ࡱ> 9 %`bjbj-Y0lBBB8BLJC|_2E: F".F.F.FHNkHH$ `9HHHHH/O.F.F/O/O/OH".F.F/OH/Oz/OU*tƜ.FE l;BN^Ɯ /0_NvƜ/OProject Name of the project: Title: Comparing different types of stimuli Subtitle: Demonstrating the effects of exercise therapy along the movement continuum via video Participating students: Michael Bramlett Drew Crowley Jason Kwak Natalia Mosley 0.3 Date: February 25, 2002; Version 6 Project Commissioner Who is responsible: Commissioner: Jan Rumpt Physiotherapy Instructor Supervisors: General Supervisor: Richard van Diesen Physiotherapy Instructor Methodological Supervisor: Annelies Simons Physiotherapy Instructor Graduation Project Coordinator: Annelies Simons Definition of the problem History Physiotherapy is a form of rehabilitation for patients who need to return to functional recovery in order to perform their activities of daily life. As rehabilitation means, physiotherapy treatments are applied in various ways. Mosbys dictionary defines physiotherapy as the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave diathermy and ultrasonic heat), hydrotherapy, electric stimulation, and light to assist in habilitating or rehabilitating patients and in restoring normal function after an illness or injury. (Mosbys, 1262) Over time many theoretical models, such as Hislops Model of Pathokinesiology (Cott et. al., 88) or the Multidimensional Load and Tolerance Model (Rumpt, 15) have been used in an attempt to define the interrelationship between the physical therapist, the patient, and the physical therapists means of therapy (e.g. therapeutic exercises or exercise therapy). A theory, which was introduced in 1995, is The Movement Continuum Theory of Physical Therapy (Cott et. al., 87). The movement continuum is a broad theoretical concept developed to help define physical therapy practice. The theory looks at the relationship between the physical therapist and movement rehabilitation, which involves all levels of the continuum. It incorporates knowledge of pathology from a holistic point of view, which includes physical, social and psychological factors. Essentially the purpose of the theory is to provide a framework for the entire profession that is applicable to education, research and clinical practice(Cott et. al., 87). The Movement Continuum can be seen as a conglomerate of parts of a hypothetical patient to be treated, beginning at a micro-level (e.g. Molecular, Sub-cellular, Cellular) and ending at a macro-level (e.g. Person in environment, Person in society). The Movement Continuum Theory claims that real physical movement occurs at each specific level. The levels are; Molecular, Sub-cellular, Cellular, Tissue, Organ system, Body part, Body, Person in environment and Person in society. An advantage of this new theory is that it is functional as it acknowledges the patients needs on numerous levels. A disadvantage is that it is difficult to understand how some levels of the continuum are stimulated via physical therapy means (e.g. exercise therapy). The disadvantage mentioned above is commonly experienced among first year English Stream physical therapy students at Fontys Paramedische Hogeschool. The students are introduced to the Movement Continuum Theory during an exercise therapy course. They find it simple to relate the influence of exercise therapy along the mid-range levels of the continuum (e.g. Tissue, Organ system, Body part, Body). However, the students find it somewhat difficult to relate the influence of exercise therapy along the macro-levels of the continuum and even more difficult to understand the influence exercise therapy has on the micro-levels. The main problem is that Fontys physical therapy English Stream students do not understand how each level of the Movement Continuum is influenced, or can be influenced via exercise therapy. In view of the difficulties the students have, an exercise therapy instructor at Fontys, Jan Rumpt, has commissioned this senior thesis project group to demonstrate the effects of exercise therapy along the movement continuum. He states; Physiotherapists work with different types of means, all of which have a certain potential as a stimulus. Modalities are mainly directed at the tissue level. Exercise is often seen as a tool to address the level of organ (joints, muscles) however exercise therapy can also be used to address other levels. In regards to the main problem, the objective of this project is to clearly illustrate that each level of the Movement Continuum can be influenced with exercise therapy. There are various ways to demonstrate this, such as booklets, readers, etc. This group will attempt to demonstrate this by means of a video, in English, as it is a two-dimensional means and complete motions are viewable from beginning to end. Upon completion of the project, the group will decide if in fact video is the best way to demonstrate the effects of exercise therapy along the Movement Continuum. Scientific and social relevance This project contains both scientific and social relevance. Its scientific relevance will be portrayed if the Movement Continuum theory is demonstrated, put into action, so that others can decide for themselves if The Movement Continuum Theory should be accepted as a framework for the basis of physiotherapy theory. Furthermore, if the objective of supporting the effects upon each level with research is achieved, this will be a valuable scientific contribution. It is socially relevant in the sense that it can be used as a learning aid to help Fontys English Stream-4 physical therapy students, first year (module periods 1-2), understand the relationship which exercise therapy has with The Movement Continuum Theory. Main question 1: Can each level of the movement continuum be stimulated with exercise therapy? Sub-questions: a. What is the movement continuum? What are the levels of the movement continuum? c. What is exercise therapy? d. Which exercise therapy techniques are effective for stimulating the particular level being considered? Main question 2: Is video a good way to demonstrate this? Sub-questions: a. What are the benefits of a video demonstration? b. Can the exercises be demonstrated on video? c. Can the movement continuum be demonstrated via video? Working Definitions: -Active Techniques- Movement within the unrestricted ROM (range of motion) for a segment that is produced by an active contraction of the muscles crossing that joint. (Kisner et. al. , p. 25) -Active Assisted Techniques- A type of active ROM in which assistance is provided by an outside force, either manually or mechanically, because the prime mover muscles need assistance to complete the motion. (Kisner et. al. , p. 25) -Body- The entire material or physical structure of an organism, especially of a human being or animal. (ahd, p. 155) -Cell- The fundamental unit of all living tissue. (Mosbys, p. 289) -Environment- The totality of circumstances around an organism or a group of organisms. (ahd, p. 460) -Joints- Any one of the connections between bones. (Mosbys , p. 886) -Modality- The method of application of a therapeutic agent or regimen. (Mosbys, p. 1043) -Motor skills- Performance of complex motor (a muscle, nerve or centre that effects or produces movement) acts. ( OMD, 12/88) -Movement continuum theory of physical therapy- The movement continuum is a broad theoretical concept developed to help define physical therapy practice. (Cott et. al., p. 87) -Movement continuum levels: Molecular, Sub-cellular, Cellular, Tissue, Organ system, Body part, Body, Person in environment and Person in society. (Cott et.al. p. 87) -Muscle- A tissue composed of fibers capable of contracting to effect a bodily movement. (ahd, p. 898) -Organ- A structural part of a system of the body that is composed of tissues and cells that enable it to perform a particular function. (Mosbys, p. 1156) -Organ system- A group of organs that work together to perform a vital body function. (Marieb, p. 1154) -Passive techniques- Movement within the unrestricted ROM for a segment that is produced entirely by an external force; there is no voluntary muscle contraction. (kisner et. al., p. 25) -Person- a living human being. (ahd, p. 1019) -Physical- combining form meaning natural. (Mosbys, p. 1261) -Physiotherapy- The treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave diathermy and ultrasonic heat), hydrotherapy, electric stimulation, and light to assist in habilitating or rehabilitating patients and in restoring normal function after an illness or injury. (Mosbys, p. 1262) -Psychological- Of or relating to the mind or mental activity (CED p. 1252) -Social- Of, relating to, or characteristics of the experience, behavior, and interaction of persons forming groups. (CED, p. 1465). -Society- An organization or association of persons engaged in a common profession, activity, or interest. (ahd, p. 1292). -Sub-cellular- Situated or occurring within a cell. (ahd, p. 1350) -Stimulus- Any agent that provokes a response, or a particular form of activity, in a cell, tissue, or other structure, which is said to be sensitive to that stimulus. (CMD, p.629) -Tissue- A collection of cells specialized to perform a particular function. (CMD, p. 664) -Variable- Liable to or capable of change. (CED, p. 1697) Objectives To demonstrate exercise therapy at each level of the movement continuum. To demonstrate this via video. To provide a research report which explains the theory behind it. To provide more study resources for Fontys hogescholen physical therapy students Method Steps related to literature research process A) Methods and standards for literature research 1. Meeting with Jan Rumpt for research advice 2. Choosing sources (journals, books, internet databases, etc.) 3. Dividing up group tasks for research 4. Gathering/collecting research 5. Deciding on target (primary/secondary body regions related to exercise therapy) 6. Filtering research (criteria: pertinent?, dates, primary vs- secondary sources, scanning journal abstracts for quick judgements, literature from referred journals) Collecting literature resources 1. Movement continuum theory 2. Exercise therapy theory BOOKSLIBRARIES- Therapeutic Exercise; Foundations and Techniques - PNF in Practice - Human Anatomy and Physiology - Foundations of Clinical Research; Applications to Practice - Clinical Decision Making in Therapeutic Exercise - Etc- University of Oklahoma Health Sciences Center - Van Hogescholen Amsterdam - Fontys Paramedische Hogeschool INTERNETDATABASEKEYWORDSBOOLEAN KEYWORDSMEDLINE MEDLINEPLUS CINAHL NAIRC APTA GOOGLE PSYCHO ABSTRACTS Etc movement continuum theory, knee; pain, rehab exercise, therapy, strengthening, rectus femoris stability, coordination, stimulation, vibration, stretch, lengthening, Hislop, Cott, Nagi, molecule, sub-cellular, cellular, tissue, organ system, body, ICIDH, muscle fibers, circulation, proprioception, skill exercise, biological factors movement continuum AND exercise, exercise therapy OR movement continuum theory, therapy OR rehabilitation, myofibril OR sarcomeres, tissue AND stability, cells AND exercise, tissue AND exercise, exercise therapy AND environment, exercise therapy AND society, physical therapy NOT electrical stimulation, molecules AND exercise JOURNALS-Physiotherapy Canada, -British Medical Journal (BMJ), -Physical Therapy Magazine -Journal of the American Physical Therapy Association -PT Magazine -Physiotherapy -Nederlands Tijdschrift Voor Fysiotherapie -The Practitioner -The Journal of Sports Medicine Filtering criteria for literature research 1. General Filtering -Scanning journal abstracts (quick judgment of content relevance) -Primary vs- secondary source? (primary is best, some secondary useful) -Recent vs-Classic source? (some classic is ok) -Is literature from a referred journal? (this is the most reliable) 2. Movement Continuum -Related to the movement continuum -Related to individual levels within the movement continuum -Related to ICIDH -Other literature authored by Cott, Hislop, Nagi, Guccione 3. Exercise therapy -Based of exercise therapy principles which are accepted within the field -Based on qualified physiotherapists acceptance or endorsement -Based on exercises which have been proven successful in treatment -Based on relationship with the movement continuum theory -Supporting the project idea and theories -Based on science (e.g. physiological effects) -In conjunction with ICIDH standards Reading and reviewing literature research (two group members teamed up) 1. Movement continuum -What is the date of the resource (current is best, classical is also useful)? -Is the journal referred? -Is the source primary (best)? -Is the source secondary (also useful)? 2. Exercise therapy theory -What is the date of the resource (current is best, classical is also useful)? -Is the journal referred? -Is the source primary (best)? -Is the source secondary (also useful)? E) Determining exercises and techniques from literature -Based on movement continuum levels -Based on physical therapy practice -Based on physiological effects -Based on region treated (muscles, ligament, tissue) Steps toward making video A) Research on making video process -Journals: Filmmaker Magazine Moviemaker magazine -Internet:  HYPERLINK http://www.learner.org/exhibits/cinema www.learner.org/exhibits/cinema  HYPERLINK http://www.moviemaker.com/index.html www.moviemaker.com/index.html  HYPERLINK http://www.google.com www.google.com -Keywords: Play screen AND filming, Screenwriting OR Script, Editing, Filming AND How to, Video AND Production, Video OR Filming etc B)) Research regarding music copy right laws -www.google.com Keywords: free music OR copyrights -www.musiclibraryassoc.org/copyright/copyhome.html Keywords: copyrights AND music C) Writing a script for a video -Based on chosen exercises and techniques from literature research E) Renting out proper equipment --Video, tripod, lights, TV, VCR, treatment table, etc. F) Environment and Setting for filming -Table, lights, space, tone, props etc. -Costumes (clothes) and make up for actors G) Rehearsal for action -According to script H) Filming the video -Recording the performance Editing the video -Choosing background music according to copy right laws -Text, voice, video copies, etc. Project product Title of the project along with a summary (half A4) End product report of comparing different types of stimuli (exercise therapy) End product video of comparing different types of stimuli (exercise therapy) Individual evaluation reports Verbal presentation Time 6.1 & 6.2 Schedule & Phasing of project activities Week / DateActivitiesWhoOctober 11, 2001Allocating information for FLPAllNovember 7Meeting with commissioner Jan RumptAllNovember 11Deliver concept of the FLP formatJasonNovember 22Meeting with supervisors (Annelies and Richard)AllNovember 22Group meeting and dividing tasksAllNovember 27Revise FLP format via e-mail to supervisorsJasonNovember 29Deliver revised FLP format (3 copies)Drew Realization PhaseWeek / DateActivitiesWhoNovember 27~29Finalize FLP format and tasksGroupNovember 22~Jan.Literature research on InternetDrewNovember 22~JanLiterature research in study landscapeMichaelNovember 22~JanLiterature research (journals and articles) JasonNovember 22~JanLiterature research (readers, module, and textbook)NataliaDecember 10~14Meeting with the supervisorsGroupDecember 10~14Correction of FLPGroupJanuary 09, 2002Final correction of FLP and discussionGroupJanuary 10Meeting with supervisorsGroupJanuary 15Hand in FLP to supervisors via emailDrewJanuary 17Reserve digital camera and video equipmentNataliaJanuary 17Reserve camera room 1413MichaelJanuary 17Reserve editing roomJasonJanuary 22Meeting with General supervisor at 10am (Richard)GroupJanuary 24~26Read and review literature of movement continuumJasonJanuary 24~26Read and review literature of movement continuum.MichaelJanuary 24~26Read and review literature of exercise therapy theoryNataliaJanuary 24~26Read and review literature of exercise therapy theoryDrewJanuary 29Discussion and filtering literatureGroupJanuary 29Choosing literature to be used; movement continuum Jason & MichaelJanuary 30Choosing literature to be used; exercise therapyDrew & NataliaJanuary 30Choosing exercises and techniques for filming Jason & MichaelJanuary 31Start working on End Product report (until 28/02/02)Drew & NataliaFebruary 1Research of how to make video; settingJason & MichaelFebruary 1Research of how to make video; processJason & MichaelFebruary 4~6Write a script for video (based on research)Jason & MichaelFebruary 6~8Write title and summary for presentationDrew & JasonFebruary 21Deliver title and summary for project presentationNataliaFebruary 21Meeting with the supervisorsGroupFebruary 22Revise script for videoJason & MichaelFebruary 26Review End Product Report as a groupGroupFebruary 27Hand in End Product Report for comments (first draft)Drew Completion PhaseWeek / DateActivitiesWhoFebruary 27Film video; camera & settingJasonFebruary 27Film video; patientNataliaFebruary 27Film video; physical therapistDrewFebruary 27Film video; read script for guide (voice not recorded)MichaelFebruary 27Reviewing the film & corrections for film #2GroupFebruary 28Film #2 (improvements and corrections)GroupFebruary 28Turn in rough video to supervisorsJasonFebruary 28Brainstorm session regarding editing processGroupMarch 1Preparation for editing; materials & rehearsal (voice)IndividualMarch 1Training of editing processGroupMarch 4Editing video: voiceDrewMarch 4Editing video: texts and scanningJasonMarch 4Editing video: musicNataliaMarch 4Editing video: musicMichaelMarch 4Review the final edited videoGroupMarch 5Final editing process (corrections, improvements) GroupMarch 5Ordering 8 duplicates of end product video JasonMarch 5Binding end product report with correctionsDrewMarch 7Deliver End Product Report (plus video)Drew & JasonMarch 8Meeting with supervisorsGroupMarch 8Finalize individual reportIndividualMarch 15Deliver individual reports IndividualMarch 15~20Individual discussionIndividualMarch 14~15Writing script for the presentation; introductionJasonMarch 14~15Writing script for the presentation; methodsDrewMarch 14~15Writing script for the presentation; resultsNataliaMarch 14~15Writing script for the presentation; conclusionMikeMarch 15Reviewing the script for correction and improvementsGroupMarch 16Make PowerPoint for the presentation; introductionJasonMarch 16Make PowerPoint for the presentation; methodsDrewMarch 16Make PowerPoint for the presentation; resultsNataliaMarch 16Make PowerPoint for the presentation; conclusionMichaelMarch 17Finalize power point and improvementsGroupMarch 18Presentation Rehearsal with supervisorGroupMarch 20Final presentationGroupMarch 21Examination committee meetingGroup 7. Estimated Cost (A reimbursment of about 210.00 will be made upon passing this project) = 45.4 (Printing and copies) = 8.10 = 1.16 X 7(Binding for each report) = 1.81 = 0.41 X 4(4 Floppy disks) = 6.8 = 2.27 X 3 (3 medium grade video tapes) = 34.0 = 6.80 X 5 (5 High quality video tapes) = 408.5 = 81.7 X 5 (Editing of video) =509.39 Euros(Grand Total) Quality requirements Functional Demands (commissioner): (Demonstrate the effects of exercise therapy along each level of the movement continuum via video (Time (45 minutes maximum) (Color film ( VHS (Pal system format) ( In the English language Operational Demands (consumer/user): Fontys Paramedische Hogeschool physical therapy students Emphasis towards English program students during first year (ES4; periods 1 and 2) (Easy to follow (English text and voice (Clear and visual understanding (Informative (Concise (Compliments existing materials being used in the program (Answers most commonly asked questions, which are currently unavailable (Educational Boundary Conditions (environment/department): (Literature Study, exploring the movement continuum (Proper grammar, spelling, and pronunciation (Scheduling with appointments and rotation of examination Design Limitations: (Reservation schedule with video/audio department (Errors and mistakes with filming and editing equipment (Financial budget (rental cost for editing room) (Availability of the rooms and equipment (Lighting of the rooms for optimal video recording (Technical difficulties (editing process) (Approval by Fontys graduation committee (Deadlines for each task Provisional Literature Adler SS, Beckers D, Buck M, PNF in practice. 2nd ed. Berlin: Springer-Verlag, 2000. Colby LA, Kisner C, editors. Therapeutic exercise, foundations and techniques (third edition). Philadelphia: F.A.Davis, 1996. Collins English Dictionary. 3rd ed: Glascow: Harper Collins Publisher, 1994. Cott CA, Finch, E, Gasner, D, Yoshida, K, Scott TG, Verrier, MC. The movement continuum theory of physical therapy. Physiotherapy Canada 1995 Spring; 47 (2):87-95. Marieb EN. Human anatomy and physiology. 3rd ed. Amsterdam: Benjamin/Cummings: 1998. Medline plus: Dictionary: CancerWEB On-line Medical dictionary 1995-97. Mosbys medical, nursing, & allied health dictionary. 5th ed. St Louis: Anderson, Anderson & Glanze, 1998. Portney LG, Watkins MP, Foundations of clinical research; applications to practice. 2nd ed. Upper saddle river(NY): Prentice-Hall, Inc., 2000. Rumpt J. Op zoek naar de essentie van fysiotherapie: een vergelijking tussen het meerdimensional belasting-belastbaarheidsmodel en het model van het bewegingscontinum. Nederlands Tijdschrift vor Fysiotherapie 2002 February; 112(1):9-16. Rumpt J, Salters E, Physiotherapy theory 1 and 2 (ET); module workbook and reader: exercise therapy (MP01). Eindhoven: Fontys Hogescholen, 1994. The american heritage college dictionary. 3rd ed. Boston: Houghton Mifflin Company, 1994. The concise medical dictionary. 4th ed. Oxford: Market House Books Ltd., 1994. FLP FORMAT VERSION 6 PAGE  PAGE 1    'LM<=Segt <Z`os P ! " iqrs𻶱 B*ph B*ph B*CJph5>*B*CJph>*CJ5CJCJ B*phB*CJmH phsH >*B*CJph B*CJph5B*CJphF   LM<=RSg p^`p^ & F `  ^ ` & F )7` ^` & F )^`_$` 9<pqs  $]^^ & F ]^` L^L`  ^ ` ^` ^`^ & F )7` ^` ! 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