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課程名稱 |
神經科學疾病物理治療與預防一
Physical Therapy Treatment and Prevention for Neurological Disorders(Ⅰ) |
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開課學期 |
111-1 |
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授課對象 |
學程 神經生物與認知科學學程 |
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授課教師 |
湯佩芳 |
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課號 |
PT4041 |
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課程識別碼 |
408 43370 |
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班次 |
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學分 |
2.0 |
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全/半年 |
半年 |
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必/選修 |
選修 |
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上課時間 |
星期三2,3,4(9:10~12:10) |
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上課地點 |
實習教室432 |
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備註 |
本課程中文授課,使用英文教科書。與黃正雅、李亞芸、劉宴齊合授
限本系所學生(含輔系、雙修生)
總人數上限：40人 |
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課程簡介影片 |
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核心能力關聯 |
核心能力與課程規劃關聯圖 |
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課程大綱
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課程概述 |
本課程系列一與二為物理治療學系六年學制之必修課程，課程內容為神經科疾病之物理治療評估、治療、與預防，以養成學生之物理治療專業核心能力。此系列課程重點有四﹕(一)神經物理治療主要治療模式與臨床處置技術之理論基礎;(二)如何對神經疾患者執行物理治療檢查、評估、功能性診斷、訂定預後與治療計畫、介入、及再檢查; (三)如何整合性的運用臨床決策、個案處理、國際功能分類、及臨床實證等模式於神經疾患者之物理治療;與(四)討論不同的神經物理治療介入與預防措施對治療神經疾患者失能與預防其功能下降之療效。本課程將涉及之主要神經科疾病含(但不限於)以下幾大類﹕(一)非進行性神經科疾病，如腦中風、創傷性頭部外傷、創傷性脊髓損傷、良性腦瘤等；(二)進行性神經科疾病，如巴金森氏症、小腦病變、多發性硬化症、運動神經元疾病、惡性腦瘤等；及(三)週邊神經系統疾病，如基藍巴瑞氏症、周邊神經損傷、前庭系統病變等。本課程系列一以腦中風為主，本課程系列二則以其它神經科疾病為主。
核心能力:
專業能力、批判思考與終身學習
專業之當責、自主與倡議領導能力
跨領域溝通的人際關係與團隊合作能力 服務倫理與人文關懷 |
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課程目標 |
在結束本課程後，學生應能:
1. 了解神經物理治療主要臨床治療模式與處置技術之理論基礎;
2. 能執行主要神經科疾病之物理治療檢查、評估、功能性診斷、訂定預後與治療計畫、介入、及再檢查;
3. 能整合性的運用臨床決策、個案處理、國際功能分類、及臨床實證等模式於對神經疾患執行之物理治療檢查、評估、功能性診斷、訂定預後與治療計畫、介入、及再檢查中;
4. 能清楚地記錄對神經疾患者執行之物理治療檢查、評估、功能性診斷、預後與治療計畫訂定、介入技術、及再檢查結果於病歷中，並能用合適與清晰的口語與書面表達方式與病患、病患家屬、病患照顧者、其他醫療專業人員、與行政人員做溝通;
5. 具備同理心，並能提供病患及其家屬適當的心理社會支持;
6. 閱讀相關文獻時，能客觀評論不同的神經物理治療介入與預防措施對治療與預防神經疾患者失能或功能下降之療效;
7. 行為表現遵從醫學倫理;
8. 具備至醫療院所神經物理治療單位作臨床實習之基本專業知識、評估與治療技巧、和團隊溝通與合作能力。
教學方式與學習經驗:
本課程設計融合多元教學與學習活動，以促進學生之自主學習與解決問題的能力。這些活動包含(但不限於)：教師授課與教師示範臨床處置技巧、及學生之研讀指定閱讀、參與課堂小考與提問討論、參與小組操作練習、參與小組討論與報告等。所有考試與報告相關規定都會於兩週前公告於此課程之NTU Cool網頁，報告也請在截止時間之前上傳至此課程之NTU Cool網頁。 |
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課程要求 |
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預期每週課後學習時數 |
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Office Hours |
另約時間 備註： 請事先用email與授課老師預約 |
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指定閱讀 |
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參考書目 |
1 Textbooks of neurosciences and neurology
1.1 Campbell WW. and Barohn R. DeJong’s the Neurologic Examination. 8th ed. [E-Book] Philadelphia: Lippincott Williams & Wilkins. 2020.
1.2 Haines DE and Mihailoff GA (Eds.) Fundamental Neuroscience for Basic and Clinical Applications (Chap. 33 Corbett JJ and Chen J. The Neurologic Examination; pp. 480-493) [E-Book]. 5th Ed. Philadelphia, PA: Elsevier. 2018
1.3 Lundy-Ekman L. Neuroscience Fundamentals for Rehabilitation. 5th ed. St. Louis, MO: Elsevier. 2018
1.4 Simon RP, Greenberg DA, Aminoff MJ. (Eds.). Clinical Neurology (Chap. 1 Neurological History and Examination) [E-Book]. 10th Ed. McGraw-Hill Education. 2018.
2 Textbooks and articles of neurologic PT and motor control:
2.1 Lazaro R, Reina-Guerra S, Quiben M (Eds.). Umphred’s Neurological Rehabilitation. 7th ed. [E-Book] St. Louis, MO: Elsevier. 2020.
2.2 O'Sullivan SB, Schmitz TJ, Fulk G (Eds.). Physical Rehabilitation: Assessment and Treatment. 7th ed. Philadelphia: FA Davis. 2019.
2.3 American Physical Therapy Association. Guide to Physical Therapist Practice 3.0. 2016 Updates. Alexandria: APTA, 2016 (http://guidetoptpractice.apta.org/).
2.4 Burke-Doe A. Physical Therapy Case Files: Neurological Rehabilitation (Cerebrovascular accident chapter). 1st ed. Blacklick: McGraw-Hill Publishing. 2013
2.5 Harris SR, Winstein CJ. The past, present, and future of neurorehabilitation: From NUSTEP through IV STEP and beyond. J Neurol Phys Ther 2017; 41 Suppl 3, S3-S9.
2.6 Kimberley TJ, Novak I, Boyd L, Fowler E, Larsen D. Stepping up to rethink the future of rehabilitation: IV STEP considerations and inspirations. J Neurol Phys Ther 2017; 41 Suppl 3, S63-S72.
2.7 林光華等編著。神經物理治療學(上、下冊)，第三版。台北：禾楓，2022。
2.8 王瑞瑤總校閱。神經疾病物理治療學。台中市：華格那企業，2016。
3. Textbooks of neurofacilitation approaches
3.1 Bobath B. Adult Hemiplegia: Evaluation and Treatment. 3rd Ed. Oxford: Butterworth-Heinemann. 1990.
3.2 Davies PM. Right in the Middle: Selective Trunk Activity in the Treatment of Adult Hemiplegia. Berlin: Springer-Verlag. 1993.
3.3 Davies PM. Steps to Follow: The Comprehensive Treatment of Patients with Hemiplegia. Berlin Heidelberg: Springer-Verlag. 1993.
3.4 Sawner K, Lavigne J. Brunnstrom’s Movement Therapy in Hemiplegia: A Neurophysiological Approach. 2nd ed. New York: JB Lippincott Company. 1992.
3.5 Johnstone M. Therapy for Stroke: Building on Experience. Edinburgh: Churchill Livingstone. 1991.
3.6 Beckers D, Buck M. PNF in Practice: An Illustrated Guide [E-Book]. 5th. Ed. Heidelberg: Springer. 2021.
3.7 Martin ST and Kessler M Neurologic Interventions for Physical Therapy (PNF pp. 231-281). 2nd Ed. St. Louis, MO: Saunders Elsevier. 2006.
4. Contemporary task-oriented approaches textbooks
4.1 Carr J and Shepherd RB. Neurologic Rehabilitation: Optimizing Motor Performance. 2nd Ed. Edinburgh: Churchill Livingstone. 2010.
4.2 Carr JH, Shepard RB. Optimizing functional motor recovery after stroke. In J Mehrholz (ed.), Physical Therapy for the Stroke Patient: Early Stage Rehabilitation. New York: Thieme. 2012.
4.3 Shumway-Cook A, Woollacott MH. Motor Control: Translating Research into Clinical Practice. 5th ed. Philadelphia: Wolters Kluwer. 2017.
4.4 胡名霞。動作控制與動作學習，第五版。第15章。台北:金名，2019。
5. Clinical practice guides for stroke rehabilitation and stroke facts
5.1 Lindsay P, Furie KL, Davis SM, Donnan GA, Norrving B. World Stroke Organization global stroke services guidelines and action plan. Int J Stroke 2014;9 Suppl A100:4-13.
5.2 Lindsay MP, Norrving B, Sacco RL, et al. World Stroke Organization (WSO): Global Stroke Fact Sheet 2019. Int J Stroke 2019;14:806-817.
5.3 Stroke Foundation. Clinical Guidelines for Stroke Management. Melbourne Australia, 2017. (https://informme.org.au/en/Guidelines/Clinical-Guidelines-for-Stroke-Management)
5.4 Scottish Intercollegiate Guidelines Network (SIGN). Management of Patients with Stroke: Rehabilitation, Prevention and Management of Complications, and Discharge Planning. A National Clinical Guideline. Edinburgh: SIGN, 2010. Publication 118. (https://www.sign.ac.uk/media/1056/sign118.pdf)
5.5 Stroke Foundation of New Zealand and New Zealand Guidelines Group. Clinical Guidelines for Stroke Management 2010, 2010.
5.6 Gittler M, Davis AM. Guidelines for Adult Stroke Rehabilitation and Recovery. JAMA 2018;319:820-821.
5.7 Winstein CJ, Stein J, Arena R, et al. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke 2016;47:e98-e169.
5.8 Hebert D, Lindsay MP, McIntyre A, et al. Canadian stroke best practice recommendations: Stroke rehabilitation practice guidelines, update 2015. Int J Stroke 2016;11:459-484.
6. Other assigned readings by instructors. |
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評量方式
(僅供參考) |
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No. |
項目 |
百分比 |
說明 |
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1. |
課堂出席與參 與課堂活動 提問、討論、操作練習 |
10% |
注意事項:
本課程將上課準時出席與簽到視為專業能力養成訓練的一部份。因此，無論是線上還是實體上課，請學生都要親自出席與且簽到。遲到超過十分鐘即算遲到。
˙ 請假:請於課前(除病假外)在臺大的學生請假系統提出申請並附證明。未能做到時皆以曠課論，按比例扣平時成績。
˙ 隨台灣大學校隊出隊比賽的運動防護公假:整學期只准此種公假一次。 |
2. |
課堂小考兩次 |
10% |
2022/10/5 and 2022/10/12 |
3. |
期中考筆試 |
20% |
2022/11/9
湯佩芳(86%)
劉宴齊(14%) |
4. |
期末考筆試 |
20% |
2022/12/14
湯佩芳(15%)
黃正雅(20%)
李亞芸(20%)
劉宴齊(45%) |
5. |
期末考跑台考 |
40% |
2022/12/21
湯佩芳(25%)
黃正雅(25%)
李亞芸(25%)
劉宴齊(25%) |
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針對學生困難提供學生調整方式 |
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上課形式 |
以錄影輔助 |
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作業繳交方式 |
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考試形式 |
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其他 |
由師生雙方議定 |
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週次 |
日期 |
單元主題 |
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第1週 |
9/07 |
˙ Orientation
˙ Theoretical foundations for clinical practice (clinical decision making, ICF, CMM, and EBP)
˙ Clinical models for neurological physical therapy
˙ 4Ps in IV Step Conference: Prediction, Prevention, Plasticity, and Participation |
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第2週 |
9/14 |
Clinical models for neurological physical therapy
˙ Muscle re-education approaches
˙ Neurofacilitation approaches- Brunnstrom, Bobath and PNF approaches |
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第3週 |
9/21 |
Clinical models for neurological physical therapy
˙ Task-oriented and neuroplasticity approaches |
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第4週 |
9/28 |
教師節(停課不停班) |
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第5週 |
10/05 |
PT for CVA (I): basic concepts of stroke; Quiz 1 (anatomy of cerebral circulation)
˙ Neuroanatomy, etiology, pathophysiology, neuroplasticity, diagnosis, prognosis, acute medical interventions, and recovery course
˙ Clinical guidelines |
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第6週 |
10/12 |
PT for CVA (II): history taking and neurologic examinations; Quiz 2 (anatomy and functions of cranial nerves)
˙ Cranial nerves, consciousness, JOMAC, language, apraxia, neglect, vision, sensation, muscle tone, coordination, NIHSS, ICH, FUNC |
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第7週 |
10/19 |
PT for CVA (III): sensory and motor function assessments
Brunnstrom hemiplegic assessment, Fugl-Meyer Assessment |
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第8週 |
10/26 |
PT for CVA (IV): Balance and sit-to-stand assessments |
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第9週 |
11/02 |
PT for CVA (V): Gait assessments |
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第10週 |
11/09 |
Midterm written exam |
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第11週 |
11/16 |
PT for CVA (VI): treatment for early stage stroke
˙ Positioning, early mobilization, and facilitation (bed mobility, transfer skills, and handling skills) |
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第12週 |
11/23 |
PT for CVA (VII): treatment for hemiplegic shoulder and upper extremity functions
˙ Common shoulder problems, sling, kinesiotaping, facilitation, NMES, CIMT, robotic assisted exercises, and mirror therapy |
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第13週 |
11/30 |
PT for CVA (VIII): trunk and lower extremity functions
sit-to-stand, sitting and standing balance training
PT for CVA (X): prevention and contemporary approaches
˙ Prevention, participation, and cardiorespiratory fitness
˙ Contemporary neuroplasticity and neuromodulation approaches |
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第14週 |
12/07 |
PT for CVA (IX): treatment for ambulation
ambulation training and fall prevention |
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第15週 |
12/14 |
Final written exam |
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第16週 |
12/21 |
Final practical exam |
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