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Physiotherapy in the Pathology of the Locomotor System III

Code: 102980
Credits: 6
2026/2027
Degree programme Type Course
Physiotherapy OB 3

Contact lecturer

Name :
Sergi Sureda Sabate
Email :
sergi.sureda@uab.cat

Teaching staff

Eduard Vilar Orellana
Marc Sigüenza Llopart

Group languages

You can consult this information at the end of the document.

Prerequisites

It is highly recommended to have the knowledge achieved in previous courses about Anatomy and Physiology of the Locomotor System, Fundamentals of Physiotherapy, General Biomechanics and of the spine, Human Pathology and Clinical Evaluation in Physiotherapy of the Locomotor System.

This subject is part of the set of Physiotherapy subjects in the Pathology of the rachis, an aspect that implies that the student is aware that concepts of Anatomy, Physiology and Biomechanics that have already been given in previous subjects will not be repeated.

 

 

Objectives

The assignment is a program to the third course of the Physiotherapy Degree and forms part of the group of the assignments of Physiotherapy of the Locomotor Equipment.


The specific objectives are:

  • Generate a therapeutic strategy based on a comprehensive model of intervention in the field of Physiotherapy, based on the integration and unification of both new knowledge and that already given in subjects prior to FPAL III.
  • Learn to identify the physiological context in which the patient is, which allows the student to be aware of the patient's possibilities of change.
  • To give the student diagnostic clinical evaluation tools, as well as clinical reasoning from a perspective based on scientific evidence.
  • Learn the main tools of manual therapy, articular mobilization of the rachis and clinical-orthopedic examination, as well as learn to personalize them in order to be able to propose efficient therapeutic strategies.
  • Solve clinical cases susceptible to physiotherapeutic treatment in the field of conditions of the musculoskeletal system, and be able to analyze, adapt and control the results.
  • Know the main affects in the field of Traumatology and Rheumatology.

Learning outcomes

  1. Locate the different muscles through surface palpation.
  2. Describe and analyse human movement.
  3. Identify the physiological and structural changes that may occur as a result of physiotherapy intervention in disorders of the musculoskeletal system.
  4. Apply physiotherapy methods, procedures and interventions in the different clinical specialisations that treat conditions of the musculoskeletal system.
  5. Apply specific physiotherapy methods to promote a healthy lifestyle, in relation to the musculoskeletal system, through health education.
  6. Use physiotherapy to treat clinical cases involving musculoskeletal system conditions.
  7. Describe and apply advanced evaluation procedures in physiotherapy in order to determine the degree of damage to the musculoskeletal system and possible functional repercussions.
  8. Establish diagnostic physiotherapy hypotheses through clinical cases with disorders of the musculoskeletal system.
  9. Define general and specific objectives when using physiotherapy treatment for disorders of the musculoskeletal system.
  10. Describe the circumstances that can influence priorities when using physiotherapy to treat disorders of the musculoskeletal system.
  11. Enumerate the different types of of material and apparatus for using physiotherapy to treat disorders of the musculoskeletal system.
  12. Describe and analyse the evidence-based physiotherapy protocols for disorders of the musculoskeletal system.
  13. Describe clinical practice guidelines applied to disorders of the musculoskeletal system.
  14. Analyse and synthesise.
  15. Organise and plan.
  16. Express ideas fluently, coherently and correctly, both orally and in writing.
  17. Solve problems.
  18. Make the most correct decisions in given situations.
  19. Display critical reasoning skills.
  20. Identify situations in which a change or improvement is needed.
  21. Analyse a situation and identify its points for improvement.
  22. Propose new methods or well-founded alternative solutions.
  23. Weigh up the risks and opportunities of suggestions for improvement: one's own and those of others.
  24. Propose new ways to measure success or failure when implementing innovative proposals or ideas.
  25. Identify the social, economic and environmental implications of academic and professional activities within one?s own area of knowledge.
  26. Critically analyse the principles, values and procedures that govern the exercise of the profession.
  27. Consider how gender stereotypes and roles impinge on the exercise of the profession.
  28. Communicate using language that is not sexist.
  29. Identify the principal forms of sex- or gender-based inequality present in society.
  30. Weigh up the impact of any long- or short-term difficulty, harm or discrimination that could be caused to certain persons or groups by the actions or projects.

Contents

COURSE CONTENTS

The course focuses on physiotherapy applied to pathologies of the musculoskeletal system, specifically spinal conditions. The course is organised around a shift in therapeutic paradigm: the integration of advanced clinical reasoning to understand the state and needs of the patient's system (a global view) before applying any clinical decision or specific technique.

The course consists of a theoretical part and a practical part, which will run simultaneously throughout the semester.


THEORY

The theoretical part of this course is organised into two major blocks:


BLOCK I: CLINICAL DECISION-MAKING PROCESS AND THERAPEUTIC STRATEGY

This first block aims to give students the reasoning, assessment and planning tools needed to carry out the 4 phases of the therapeutic strategy (History-taking, Assessment, Treatment and Prognosis) effectively.

  • UNIT 1. Therapeutic Strategy:

The paradigm shift (from what the patient has to what the system needs). The clinical decision-making process and the physiotherapist's role in choosing the appropriate input for each organism.

  • UNIT 2. Physiological Context:

The concept of resistance to change and energy expenditure. Assessment of the flexibility of the Central Nervous System and the Immune System.

  • UNIT 3. Biomechanical Context of the Spine:

Biomechanics understood as an engineering model (mechanical efficiency, containment arches and buttresses). Analysis of physiological curves, lines of gravity and force transfer during vertebral movement.

  • UNIT 4. History-taking:

Transition from the traditional questionnaire to a genuine clinical decision-making process. Identification of the functional reason for consultation, assessment of risk (Red Flags) and resources, detection of psychosocial modulators, and creation of hypotheses to establish a pre-test probability.

  • UNIT 5. Physical Examination:

An active clinical algorithm in which one does not "look for the lesion" but rather confirms or rules out hypotheses. Application of the Clinical Traffic Light rule to define the depth of the examination, and safety testing (such as ruling out instabilities due to ligament involvement).

  • UNIT 6. Treatment:

Choice of intervention according to the 4-Variable Model (dominant mechanism, phase, patient profile and immediate goal). Analysis of the tools from their neurophysiological foundations (activation vs modulation depending on the patient's resources) and clinical dosage guidelines to avoid errors.

  • UNIT 7. Prognosis:

Principles of therapeutic anticipation. A protocol to differentiate the evolution of the pathological condition, the person and their life stage. Selection of objective markers of improvement and monitoring guidelines.


BLOCK II: PATHOPHYSIOLOGY AND CLINICAL APPROACH

Once the decision-making model has been integrated, the second part of the course organises specific reasoning through the classification of spinal pathology into two major branches: Traumatic Pathology and Degenerative Pathology.

  • UNIT 8. Inflammation and Resolution:

Phases of the inflammatory process, influence of the stress axes (HPA and SNS), associated nutrition and the limiting effects of NSAIDs on the natural resolution of tissue.

  • UNIT 9. Autoimmune Pathology:

Examination and physical approach to systemic inflammatory diseases such as Ankylosing Spondylitis. Flare-up control, deformity assessment and improvement of mobility/respiratory function.

  • UNIT 10. Traumatic Pathology:

Pathophysiology, clinical reasoning and conservative treatment of Thoracic Outlet Syndrome and vertebral fractures.

  • UNITS 11 and 12. Mechanical Pathology (Parts I and II):

A comprehensive approach to disc pathologies, radiculopathies (neural involvement) and spinal canal stenosis (including short- and long-term management of myelopathy).

  • UNIT 13. Idiopathic Scoliosis:

Assessment of the structural spine and functional preservation in the face of three-dimensional spinal deformity.


PRACTICAL WORK

Laboratory Practicals (PLAB): Assessment and Manual Therapy of the Spine and Pelvis

The practical learning in this course does not begin with the mechanical application of techniques; instead, it places the initial emphasis on the physiotherapist's way of palpating. The quality of contact (posture, communication and intention) will be worked on in depth to educate the hand under the principle of "sensitivity before strength". This will bring students closer to the subtlety of the structures of the spine, feeling and understanding the state of the tissues before performing any intervention.

The practical sessions will progress towards the application of treatment techniques through manual therapy, integrating, as knowledge of these techniques develops, this capacity for fine palpation and segmental examination of movement restrictions. These physical treatment interventions will be applied specifically to all the relevant anatomical regions:

  • The structures of the spine: Approach to dysfunctions in the cervical, thoracic and lumbar regions.
  • The pelvic region: Biomechanical assessment and specific manual treatment of dysfunctions of the sacroiliac joints and the pubis.

In this way, the application of manual therapy in the practical sessions is understood not as an end in itself, but as the expression and result of careful prior clinical reasoning and palpation.



Learning activities and methodology

Title Hours ECTS Learning outcomes
works delivery 25 1
SELF-STUDY 40 1.6
Research and information treatment 20 0.8
READING ARTICLES /REPORTS OF INTEREST 17 0.68
THEORY (TE) 30 1.2
LABORATORY PRACTICALS (PLAB) 15 0.6

Teaching is based on: theoretical lectures (which may include practical demonstrations in the classroom itself and for which the collaboration of a student will be required), and practical classes (which will be held in the laboratory classrooms).

In this assignment, the use of Artificial Intelligence (AI) technologies is not allowed in the case of the seve phases. Any work that includes fragments generated amb IA will be considered a lack of academic honesty and can involve a partial or total penalty in the note of the activity, or major sanctions in cases of gravity.

In the last theory class, a compulsory assessed activity will take place, in which students, working in groups, will work through a clinical case and submit a written.

The USE of MOBILE PHONES, SMARTWATCHES, HEADPHONES or other ELECTRONIC DEVICES is NOT allowed during the exams. The PLAB dossiers must be printed on paper.

It is NOT allowed to take PHOTOGRAPHS OR RECORDINGS during CLASSES. All material is subject to copyright and will be posted on the virtual campus. Doing business with the material posted on the virtual campus will automatically imply suspending the subject and it will be the decision of the lecturer if he or she takes legal action against the student through the UAB's legal services.

ATTENDANCE AT THE PLAB IS MANDATORY.

Access to the classroom for laboratory practices will not be allowed after 10 minutes from the start of the class, and it will be counted as unjustified lack of attendance.

It is MANDATORY to attend the PLAB with the appropriate clothing (bikini (or sports shorts), throughout all practical classes of the course.

It will NOT be allowed to carry out the PLABs with watches, rings, bracelets, earrings... or any other element that may be detrimental to the comfort and safety of students during the execution of physiotherapy maneuvers. The student must attend the PLAB with their hair up and their nails short.

An INAPPROPRIATE BEHAVIOUR of the student during classes, which may be a nuisance to the teacher or other students, gives the teacher the right to expel the student from the classroom. Each expulsion will be treated as an unjustified absence of attendance and 0.5 points will be deducted from the final grade.

You can NOT EAT OR DRINK during classes.

Note: 15 minutes of a class will be reserved, within the calendar established by the center/degree, for students to complete the surveys for the evaluation of the performance of the teaching staff and the evaluation of the subject/module.

This subject is based on a theoretical-practical teaching.

Annotation: within the schedule set by the centre or degree programme, 15 minutes of one class will be reserved for students to evaluate their lecturers and their courses or modules through questionnaires.

Assessment

Continuous assessment activities

Title Weight Hours ECTS Learning outcomes
Narrative records 10% 0 0 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 17, 18, 19, 20
Written assessments with objective tests: multiple choice tests 30% 1 0.04 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 28
Practical evaluation 35% 1 0.04 1, 2, 3, 4, 5, 6, 7, 8, 9, 14, 15, 16, 17, 18, 19, 20, 21, 22, 26, 28, 29, 30
Exam clinical case 25% 1 0.04 3, 4, 5, 6, 7, 8, 9, 10, 12, 14, 15, 17, 18, 19, 22, 23, 24, 25, 26, 27, 28, 29

Single Assessment:

This course does not offer the single-assessment system.

The FINAL assessment of the course will consist of:

- Final exam: (55% of the final grade):

  • Multiple-choice exam on the contents taught in the theory classes (30% of the final grade). This test will consist of 40 multiple-choice questions, with four answer options (of which only one will be correct), where incorrectly answered questions will deduct 0.33 from the final grade. Unanswered questions will not subtract points. Minimum grade to pass: 5.
  • Resolution of a clinical case (25% of the final grade): which will take place on the same day as the multiple-choice exam, and in which the student must establish the objectives in each of the sections of the physiotherapy treatment, specify therapeutic hypotheses, propose exploratory tools to reach a functional physiotherapy diagnosis, produce a coherent treatment proposal (initially proposing its objectives and the phases for achieving them), and finally, generate a prognosis based on the particularities of the pathology as well as the patient's profile. Minimum grade to pass: 5.

- Practical final exam: (35% of the final grade).

  • A practical exam will be carried out through an objective structured clinical evaluation. The student must apply clinical reasoning, answer the teacher's questions during the exam, and perform some of the exploratory and/or therapeutic physiotherapy techniques discussed in the seminars and theory classes. Minimum grade to pass: 5

- Scientific project and attendance (10% of the final grade)

  • Completion of the "clinical case" project in groups. Minimum grade to pass: 5


The percentage of each part in the final grade of the course will be: 55% final exam grade (30% multiple-choice test + 25% clinical case exam), 35% for the practical final exam grade (practical and/or practical test) and 10% for the clinical case on the last day of class (grade for the presentation and delivery of the scientific project.

In order for these percentages to apply, it is essential to have a minimum of 5.00, in the multiple-choice exam, the clinical case, the practical exam and the scientific project.

The following are considered criteria for assigning the grade of NOT ASSESSABLE:

  • A student will be considered \"Not Assessable\" if they do not take the assessment tests, both theoretical and practical, thereby using up their enrolment rights for the course
  • Obtaining a score of 0.00 in any of the assessable tests (final exam (theoretical or clinical case), practical exam or scientific project)
  • Missing more than 20% of the practical classes (PLAB)
  • Not completing the assessable written project.

Class attendance:

- Theory classes. Although attendance is not compulsory, it is highly recommended, since masterful demonstrations of certain techniques may be carried out, as well as group activities that are important for properly following the subject.

- Assessable activity of the last theory class: Attendance is 100% compulsory. An absence justified on medical grounds will be accepted (with the corresponding medical certificate), in which case the student must still complete the activity, since failing to do so will mean the student is considered NOT ASSESSABLE

- Practical classes. Attendance is 100% compulsory. An absence justified on medical grounds will be accepted (with the corresponding medical certificate), provided these do not exceed 20% of the total classes, beyond which the student will be considered NOT ASSESSABLE.


The procedure for reviewing the tests will comply with the UAB's current regulations and will in any case be done individually, upon prior written request within the established deadlines.


Students who have not passed some of the compulsory tests may take a resit or synthesis exam that will have the same morphological characteristics as the failed test. Minimum grade to pass: 5. The maximum grade the student can obtain in this test will also be a 5.



Bibliography

  • Douglas G, Nicol F, Robertson. Macleod. Exploración Clínica+ StudentConsult en español. 13th Edition. Barcelona: Elsevier; 2014.
  • Hoppenfeld, RS. Exploración física de la columna vertebral y las extremidades. Ed. El Manual Moderno. 1979.
  • Cleland J, Koppenhaver S, Su J. Netter. Exploración Clínica en Ortopedia. Un enfoque basado en la evidencia. 3a Edición. Barcelona: Elsevier Masson; 2006.
  • Palmer L, Epler ME. Fundamentos de las técnicas de evaluación musculoesquelética. Barcelona: Paidotribo; 2003.
  • Clarkson HM. Musculoskeletal Assessment. 3th edition. LWW; 2012.
  • Brotzman SB. Mnaske RC. Rehabilitación Ortopédica Clínica. Un enfoque basado en la evidencia. 4a Edicion. Barcelona: Elsevier; 2018.
  • Parsons J, Marcer N. Osteopatia. Modelos de diagnóstico, tratamiento y práctica. Ed. Elsevier 2007
  • Perry, Clayton R. Manual de fracturas. 2ª ed. Ed. McGrawHill. 2001.
  • Magee D. Orthopedic Physical Assessment (Musculoskeletal Rehabilitation). 6th Ed. ElSevier; 2014.
  • Heimann, D. Compendio de Terapia Manual. Barcelona: Paidotribo; 2007.
  • Kaltenborn FM. Fisioterapia manual columna. Madrid: Mc Graw-Hill Interamericana; 2000.
  • Vilar Orellana E, Sureda Sabaté S. Fisioterapia del aparato locomotor. Ed. McGraw-Hill, Interamericana de España; 2005.
  • Craig Liebenson. Manual de Rehabilitación de la columna vertebral. Ed. Paidotribo. 1999.
  • George V. Lawry. Systematic musculoskeletal examination. Ed. McGraw-Hill. 2011.
  • Karen S. Rucker, Andrew J. Cole, Stuart M. Weinstein. Dolor Lumbar. Enfoque del diagnóstico y el tratamiento basado en los síntomas. Ed. McGraw-Hill. 2003.
  • Haaner-Becker R, Schoer D. Manual de técnicas defisioterapia. Aplicación en traumatología y ortopédia. Ed. Paidotribo; 2001.
  • Travel y Simons. Dolor y disfunción miofascial. 2ª Edición. Ed. Medica Panamericana, 2002
  • Buckup J, Hoffmann R. Pruebas clínicas para patología osea, articular y muscular. Exploraciones, signos y síntomas. Ed. Elsevier. 2019.

Software

No specific software required

Course groups and languages

The information provided is provisional until November 30. After this date, you will be able to consult the language of each group through this link. To access the information, you will need to enter the course CODE

Type of teaching Group Language Semester Shift
(TE) Theory 201 Catalan second semester afternoon
(PLAB) Practical laboratories 201 Catalan second semester afternoon
(PLAB) Practical laboratories 202 Catalan second semester morning-mixed
(PLAB) Practical laboratories 203 Catalan second semester morning-mixed