Therapeutic Exercise II

I.     Course Prefix/Number: PTA 210

       Course Name: Therapeutic Exercise II

       Credits: 4 (3 lecture; 3 lab)

II.    Prerequisite

PTA 162 with a minimum grade of C; concurrent enrollment in PTA 207, PTA 211 and PTA 241.

III.   Course (Catalog) Description

Course continues study of physical therapy skills. Content includes manual muscle testing, progressive resistive exercise, stretching and patient instruction. Focus is on physical therapy appropriate for orthopedic diseases and disorders that affect all age groups.

IV.   Learning Objectives

Upon completion of this course, the student will be able to:

  1. Apply knowledge previously learned in science, general education and PTA courses to content studied in this course.
  2. Relate structure and physiology of muscle to orthopedic conditions.
  3. Demonstrate a knowledge of the rationale and effectiveness of therapeutic exercise for orthopedic conditions.
  4. Select appropriate exercises for various orthopedic conditions.
  5. Demonstrate a knowledge of the principles of orthopedic patient assessment including flexibility, joint, range of motion, muscle length, muscle strength, endurance, palpation, orthopedic tests and functional rating scales, and gait analysis.
  6. Skillfully perform various patient assessment activities including flexibility and muscle length, strength, endurance, functional rating scales, orthopedic tests, palpation and gait analysis.
  7. Demonstrate ability to utilize results of various orthopedic and medical tests and assessment procedures to identify patient status.
  8. Discriminate between normal and abnormal gait.
  9. Describe various orthopedic impairments, problems and conditions using ICF models and recognize indications and contradictions for physical therapy treatment.
  10. Relate various physical therapy, surgical, and medical interventions to specific orthopedic problems and conditions.
  11. Compare stretching, mobilization and PROM treatments in terms of definitions, implementation, rationale and effectiveness.
  12. Compare types of exercise equipment and devices.
  13. Describe appropriate use of supportive devices, splints and orthotics used in orthopedics.
  14. Implement an appropriate exercise program/protocol for specific orthopedic problems and conditions.
  15. Design and teach home exercise programs utilizing available software and technology.
  16. Integrate knowledge of exercise principles and apply to the progression of patients in exercise programs.
  17. Relate the role of therapeutic exercise to the total care of the patient, and teaching of family and caregivers.
  18. Collaborate in group activities, demonstrating sensitivity to cultural differences.
  19. Demonstrate industry, punctuality and self-discipline in classroom and laboratory activities.
  20. Complete a self-directed learning project utilizing technology/multimedia resources and share knowledge gained with classmates and faculty.

V.    Academic Integrity and Student Conduct

Students and employees at Oakton Community College are required to demonstrate academic integrity and follow Oakton's Code of Academic Conduct. This code prohibits:

• cheating,
• plagiarism (turning in work not written by you, or lacking proper citation),
• falsification and fabrication (lying or distorting the truth),
• helping others to cheat,
• unauthorized changes on official documents,
• pretending to be someone else or having someone else pretend to be you,
• making or accepting bribes, special favors, or threats, and
• any other behavior that violates academic integrity.

There are serious consequences to violations of the academic integrity policy. Oakton's policies and procedures provide students a fair hearing if a complaint is made against you. If you are found to have violated the policy, the minimum penalty is failure on the assignment and, a disciplinary record will be established and kept on file in the office of the Vice President for Student Affairs for a period of 3 years.

Please review the Code of Academic Conduct and the Code of Student Conduct, both located online at
www.oakton.edu/studentlife/student-handbook.pdf

VI.   Sequence of Topics

  1. Principles of Therapeutic Exercise
    1. Passive vs. Active exercise
    2. Closed chain vs. open chain exercise
    3. Manual and mechanical resistance exercise:
      1. Isometric
      2. Isotonic:
        1. Concentric
        2. Eccentric
    4. Comparison of techniques and available equipment:
      1. stretching, mobilization, PROM
      2. manual vs. mechanical resistance
      3. types of equipment
  2. Objectives of therapeutic exercise:
    1. Muscle strength and power
    2. Flexibility
    3. Coordination and balance
    4. Functional abilities
    5. Endurance/cardiovascular fitness
    6. Sports and work performance
  3. Principles of patient assessment:
    1. Physical therapy examination procedures
      1. Patient history and complaints
      2. Observation/screening
      3. Joint motion/goniometry (review)
      4. Muscle palpation
      5. Manual muscle testing
        1. history and rationale
        2. proper positioning and command
        3. grading scales
        4. use of results
      6. gait analysis
      7. orthopedic tests
        1. drop arm best
        2. apprehension test
        3. Tinel sign
        4. Phalen’s test
        5. Trendelenberg test
        6. Obu test
        7. Thomas test
        8. “Bounce Home” test
        9. Drawer sign
        10. Grinding test
        11. Apley’s tests
        12. forward bending test
    2. Utilization of testing procedures and reports
      1. Functional rating scales
      2. Orthopedic tests and scales
      3. Work capacity/work hardening definitions
      4. Other medical tests
    3. Analyze and address patient problems based on physical therapy assessment:
      1. Indications and contraindications for exercise
      2. Patient goals and physical therapy intervention
      3. Appropriate exercise methods
      4. Outcomes of exercise procedures
  4. Appreciation of physical therapy interventions to specific orthopedic problems and corrections.
    1. Fracture management
      1. classification
        1. open
        2. closed
      2. normal healing
        1. Wolff’s Law
        2. stages
      3. types of fracture
        1. transverse
        2. oblique
        3. spiral
        4. comminuted
        5. displaced
        6. pathological
        7. greenstick
        8. Colle’s fracture
        9. Pott’s fracture
        10. Dupuytren’s (tri-malleolar) fracture
        11. physeal
      4. physician role
        1. reduction
          1. open
          2. closed
          3. traction
        2. fixation
          1. traction
          2. external
          3. internal
        3. no intervention
      5. Physical therapy role
        1. pain management
        2. general conditioning
        3. immobilization problems
        4. functional considerations
        5. home programs
      6. Complications
        1. non-union
        2. delayed union
        3. malunion
        4. infection
        5. nerve damage
    2. Surgical Management
      1. common surgical procedures
        1. arthroscopy
        2. arthrodesis
        3. arthroplasty
        4. capsulotomy
        5. laminectomy
        6. osteotomy
        7. synovectomy
      2. Indications and complications
      3. Patient and family instruction and home programs
    3. Abnormal gait
      1. deviations
        1. abducted leg
        2. abnormal motions
        3. trunk bending
        4. circumduction
        5. decreased arm swing
        6. excessive knee flexion
        7. excessive medial/lateral foot contact
        8. head down
        9. hip hiking
        10. genu recurvatum
        11. decreased dorsifexion in stance
        12. decreased dorsifexion in swing
        13. decreased pushoff
        14. internal/external hip rotation
        15. unequal rhythm
        16. unequal step length
        17. vaulting
        18. wide base
        19. antalgic
        20. Trendelenburg
      2. implications
    4. Bone and Joint diseases
      1. Arthritis
        1. Rheumatoid
        2. osteoarthritis
        3. ankylosing spondylitis
        4. gout
        5. hemaphilic
      2. osteomalacia/osteoporosis
      3. Paget’s Disease
      4. collagen diseases
    5. Other orthopedic conditions:
      1. Aseptic necrosis of femoral neck
      2. bone tumors and cysts
        1. osteochondroma
        2. osteogenic sarcoma
      3. Bursitis
      4. Carpal tunnel syndrome
      5. congenital abnormalities
      6. contractures
      7. dislocations and subluxations
        1. hip
        2. shoulder
        3. elbow
        4. knee
      8. Dupuytren’s contracture
      9. elbow injuries
      10. adhesive capsulitis
      11. finger injuries
      12. genu valgum and varum
      13. hallux valgus and varus
      14. hammertoes
      15. plantar fasciitis
      16. leg length discrepancies
      17. knee injuries
        1. meniscus
        2. cruciate ligaments
        3. collateral ligaments
      18. Legg-Calve-Perthes
      19. torsions
      20. osteomyelitis
      21. patello-femoral pain syndrome
      22. overuse and repetitive strain injuries
      23. rotator cuff tears
      24. scoliosis
      25. shoulder-hand syndrome
      26. spondylolisthesis
      27. sprains/strains
      28. synovitis
      29. Sudeck’s atrophy
      30. talipes calcaneovalges-equinovarus
      31. tendon injuries
      32. tenosynovitis
      33. torticollis
      34. Volkmann’s ischemic contracture
  5. Non-Physical Therapy Management of Orthopedic Conditions
    1. Medical
    2. Pharmacological
  6. External support devices
    1. braces and supports
    2. in-shoe orthotics
    3. casts and splints
    4. corsets and spinal orthoses
  7. Discuss the role of therapeutic exercise in total care of the patient
    1. physical and psychological barriers to exercise
    2. related healthcare personnel and procedures
    3. teaching patients and care givers
    4. workplace and industrial applications
    5. cost efficient treatment and discharge planning

VII.  Methods of Instruction

  1. The primary modalities for relay of information from the instructor are lecture, discussion and demonstration of techniques.
  2. Guided practice with immediate feedback is utilized in the lab sessions.
  3. Written examinations and homework assignments are included
  4. Laboratory practicals are held each semester.
  5. Computer software for home programs.
  6. All evaluation results are shared with each student on an individual or group basis soon after test administration to ensure comprehension of material.

Course may be taught as face-to-face, hybrid or online course.

VIII. Course Practices Required

  1. Student must attend three hours lecture per week and three hours lab per week.
  2. Students are responsible for all assigned readings and materials presented in class and all homework assignments to be completed in a timely manner.
  3. Students are expected to actively participate in class activities in both lecture an lab sessions.
  4. Complete a self-directed learning project.
  5. Course may be taught as face-to-face, hybrid or online course.

IX.   Instructional Materials

Note: Current textbook information for each course and section is available on Oakton's Schedule of Classes.

  1. Required texts: Current textbook information for each course and section is available on Oakton’s Schedule of Classes
    1. Shankman, Fundamentals of Orthopedic Management for the PTA, 2nd ed.
    2. Hislop and Montgomery, Muscle Testing
    3. Kisner and Colby, Therapeutic Exercise, Foundations and Technique or texts of comparable content.
  2. Audio-visual material, including selected video, software and CD-ROMs available in lab.
  3. Handouts

X.    Methods of Evaluating Student Progress

  1. Written assignments
  2. Written tests
  3. Comprehensive final exam
  4. Lab practicals
    1. All students must successfully pass each practical exam with a minimum score of 70% in order to continue in the physical therapist assistant program. Each lab practical exam delineates critical safety elements for the skill being tested. Failure to meet any of these critical safety elements will cause the student to fail the practical exam. Each student will be afforded the opportunity to take a make-up practical exam in the event of a failing score on a first attempt.
    2. There will be no rounding-up of grades earned.
  5. Self-directed learning project
  6. Lecture and lab attendance. (Class participation, professional attitude and behavior may also be considered in computing the final grade.)

Final course grade is a composite of 60% lecture (classroom), 40% lab.
(See Grade Determination Sheet).

Final grades will not be “rounded up”. The grading scale is as:
A 90 – 100
B 80 – 89.99
C 70 – 79.99

Lecture and lab grades must each be a minimum grade of 70% in order to receive a passing grade for the course.

XI.   Other Course Information

  1. Attendance is mandatory at all scheduled lecture and laboratory times. All absences must be excused in advance of class or lab. Any unexcused absences after 2 grace absences will result in a lowering of the final grade by 2 percentage points for each lecture or lab missed.
  2. Make up exams may be given at the discretion of the instructor. There will be no make-ups of unannounced quizzes. Late homework assignments will receive a 10% deduction for each day late.
  3. Lab policy:
    1. Lab clothes are required for all lab sessions unless otherwise instructed.
    2. Students will rotate lab partners.
    3. Students are requested to administer and receive all modalities and treatments prescribed
    4. Students should be prepared to take notes during lab sessions as some lecturing will be done.
    5. Students will clean up the lab after each session.
    6. The use of cellular phones or audible paging devices is NOT permitted during class or lab.
    7. No visitors are allowed in lab unless approved by instructor.
  4. Correct spelling is required on all written assignments. Papers MUST be typed.
  5. Students guilty of plagiarism/cheating are subject to dismissal from the program and/or disciplinary action under the Student Code of Conduct.


If you have a documented learning, psychological, or physical disability you may be entitled to reasonable academic accommodations or services. To request accommodations or services, contact the Access and Disability Resource Center at the Des Plaines or Skokie campus. All students are expected to fulfill essential course requirements. The College will not waive any essential skill or requirement of a course or degree program.

Oakton Community College is committed to maintaining a campus environment emphasizing the dignity and worth of all members of the community, and complies with all federal and state Title IX requirements.

Resources and support for
  • pregnancy-related and parenting accommodations; and
  • victims of sexual misconduct
can be found at www.oakton.edu/title9/.

Resources and support for LGBTQ+ students can be found at www.oakton.edu/lgbtq.