REHABILITATION OF VISCERAL DISABILITY
cod. 07654

Academic year 2007/08
3° year of course - First semester
Professor responsible for the course unit
BONETTI Antonio
integrated course unit
5 credits
hub:
course unit
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Course unit structured in the following modules:

Learning objectives

The Course has been designed to provide the student with concepts and critical tools regarding burns from a local and general standpoint; on the surgical process and rehabilitation of mastectomised patients and patients undergoing post-tumour breast reconstruction; on lymphodrainage in the results of mastectomy and lymphonodal removal and/or damage; on the prevention, physiotherapy and post-surgical rehabilitation of decubitus ulcers; on the significance of obesity for the patient and society; on the clinical signs of scoliosis, including hypothesising of short- and long-term treatment goals; on the pathophysiological phenomena, principles and therapeutic goals of the main gynecologic and obstetric diseases that can cause disability and assistance techniques in the urogynecologic field; on the indications and limitations of competitive and non-competitive sports activity; on the nutritional principles, integration and use of drugs in sport and problems related to doping; on the adjustments and adaptations caused by physical exercise; on the athlete’s heart and related diseases; on sports traumatology and cardiovascular reanimation; on the role of physical exercise in the prevention, treatment and rehabilitation of chronic degenerative disease; on the equipment used in instrumental rehabilitation and on its use and functioning.<br />The student must be able to perform the main manoeuvres of physiokinetic respiratory, postural and active and passive motor therapy in the various burn phases; be able to perform lymphodrainage correctly; be able to use equipment for instrumental rehabilitation correctly and to perform initial manoeuvres of cardiovascular reanimation.<br />Upon completion of the course the student must be a physiotherapist in rehabilitation of acquired disabilities, with a solid grounding in rehabilitation of reconstructive plastic surgery, sports traumatology, obstetric and uro-gynecologic diseases, and chronic degenerative diseases (secondary prevention), in order to become properly integrated into a mixed rehabilitation team.

Prerequisites

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Course unit content

<br />Sports activity and competitive sports: indications and limits. Nutritional information and hydration. Integration, reintegration and drugs: sports and doping. Physical exercise in the prevention and treatment of metabolic disorders. Physical activity and cardiovascular risk. Cardiovascular adjustment and adaptation in physical exercise. The athlete’s heart and related diseases. Sport traumatology: Clinical aspects, physical therapy and functional recovery. Cardiovascular reanimation of athletes. <br /> - The female pelvis. Normal and functional anatomy of the pelvic floor and lower urinary tract. Urogenital prolapse: pathogenesis, classification, principles of therapy. Urinary incontinence: pathogenesis, classification, principles of therapy. Techniques of pelvic-perineal rehabilitation: kinesitherapy, biofeedback, functional and electrical stimulation. Perineal rehabilitation in uro-gynecology. Perineal rehabilitation during pregnancy and puerperium. Main complications following oncological gynecological surgery. Climateric syndrome: primary changes in organs and apparatuses. Physiological changes in pregnancy.<br />The pelvic floor. Dysfunctions of the pervic floor. Classification of urinary incontinence. The micturition diary. Clinical evaluation of the pelvic floor. Perineal testing. Perineal re-education: kinesitherapy, electrostimulation, biofeedback, bladder retraining, vaginal cones. Prevention of perineal dysfunction. The perineum during pregnancy, childbirth and puerperium. <br />- Burns: classification (degree, extent, phase), prevention, prognosis, medical treatment, surgical treatment during the acute phase, surgical treatment of the results, physio-kinesitherapy. Scars: physiopathology of cicatrisation phases. Reconstructive surgery and breast tumours: local flaps, expanded flaps (tissue expanders), remote flaps (micro-surgery). Decubitus ulcers: etiopathology, classification, medical treatment, pre- and post-surgical physiotherapy, surgical treatment, rehabilitation. Obesity: Multi-disciplinary approach; role of the plastic surgeon in obesity treatment; results and perspectives. <br />- Paramorphism. Dysmorphism. Bad posture and paramorphism of the spinal column: evaluation and treatment. Principles of kinesitherapeutic treatment of scoliosis: history of various approaches. Static imbalance according to Bienfait: connective tissue, static functioning, dynamic functioning, static exam, totality concept, treatment and progression. Rehabilitative approach to acquired deformities. Evaluation and treatment in mastectomised patients: interdisciplinary approach; home rehabilitation program, rehabilitative nursing.<br />- Overview of fascial manipulation according to Stecco. Review of the anatomy of the lymphatic system (flow of the lymphatic tracts, concept of anastomosis); function of the lymphatic system, manual lymphodrainage (principles, effects, indications and contraindications); technique of manual lymphodrainage and its application in mastectomy; overview of mastectomy. Fascial manipulation in reference to post-mastectomy complications (pain): concept of fascia, principles of treatment, technique of fascial manipulation.<br />- Introduction to the isokinetic machine: when to use it and how to use it; principles and differences between the various existing systems. Isokinetic exercise during rehabilitation: protocols for various diseases of athletes. Stabilometric platform (Computerised Stabilo-Posturometry): what it studies, how it functions and its use as an evaluative tool. Rehabilitation through computerised stabilometry . Elaboration of television images (ElIte): its role in rehabilitation. Elements comprising a walking laboratory. Research using ElIte: analysis of walking, technology and methodology, diagnosis and recovery of motor disorders, posture and equilibrium, analysis of sports movement. Comparison of methods and their application to rehabilitation. Strengths and weakness of the equipment examined. Pain: Tools of evaluation, localisation, characterisation, functional evaluation and treatment.   

Full programme

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Bibliography

P. Zeppilli, V. Palmieri ? Manuale di Medicina dello Sport e Pronto Soccorso. ? CESI: Casa Editrice Scientifica Internazionale.<br /><br />Fox Bowers Foss ? Le basi fisiologiche dell?educazione fisica e dello sport. ? Il Pensiero Scientifico Editore.<br /><br />D.R. Mottram: Farmaci e Sport. Casa Editrice Ambrosiana.<br /><br />P. Zeppilli ? Cardiologia dello sport. - CESI: Casa Editrice Scientifica Internazionale.<br /><br />G. Puddu, A. Piombini, A Salvanetti ? Rehabilitation of Sports Injuries ? Springer Ed.<br /><br />I disequilibri statici secondo Bienfait<br /><br />Barisoni - Le ustioni e il loro trattamento - Piccin Ed 1984.<br /><br />Scuderi-Rubino - Chirurgia plastica - Piccin Ed 2004.<br /><br />Appunti-Dispense delle lezioni del P rof. Caleffi.<br /><br />H&G Wittlinger - Introduzione al linfodrenaggio manuale - Marrapese Ed.<br /><br />L. Stecco - Manipolazione della fascia - Piccin Ed.<br /><br />P. Di Benedetto - Riabilitazione uro-ginecologica - Minerva Medica Ed.<br /><br />Dispense del Prof. Chiampo<br />

Teaching methods

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Assessment methods and criteria

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Other information

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