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課程名稱	肌肉骨骼疾患物理治療評估與鑑別診斷二 Assessment and Differential Diagnosis in Musculoskeletal Disorders(Ⅱ)
開課學期	112-2
授課對象	醫學院物理治療學系
授課教師	王淑芬
課號	PT3058
課程識別碼	408 36200
班次
學分	2.0
全/半年	半年
必/選修	必帶
上課時間	星期四6,7,8(13:20~16:20)
上課地點	物治實習3F
備註	本課程中文授課,使用英文教科書。與楊靜蘭、張心怡、何兆邦、蘇錦勤、王崇禮、林慧芬、林冠吟合授限本系所學生(含輔系、雙修生) 且限學士班三年級總人數上限：40人

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課程概述	Course Description: This course designed to address Assessment and differential diagnosis and clinical decisions in the management of subjects with disorders associated with the musculoskeletal system for axial part. This course will first focus on evidence-based principles to guide the examination, evaluation, diagnosis and prognosis of musculoskeletal patient problems. Pathology will be presented regionally and differential diagnosis, principle of physical therapy and prevention will be addressed with focus placed on the cervical spine, thoracic spine, lumbar spine, temporomandibular joint disorder, postural dysfunction, obstetric patient. To facilitate the development of effective decision-making, critical thinking, and manual skills, course activities will include lectures, discussions, laboratories and problem-solving activities with real or simulated patients. All previous musculoskeletal-related courses in the curriculum are prerequisite to this course and all exams, skill checks and practical exams should be considered cumulative throughout the musculoskeletal-related physical therapy curriculum.
課程目標	Course Objectives: By the completion of this course students will be able to do the following, given a variety of health care environments, situations, and patient/clients across the lifespan: 1. Conduct a musculoskeletal patient examination through: 1.1 Establishing a subjective examination with appropriate questions 1.2 Utilizing information from the subjective examination to develop further specific questions to clarify precautions, contraindications, severity/irritability of the problem, or differential diagnoses that may influence the objective examination, evaluation, diagnosis and prognosis 1.3 Generating hypotheses about the differential diagnosis and potential movement problems based on the subjective examination 1.4 Selecting and demonstrating appropriate tests that may include: 1.4.1 Functional tests that most closely represent the subject’s activity limitations and participation restrictions 1.4.2 Selective tissue tension testing including AROM, PROM and Resisted tests followed by physiological and accessory joint motion testing 1.4.3 Postural assessment 1.4.4 Special tests 1.4.5 Other tests pertinent to the patient 1.5 Sequencing the examination according to value of information gained, safety and efficiency 1.6 Discussing the principles and evidence supporting the examination tools 1.7 Modifying the examination as needed taking into account pain, mechanism, psychosocial factors and patient preference 2. Synthesize and interpret results to form a clinical diagnosis and/or Clinical Practice Guideline Classification through 2.1 Categorizing clusters of signs and symptoms 2.2 Incorporating the results of diagnostic imaging and limitations 2.3 Identifying precautions or conditions where referral to other health care professionals 2.4 Identifying contributing factors to the patient presentation 2.5 Identifying pathology mechanisms 3. Use appropriate communication skills in an oral and written manner for patients and other health care professionals through 3.1 Explaining the problem to the patient/involved parties 3.2 Recording results accurately and communicate results to other healthcare profession 3.3 Referral to community resources 4. Recognize the importance of interacting with patients and families in a manner which provides the desired psychosocial support 4.1 Recognizing patient, family, and self---reaction to patient’s illnesses, thoughts, goals and beliefs 4.2 Recognizing patient, family and self---reaction to barriers to achieving patient goals 4.3 Respecting individual cultural, religious, and socio---economic differences by utilizing appropriate communicative responses 5. Describe the clinical decision-making processes involved in the diagnosis of disorders and injuries involving musculoskeletal tissues by 5.1 Describing the incidence, etiology, and common findings of selected musculoskeletal disorders 5.2 Describing the physiological, anatomical, neural, biomechanical, and psychosocial factors underlying the presentation of common clinical conditions that affect the musculoskeletal system 5.3 Identifying the purpose and usefulness of selected physical examination procedures, findings and/or diagnostic tests 6. Integrate information regarding health conditions into the decision making process for making appropriate examination choices through 6.1 Discussing an orthopedic surgical procedure and safe post---surgical rehabilitation 6.2 Explaining the altered anatomical, physiological, neural, biomechanical, and psychosocial factors resulting from surgery and post---surgical rehabilitation 6.3 Developing an examination and intervention sequence based on the tissue healing stages of inflammation, proliferation, and remodeling 6.4 Discussing prognosis, prevention, and discharge issues as they relate to the surgical procedure and post---surgical rehabilitation 7. Behavioral 7.1 Adhere to legal practice standards 7.2 Have a responsibility for all patients/clients 7.3 Practice in a manner consistent with the Ethics 7.4 Exhibit caring, compassion, and empathy in providing services to patients/clients 7.5 Promote active involvement of the patient/client 7.6 Demonstrate professional behavior in all interactions with patients/clients, family members, caregivers, other health providers, students, other consumers, and payers 7.7 Participate in self---assessment to improve the effectiveness of care 7.8 Identify, respect, and act with consideration for patients'/clients' differences, values, preferences, and expressed needs in all professional activities 8. Evidence 8.1 Consistently apply current knowledge, theory, and professional judgment 8.2 Consistently and critically evaluate sources of information related to PT practice, research, and education and apply knowledge from these sources in a scientific manner 8.3 Consistently integrate the best evidence for practice from sources of information with clinical judgment and patient/client values to determine the best care for the patient/client
課程要求	Scoring Midterm lecture 30% Final lecture: 30% Final practice: 30% Participation: 10% 計分方式：期中、期末lecture考各30％，期末practice考30％(需大於70分)，平時參與＆團隊作業10％筆試：選擇題（國考形式），簡答跑考：大三：單項檢查，案例分析
預期每週課後學習時數
Office Hours
指定閱讀	待補
參考書目	references： 1 Myers B, Hanks J: Management of Common Orthopaedic Disorders: Physical Therapy Principles and Methods, 5th ed. Lippincott Williams & Wilkins, Philadelphia, 2023. 2 Magee DJ, Manske RC: Orthopedic Physical Assessment, 7th ed. W.B. Saunders Company, Philadelphia/ London, 2020. 3 Kisner C, Colby LA, Borstad J: Therapeutic Exercise: Foundations and Techniques, 8th ed. F.A. Davis, Philadelphia, 2022. 4 Brotzman SB, Wilk KE: Clinical Orthopedic Rehabilitation, 3rd ed. Mosby, 2011. 5 Donatelli RA, Wooden MJ: Orthopaedic Physical Therapy, 4th ed. Churchill Livingstone, New York, 2010. 6 Orthopedic Physical Therapy (II) 骨科物理治療學)(下) 第四版禾楓 2022 7 教學影片-物理治療評估系列 https://www.space.ntu.edu.tw/navigate/a/#/s/1A87D7972808477DB287523D39C96410QQY
評量方式 (僅供參考)

課程進度

週次	日期	單元主題
第1週	2/22	Introduction Mobility Stability and control/CMM/STTT
第2週	2/29	Postural and gait assessment for patients with spinal dysfunction
第3週	3/07	Lumbar spine (I)
第4週	3/14	Lumbar spine (II)
第5週	3/21	Pelvic and SI dysfunction
第6週	3/28	Hip-pelvic-lumbar complex dysfunction Spinal imaging and spinal surgery
第7週	4/04	Holiday
第8週	4/11	Mid-term
第9週	4/18	Obstetric Patient
第10週	4/25	Cervical spine (I)
第11週	5/02	Cervical spine (II)
第12週	5/09	Cervical spine (III)
第13週	5/16	Thoracic spine and rib
第14週	5/23	TMJ
第15週	5/30	Practice examination
第16週	6/6	Final written examination (1hour) Pain science updated (1 hour)