課程資訊
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) 
開課學期
110-1 
授課對象
醫學院  物治系六年制  
授課教師
湯佩芳 
課號
PT4041 
課程識別碼
408 43370 
班次
 
學分
2.0 
全/半年
半年 
必/選修
必帶 
上課時間
星期三2,3,4(9:10~12:10) 
上課地點
 
備註
本課程中文授課,使用英文教科書。上課教室:物治系四樓實習教室。與黃正雅、李亞芸、劉宴齊合授
限本系所學生(含輔系、雙修生) 且 限學士班四年級
總人數上限:50人 
 
課程簡介影片
 
核心能力關聯
核心能力與課程規劃關聯圖
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。此系列課程重點有三﹕(一)介紹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)對神經疾患執行物理治療檢查、評估、功能性診斷、訂定預後與治療計畫、介入、及再檢查時,整合性的運用臨床決策、個案處理、國際功能分類、及實證實務等模式;與(三)不同的神經物理治療介入與預防措施對治療與預防失能或功能下降之療效評論。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。 

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. 整合性的運用臨床決策、個案處理、國際功能分類、及實證實務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. 能清楚記錄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. 具備與病患與病患家屬互動時,能提供必需的心理社會支持的能力;
6. 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。


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 
課程要求
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、參與課堂小考與討論、參與小組操作練習、參與個案報告(case presentations)之小組討論與報告等。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。
 
預期每週課後學習時數
 
Office Hours
另約時間 備註: 請事先用email與授課老師預約 
參考書目
參考書目: (Syllabus檔案中粗體標示者為較重要的。請善用醫圖電子資源)
1 Textbooks of neurosciences and neurology
1.1 Campbell WW. DeJong’s the Neurologic Examination. 7th ed. [Electronic Book] Philadelphia: Wolters Kluwer. 2012.
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) [Electronic 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) [Electronic 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. [Electronic 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 Shumway-Cook A, Woollacott MH. Motor Control: Translating Research into Clinical Practice. 5th ed. Philadelphia: Wolters Kluwer. 2017.
2.4 American Physical Therapy Association. Guide to Physical Therapist Practice 3.0. 2016 Updates. Alexandria: APTA, 2016 (http://guidetoptpractice.apta.org/).
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,2021。
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. Brunnstroum’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 Adler SS, Beckers D, Buck M. PNF in Practice: An Illustrated Guide [Electronic Book]. 4th. Ed. Heidelberg: Springer. 2014.
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 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 Jolliffe L, Lannin NA, Cadilhac DA, Hoffmann T. Systematic review of clinical practice guidelines to identify recommendations for rehabilitation after stroke and other acquired brain injuries. BMJ Open 2018;8:e018791.
5.7 Burris JE. Stroke Rehabilitation: Current American Stroke Association Guidelines, Care, and Implications for Practice. Mo Med 2017;114:40-43. (Correction to: Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2017;48:e369.)
5.8 Gittler M, Davis AM. Guidelines for Adult Stroke Rehabilitation and Recovery. JAMA 2018;319:820-821.
5.9 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.
5.10 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.
5.11 Quinn TJ, Paolucci S, Sivenius J, Walker MF, Toni D, Lees KR. Evidence-based stroke rehabilitation: an expanded guidance document from the European stroke Organisation (ESO) guidelines for management of ischaemic stroke and transient ischaemic attack 2008. J Rehabil Med 2009;41:99-111.

6. Other assigned readings by instructors. 
指定閱讀
 
評量方式
(僅供參考)
 
No.
項目
百分比
說明
1. 
課堂出席與參與課堂活動 
5% 
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,學生都要親自出席且親自簽到。遲到超過十分鐘即算遲到。請假時,必須於課前在臺大的學生請假系統提出申請。公假與事假必須於課前至少一天申請並得到核准,病假可於課前當天申請。提出公假與病假申請時請附證明。未能做到時皆以曠課論。遲到與曠課都會按比例扣平時成績。隨台灣大學校隊出隊比賽的運動防護公假則整學期只會被核准一次。 
2. 
課堂小考兩次 (2021/10/13 and 2021/10/20) 
5% 
 
3. 
個案報告兩次 (2022/1/12、2022/1/19) 
10% 
 
4. 
期中考筆試 (2021/11/17)  
20% 
 
5. 
期末考筆試 (2021/12/29) 
20% 
 
6. 
期末考跑台考 (2022/1/5)  
40% 
 
 
課程進度
週次
日期
單元主題
第1週
2021/9/22  ˙ 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 
第2週
2021/9/29  Clinical models for neurological physical therapy
˙ Muscle re-education approaches
˙ Neurofacilitation approaches- Brunnstrom, Bobath and PNF approaches 
第3週
2021/10/6  Clinical models for neurological physical therapy
˙ Task-oriented and neuroplasticity approaches  
第4週
2021/10/13  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 
第5週
2021/10/20*  PT for CVA (II): history taking and neurologic examinations; Quiz 2 (anatomy and functions of the 12 cranial nerves)
˙ Cranial nerves, JOMAC, language, vision, sensation, ROM, muscle tone, NIHSS 
第6週
2021/10/27*  PT for CVA (III): motor function assessment
˙ Brunnstrom stage assessment, Fugl-Meyer Assessment, motor function  
第7週
2021/11/3*  PT for CVA (IV): Balance assessments 
第8週
2021/11/10*  PT for CVA (V): Gait assessments 
第9週
2021/11/17  Midterm written exam 
第10週
2021/11/24*  PT for CVA (VI): treatment for early stage stroke
˙ Positioning, early mobilization, and facilitation (bed mobility and transfer) 
第11週
2021/12/1*  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 
第12週
2021/12/8*  PT for CVA (VIII): trunk and lower extremity functions
˙ sit-to-stand, sitting and standing balance training  
第13週
2021/12/15*  PT for CVA (IX): treatment for ambulation
˙ ambulation training and fall prevention 
第14週
2021/12/22*  PT for CVA (X): prevention and contemporary approaches
˙ Prevention, participation, and cardiorespiratory fitness
˙ Contemporary neuroplasticity and neuromodulation approaches 
第15週
2021/12/29  Final written exam 
第16週
2022/1/5  Final practical exam 
第17週
2022/1/12  教師彈性補充教學
Case presentations I:
Basic assessments of a patient with stroke
邀請中風病人至教室讓學生做評估
或學生在問題導向臨床實習三課中先拍好影片在課堂中報告 
第18週
2022/1/19  教師彈性補充教學
Case presentations II:
Interventions on a patient with stroke
邀請同一位中風病人至教室讓學生做治療
或學生在問題導向臨床實習三中先拍好影片在課堂中報告