Advanced Procedures for the PTA

I.     Course Prefix/Number: PTA 230

       Course Name: Advanced Procedures for the PTA

       Credits: 3 (2 lecture; 3 lab)

II.    Prerequisite

PTA 207, PTA 210, and PTA 211 with minimum grade of C in all courses; PTA 261 or concurrent enrollment; concurrent enrollment in PTA 220 and PTA 218.

III.   Course (Catalog) Description

Course covers implementation of treatment programs for patients with specific diseases and disabilities.  Content includes techniques used for neurological disorders, amputees, prosthetics and orthotics, pediatrics, cardiopulmonary physical therapy.

IV.   Learning Objectives

Upon completion of this course, the student is able to:

  1. Integrate evidence-based knowledge previously learned in science, general education and PTA courses to the content studied in this course.
  2. Correctly perform patient status assessments and data collection for patients with neurological, amputation, respiratory and cardiac impairments with assessments of motor milestones, righting and equilibrium reactions, cyanosis, dyspnea, chest expansion/excursion, cough and sputum.
  3. Formulate and correctly implement effective interventions, using PNF, for either strengthening or increasing range of motion.
  4. From the PT’s plan of care, integrate and implement components from various neurological treatment approaches and therapeutic exercise treatments for activities of daily living, functional training, balance and gait, and developmental activities for patient with neurological impairments.
  5. Apply knowledge of assessment, data collection and interventions studied in this course to selected pediatric diagnoses and discuss appropriate treatment progressions for the pediatric patient.
  6. Recognize pathology contributing to lower extremity amputation.
  7. Identify the rationale and determine the effectiveness of appropriate interventions for the new amputee.
  8. Identify the rationale and determine the effectiveness of components for lower extremity orthotics and prosthetics and make adjustments based on patient feedback and responses with report to the supervising PT.
  9. Recognize changes in skin condition while using devices and equipment.
  10. Identify various methods of stump compression for both transfemoral and transtibial amputation.
  11. Synthesize knowledge into an effective treatment program for patients with lower extremity amputation.
  12. Identify anatomical mechanics of normal respiration as well as the signs and symptoms of Pulmonary disease.
  13. Correctly implement and perform treatment interventions for patients with pulmonary disease, including breathing exercises, coughing techniques and activities to promote pulmonary hygiene.
  14. Identify the rationale and determine the effectiveness of various cardiac rehabilitation programs.
  15. Identify the rationale and determine the effectiveness of aquatic exercise.
  16. Determine safe limits of exercise/treatment for the scope of patients presented in PTA 230 and identify need for PT re-evaluation.
  17. Collaborate with classmates and faculty in group activities with cognizance of and sensitivity to cultural differences.
  18. Recognizes activities, positioning and postures that aggravate or relieve pain or altered sensation, or that can produce associated skin trauma.
  19. Observe the presence or absence of muscle mass.
  20. Recognizes changes in muscle tone.
  21. Recognizes level of functional status for self-care, civic, community, domestic, education, social and work life.
  22. Display professional behaviors as mandated by the APTA/IPTA.

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

VI.   Sequence of Topics

    1. Tests and Assessment
      1. Cranial nerves
      2. Spinal cord levels
      3. Sensory
      4. Proprioception
      5. Balance, righting and equilibrium
      6. Muscle tone
      7. Functional activities
      8. Motor milestones
      9. Dyspnea, chest exercises, cough & sputum
      10. Vital signs
    2. Short and long term goals and the plan of care.
    3. Interventions for the following neurological conditions:
      1. Stroke
      2. Cerebral palsy
      3. Spinal cord injury
      4. Parkinsonism
      5. Guillian Barre
      6. Multiple Sclerosis
      7. Traumatic Brain Injury
    4. Treatment interventions and techniques for:
      1. Individual muscle recruitment
      2. Group muscle recruitment
      3. Activities of daily living
      4. Functional training
      5. Balance and gait
      6. Spasticity management
    5. Pathology related to lower extremity amputation
      1. Peripheral vascular disease
      2. Trauma
      3. Tumor
      4. Congenital
    6. Treatment for new amputees.
      1. Pre-prosthetic care
        1. Care for the incision
        2. Compression
        3. Skin care
        4. Exercise
      2. Post-prosthetic instruction
        1. Donning/doffing
        2. Gait training
        3. Gait deviations and their related meanings
        4. Skin care
    7. Components of prosthetics/orthotics and their related purpose/function.

      Prosthetic Component Parts
      1. Prosthetic feet
        1. SACH
        2. Single-axis
        3. Multi-axis
        4. Transverse rotational
        5. Dynamic response
      2. Prosthetic knee systems
        1. Outside hinges
        2. Single axis
        3. Weight activated friction
        4. Polycentric
        5. Manual locking
      3. Prosthetic suspensions
        1. Belts
        2. Suction
      4. Socket designs for transfemoral prostheses
        1. Plug fit
        2. Quadrilateral
        3. Ischial containment
Orthotic Component Parts
      1. Foot Orthotics
      2. Ankle Foot orthotics
        1. Double-uprights
        2. Plastic
      3. Knee Ankle Foot Orthotics
        1. Double-uprights
        2. Plasic
      4. Hip Ankle Foot Orthotics
      5. Trunk Orthotics
    1. Functional activities for prosthetics/orthotics.
        1. Learning to don/doff the devices
        2. Gait training
        3. Appropriate strengthening activities
        4. Management of skin
      1. Mechanics of respiration.
      2. Signs and symptoms of pulmonary disease.
        1. Abnormal mechanics associated with restrictive lung dysfunction.
        2. Abnormal breathing patterns associated with congestive lung dysfunction.
        3. Abnormal auscultation sounds
          1. Rales>
          2. Ronchi
          3. Wheezing
      3. Pulmonary rehabilitation.
        1. Auscultation
        2. Percussion
        3. Vibration
        4. Shaking
        5. Deep breathing
        6. Postural drainage
        7. Resisted diaphragmatic breathing
        8. Assisted coughing
      4. Signs and symptoms of cardiac disease.
        1. Post MI
        2. Ischemia
      5. Cardiac rehabilitation and functional endurance.
        1. Maximum heart rates
        2. Borg’s scale of exertion
        3. Progression of exercise
        4. Phases of cardiac rehabilitation
      6. Aquatic exercises.
        1. As an assist to weak musculature
        2. As a form of resistance
      7. Modifications of interventions for co-existing conditions
        1. Metabolic diseases – Diabetes (I and II), thyroid
        2. PVD
        3. Cardiac diseases – CHF, MI, cholesterol, HTN
        4. Respiratory/pulmonary diseases
        5. Musculoskeletal – OA, osteoporosis, scoliosis
        6. Psychological/psychiatric conditions – depression, PTSD, schizophrenia, dementia, etc.

VII.  Methods of Instruction

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

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

VIII. Course Practices Required

  1. Attend two hours of lecture per week, three hours of lab per week.
  2. Students are responsible for all assigned readings and materials presented in class.
  3. Written materials will be assigned to be completed outside of class.
  4. Students are expected to actively participate in class and laboratory activities.

IX.   Instructional Materials

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

  1. Required texts:
    O’Sullivan, Physical Rehabilitation, 6th ed.

    or texts of comparable content.

  2. Selected handouts
  3. Selected audio-visual material

X.    Methods of Evaluating Student Progress

  1. Written assignments
  2. Quizzes, announced and unannounced
  3. Written tests
  4. Final exam
  5. Lab practicals
    All students must score at least 70% correct on each lab practical in order to pass the course. 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 have a maximum of two attempts to pass a practical exam.
  6. Lecture and lab attendance, class participation and professional attitude and behavior may also be considered in computing the final grade.

Grades will be determined in a total point basis computed into a percentage. The grading scale is as follows:
A: 90-100%
B: 80-89.9%
C: 70-79.9%

It is not the policy of this program to “round up” grades.

Lecture Grades consist of 60% and lab 40% of final grade.
Lecture & lab grades must each be a minimum of 70% in order to receive passing grade.

XI.   Other Course Information

Attendance is mandatory for all lectures and labs.  Recurrent absences or tardiness may result in lowered grade or expulsion from program.  Students who inform the instructor in advance (at the beginning of the semester) of an intended absence for a MAJOR religious observance will not be penalized.  However, instructors are not responsible for teaching material again and missed work, exams or quizzes must be made up either in advance or immediately following the intended absence. Students found guilty of plagiarism or cheating are subject to dismissal and/or disciplinary action under the Student Code of Conduct.

There will be no make ups of announced or unannounced exams or quizzes.  Late homework assignments will not be accepted.

Lab Policy –

  1. Lab clothes are required for all lab sessions unless otherwise instructed. Uniform consists of shorts, blouse or shirt, halter or bathing suit top for female students, shoes or slippers.
  2. Students will rotate lab partners.
  3. Students are requested to administer and receive all modalities and treatments practiced in this course.
  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. Food and drink may be permitted in lab as long as garbage is properly disposed of.
  7. No visitors are allowed in lab unless approved by instructor.

Correct spelling is required on all written assignments.  Incorrect spelling will be penalized – ½ pt. for a medical related word and ¼ pt. for any other word.

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

Resources and support for LGBTQ+ students can be found at