sexuality; Home care and exercise at home, community
oriented approach to rehabilitation. Nature of impairment, disability and handicap in
cardio respiratory conditions.

LIST OF BOOKS RECOMMENDED

Physiotherapy in Cardio – respiratory conditions.

1. Wenger, Nanette Kass & Hellerstain, Herman K. Rehabilitation of the Coronary

Patient (1992) – Churchill Livingstone, N.Y.
2. Amuerdsen, Louis.R. Cardiac Rehabilitation - Churchill Livingstone, N.Y.
3. Jackon, Osa, Litrap – Therapeutic consideration for the Elderly - Churchill
Livingstone, N.Y.
 4. Zadai, Cynthia – Pulmonary Management in Physical Therapy. - Churchill
Livingstone, N.Y.
5. Hass, Francois & Axen, Keneth – Pulmonary therapy and Rehabilitation –
Williams and Wilkins, Maryland.
6. Bethall, Hugh - Exercise based Cardiac Rehabilitation. Publishing Initiatives,
Kent, U.K.
7. Smith, M; Ball,V.Cardiovascular and Respiratory Physiotherapy(1998) Harcourt
Brace, Edinburgh, U.K.
8. Pryor JA; Webber BA – Physiotherapy of Respiratory & Cardiac Problems
Publishers (1998). Harcourt Brace, Edinburgh, U.K.

SPECIALTY PAPER
Specialty: Physiotherapy in Pediatric Conditions

UNIT – I Growth and development

Patients of normal growth, Milestones, of development, various indices of health.

Modality and morbidity statistics of infancy and childhood.

UNIT – II Evaluation

Evaluation of the pediatrics patients, Eliciting history and information, from child
communication skills for managing paediatric patients, securing co-operation of the sick
child, sharing information with parents/caregivers.

Unit – III Development Disorders

Factors related to development disorders, Early/late detection of disorders.

Various disorders related to development. Hereditary and genetic disorders, Prematurity.

Unit – IV Principles of pediatric nursing

Specific goals of pediatric nursing, caring the infant. Managing premature infant.
Organisation of premature nursery. Equipment in premature nursery and paeditric
intensive / Critical care units. Correct use of equipment; problems in managing infants /
children with special needs eg. patients on support systems / assistive devices, patients
who have visual / hearing imparitment patiets with mental subnormality and patients with
progressive disorders. Caring the child before and surgery.

Unit – V Pediatric Nutrition

Elements of Nutrition, Daily allowance / requirement of nutrients, Nutritional
disorders and their relevance to physiotherapy.

Unit – VI
 Various assessment of child with developmental delay. Child on life support
systems, child with spasticity ataxia, in co-ordination and other neurological conditions,
child with congenital limb deficiency / abnormality.

Unit – VII

Physiotherapy in intensive / critical care unit and premature Nursery.

Unit – VIII Modalities and Techniques

Choosing the modality, precautions, contraindications, and care of equipment in

the pediatric setting. Correct use of techniques of exercise; techniques and movement
patterns; emphasis on various Bio-feedback, Retraining, neuro development and PNF
approaches, monitoring and evaluation of patients on therapy.

Unit – IX Physiotherapy of musculoskeletal conditions

Musculoskeletal disorders / injuries with special reference to congenital limb

disorders deficiencies, arthropathy / polyarthropathy primary muscle and skeletal diseases
including scoliosis systemic diseases with musculoskeletal manifestation eg.
haemophilia, Nature of impairment / deformity. Means of correction. Leprosy
physiotherapy.

Unit – X Physiotherapy of neruovascular conditions

Neurological and vascular conditions with emphasis on spina bifida, cerebral

palsy, poliomyelitis anterior horn cell diseases, sequelac of encepholpathy, meningitis &
carebro-vasuclar disease, paralytic disorders including peripheral nervous system disease,
Traumatic Brain injury sequelae – Disorders in co-ordination and movement. Identifying
goals, planning goals-oriented physiotherapy, monitoring evaluations.

Unit – XI Physiotherapy in surgical conditions

Pre-surgical physiotherapy, assisting to attain surgical goals. Post operative

complications and then physiotherapy, emphasis on pulmonary. Cardiac and limb
problem including prevention of DVT and pressure sores. Burns and their management.

Unit – XII Physiotherapy in Cardiopulmonary conditions

Cardiac diseases of children including congenital heart diseases, their impact on

the child’s health. Role of Exercises in these conditions. Pulmonary conditions like
Broncritics Asthma, Lung abscess, Bronchiectasis, and fibrocystic lung disease, their
physiotherapy, including management after cardiac and lung surgery.

Unit – XIII Aids, Appliances, support systems

 Use of Orthoses / prostheses in childhood and training. Special care needed for
orthotic and prosthetic use. Enhancing function / participation of a child using support
systems. Crutches, Wheelchairs and mobility aids.

Unit XIV Therapeutic recreation

Definitions, need of recreation in children, recreation activities as therapy /

exercises.

Unit – XV Community Physiotherapy

Need for communication physiotherapy, planning exercise at home, Creating

awarness of physiotherapy in selected members of community, monitoring & Evaluation
of community work.

Unit XVI Child with special needs

Physiotherapy management of children with various health conditions if they are

specially challenged as in Mongolism. MR, Seizures, Attention Disorders and progressive
diseases, Needbased physiotherapy in a child with cancer.

Unit XVII

Recent advances, Emerging issue: Schooling and physiotherapy, issues related to

HIV and TB in children.

PHYSIOTHERAPY IN PEDIATIC CONDITIONS

1. Case-Smith J. Paediatric Occupational therapy & Early Intervention Butterworth

Heinemann, Oxford
2. Banerjee, A. Infant Assessment, Spastics Society of India, Calcutta.
3. David. C.Lyod Gill Rheumatological physiotherapy Harcourt Brace, Edinburgh.
4. Haas, F. & Kenneth A. Pulmonary Therapy and Rehabiltation Williams & Wilkins,
Battimore.
5. Campbell. S.K. Paediatric Neruologic Physical Therapy Churchill Livingstone New
York.
6. Rothstein J.M., Measruemnt of physical therapy Churchill Livingstone, New York
7. Echternach, J.L. Pain Churchill Livingstone, New York
8. Tecklin, J.S. Paediatric Physical Therapy J.B. Lippincott C.United state.
9. Moran, C.A., Hand Rehabilitation Chruchil Livingstone, New York.
10. Smidt, G.L. Gait in Rehabilitation Churchill Livingstone, New York.
11. Donatelli, R.S. Wooden, M.J. Orthopaedic physical therapy Churchill Livingstone.
12. Stokes. M., Neurological Physiotherapy 1998, Harcourt Brace, Edinburgh.
 SPECIALITY

Speciality: Sports Physiotherapy

Unit – I Hisotry and Background

Origin of sports, Historical, Background, Qualities of an athiete, Relevances of
sports in the modern time. Introduction to sports physiotherapy, occurrence of injury in
sports.

UNIT –II Nutrition, Weight Control Performace & Recovery

Essential food groups – pre game meal – diet and performance weight control and
exercise body composition methods of assessing body composition, determining desired
weight, Muscular fatigue, soreness.

UNIT –III Exercise and Altitude

Effect of high altitude on physical performance physiological adaptations of
altitude, Altitude Traning and conditioning Mountain sickness.

UNIT – IV Walking and running

Structure and function kinematics of walking and running, differences between
walking and running, overuse syndromes and their management.

UNIT –V Standard tests to assess fitness

Physical fitness – Health related fitness, Motor fitness, Motor fitness, Motor
capacity, educability, and related variables.

UNIT –V Training Schedules

Warm up and cool off – definition and physiology, partner stretching, types of activity in
warm up and cool off. Intervcal sports programme, Sporting seasons, non-sporting
activity. Management of fatigue, Aerobic and anaerobic exercises/training Resistance
training.

UNIT – VII Sex Differences in Exercise

Structural and physiological characteristics – Gynaecological factors. Effects of
training and athletic competition on pregnancy, childbirth and the postpartum period,
Family, Female injuries Trinability.

UNIT-VIII Ageing and Exercise

Physiological chages accompanying the aging process-Traing adaptation in the
aged. Basic principles and guidelines for exercise programme for the aged.

UNIT –IX Prevention of Athletic injury

Types of injuries, in contact sports, non-contact sports, accidents, other health
hazards, infections. Health Education of the athlete on injuries, Athletic co-ordinating
programme, Risk free environment in sports, management of stress in athletes,
preparticipation screening, Orthotic management, bandaging and taping in sports,
prevention of sudden death in athlete-role of physiotherapist. Protective and supportive
equipment, limiting devices.

UNIT –X Common injuries of the upper limb ad lower limb

Injuries of shoulder, elbow, wrist and hand, Mechanisms of injury, principles of
treatment and Rehabilitation.

Structure and function of Hamstrings, Quadriceps, Adductors; Strains, Cramps

and other injuries of Low back and Thigh. Common knee injuries, injuries to ankle and
foot, exercise induced pain in leg. Ligament injuries. Skeletal and soft tissue injuries
during training/sports and management. Stress fractures overuse injuries, obscure pain –
principles of treatment & Rehabilitation.

UNIT – XI injuries in Children Adolescents

Types of injuries in children and adolescents, injuries, to the growing skeleton, Traning
for sport in children, Indication/ Contraindication of testing and training. Injuries and
inflammation of soft tissues. Identifying major injuries, Phychological stress and
motivation in children with injuries, management, Long-term physiotherapy to young
atheletes, consent for care, ethical issues.

UNIT – XII injuries due to hot and cold climate

Heat loss and heat gain-Diurnal changes exercises and Temp. regulations in hot
climate-Heat acclimatization – exercise and temperature regulation in cold climate.

UNIT- XIII injuries related to specific sport

Common injuries, their mechanism and specific management of
a) Contact sport like boxing,wrestling, football, hockey, polo, basketball,
volley ball.
b) Non-contact sports like sprints, hurdles, jumps, throws, vaults, cricket,
cycling, gymnastics, sking, swmming, water sports racing, equestrian
events.

UNIT-XIV Athletic psychology

Psychological aspects of sport injury – Athletes reaction to injury- athletes
response to injury – psychological aspects of pain –Anxiety – Stress – Motivation –
Psychological aspects of exercise.

UNIT – XV On-field management of athletic injury

Identifying on field injury, Assessment of injury and risks, major injuries and life
threatening, truma/illness, internal injury, spinal injury, fractures; Other bone, Joint,
muscle injury shock, First aid in sports, immedicate management, Definitive
management, referral, return to sport. On-field medical team, rapport with other
professionals, Triage- concept and practice.

UNIT – XVI Modalities and Techniques

Thermal and Electrical modalities used in training and treatment. Various types of
electrical stimulation, Bio-feedback Basic methods of muscle contraction, viz.,
mobilization, eccentric contractions, relaxation exercises, isokietic and conditioning
exercises, PNF, Neuromotor control. plymetrics, underwater exercises.

UNIT – XVIII Sports physiotherapy for the disabled persons

Sports for the Disabled persons – need, opportunities limitations. Special needs
and protection, prevention and management of injuries.

UNIT-XIX Community and Sports physiotherapy

Using knowledge of sports physiotherapy in the community health programmes,
Interacting with youth/sports clubs in the non –formal sector, professional relationship/
rapoort with other professionals like physicians/physical educationists /coaches/teachers.

LIST OF BOOKS SPORTS PHYSIOTHERAPY

1. Schridvier, Richard C. kennedy John C.Plant Mar5cus. L. – Sports injuries,

Mechanisms, prevention and Treatment – Williams and Wilkins (1985) –
Maryland.
2. Webb Gurrick – Sports injuries, Diagnosis and Mangement, W.B. Saunders co.,
Philadelphia
3. American Academy of Orthopaedic Surgeons – Athletic Trainig in Sports
Medicine, The CV Mosby company philadepphine
4. Richard, SR. Irvin – Sports Medicine, Prevention, Evaluation, Management &
Rehabilitation – Prentice Hall
5. Tacklin, Jon Stepher - Paediatric physical Therapy. J.B. Lippincott Company
6. Bern Lordt, Donna – Sports physical Therapy – Churchill Livingstone, New York.
7. Ryan, Allan. J.& Allman Jr. FL. Sports Medicine – Academic press New York.
8. Koury, Joanne, M. Aquatic Therapy programming -96 – Human kinetics Leeds
9. Guten, G.N.Runnunbg Injuries 1997 – WB saunders philadephia
10. Zachazew ski, J.E Magee, D.J & Quilen, MS – Athletic Injuries and
Rehabilitation 1996. WB saunders, Philadelphia
11. Zuluaga, M. Brigg C. Carlisle J. Sports physiotherapy 1995 churcill Livingstone,
London.
12. Nicholas, James, A. Hershman, Elliot B.-The Upper Extremity in sports Medicine.
The C.V.Mosby Company (1990) Philadelphia.