Identifying Data 2022/23
Subject (*) Functional Rehabilitation in Foot and Leg Disorders Code 750G02137
Study programme
Grao en Podoloxía
Descriptors Cycle Period Year Type Credits
Graduate 2nd four-month period
Fourth Optional 6
Language
Spanish
Galician
Teaching method Face-to-face
Prerequisites
Department Fisioterapia, Medicina e Ciencias Biomédicas
Coordinador
Souto Gestal, Antonio
E-mail
antonio.souto@udc.es
Lecturers
Souto Gestal, Antonio
E-mail
antonio.souto@udc.es
Web http://https://campusvirtual.udc.gal/
General description Esta materia ten como obxectivo dar a coñecer aos estudiantes de podoloxía un protocolo de carácter interdisciplinar para a valoración do complexo articular do nocello e pé, así como as súas implicacións globais no resto de segmentos corporais, utilizando para ilo a exploración física e o razonamento clínico seguidos no proceso de fisioterapia. A partir de biomecánica clínica, exponse protocolos de valoración neuro-ortopedica e funcional a partir dos cales implementar estratexias terapéuticas baseadas na cinesiterapia nas súas distintas modalidades e a reeducación sensorio-perceptivo-motora.

Study programme competencies
Code Study programme competences
A66 CE2 -Coñecer a anatomía específica do membro inferior
A69 CE5 - Coñecer os principios físicos aplicables á marcha humana
A70 CE6 - - Coñecer o concepto anatómico e funcional da enfermidade e a clasificación de enfermidades, adquirindo capacidade de describir as patoloxías máis prevalentes do ser humano
A85 CE21 - Coñecer os instrumentos de análise biomecánico e a biomecánica da marcha humana e obter a capacidade de análise da marcha
A86 CE22 - Coñecer as alteracións estruturais do pé e o seu comportamento biomecánico e coñecer as alteracións posturais do aparello locomotor e a súa influencia sobre o pé e viceversa
A89 CE25 - Coñecer e desenvolver as técnicas de exploración física e clínica e os parámetros clínicos normais en decúbito, bipedestación estática e dinámica
A90 CE26 - Coñecer os fundamentos da Podoloxía, o concepto de profesión e saber recoñecer as capacidades profesionais propias da mesma no equipo multidisciplinar de saúde
A96 CE32 - Identificar e analizar os problemas de saúde do pé nos diferentes aspectos ambiéntais, biodinámicos e sociais, así como unha aprendizaxe relativa á avaliación dos feitos cientificamente probados e á análise dos datos en xeral, para aplicar a Podoloxía Baseada na Evidencia Científica
A100 CE36 Coñecer e diferenciar, segundo os parámetros clínicos, os procesos patolóxicos do pé, as afeccións estruturais e funcionais do aparello locomotor, as patoloxías de membro inferior e os procesos sistémicos con repercusión podolóxica
A103 CE39 - Coñecer e desenvolver as técnicas de exploración, para emitir un diagnóstico e prognóstico, e deseñar o plan de tratamento ortopodolóxico de acordo aos obxectivos terapéuticos
A112 CE48 - Coñecer e aplicar os métodos físicos, eléctricos e manuais na terapéutica das distintas patoloxías morfolóxicas e funcionais do pé e no tratamento da dor e a inflamación
B23 CB1 - Que os estudantes demostrasen posuír e comprender coñecementos nunha área de estudo que parte da base da educación secundaria xeral, e adóitase atopar a un nivel que, aínda que se apoia en libros de texto avanzados, inclúe tamén algúns aspectos que implican coñecementos procedentes da vangarda do seu campo de estudo
B24 CB2 - Que os estudantes saiban aplicar os seus coñecementos ao seu traballo ou vocación dunha forma profesional e posúan as competencias que adoitan demostrarse por medio da elaboración e defensa de argumentos e a resolución de problemas dentro da súa área de estudo
B25 CB3 -- Que os estudantes teñan a capacidade de reunir e interpretar datos relevantes (normalmente dentro da súa área de estudo) para emitir xuízos que inclúan unha reflexión sobre temas relevantes de índole social, científica ou ética
B29 CG02 - Coñecer a estrutura e función do corpo humano en especial da extremidade inferior, semioloxía, mecanismos, causas e manifestacións xerais da enfermidade e métodos de diagnóstico dos procesos patolóxicos médicos e cirúrxicos, interrelacionando a patoloxía xeral coa patoloxía do pé.
B30 CG03 - Obter a capacidade, habilidade e destreza necesarias para diagnosticar, prescribir, indicar, realizar e/ou elaborar e avaliar calquera tipo de tratamento podolóxico, ortopodolóxico, quiropodolóxico, cirurxía podolóxica, físico, farmacolóxico, preventivo e/ ou educativo, baseado na Historia clínica
B32 CG05 - Colaborar cos profesionais sanitarios especificamente formados na materia, na adaptación e uso de prótese e axudas técnicas necesarias, segundo as condicións físicas, psicolóxicas e sociais dos doentes
C9 CT01 - - Expresarse correctamente, tanto de forma oral como escrita, nas linguas oficiais da comunidade autónoma
C15 CT07 - Desenvolver a capacidade de traballar en equipos interdisciplinares ou transdisciplinares, para ofrecer propostas que contribúan a un desenvolvemento sustentable ambiental, económico, político e social

Learning aims
Learning outcomes Study programme competences
Be able to apply the technicians of clinical examination of the musculoskeletal system in supine position, static bipedestation and dynamic for the diagnostic of the foot dysfunctions A66
A69
A70
A85
A86
A89
A100
A103
B23
C9
Be able to apply the protocol of analytical examination of foot and ankle complex, as well as to identify its possible relation with the superjacent levels (knee, hip, pelvic belt and raquis), integrating these appearances in the treatment of the more frequent foot dysfunctions. A66
A69
A85
A86
A89
A100
A103
B23
B24
B25
B29
B30
C9
C15
Be able to identify the physiotherapy techniques (curative or palliative) employees in the treatment of the foot dysfunctions. A90
A96
A112
B32
C15
To know the principles and indications of the physical agents used in the treatment of the foot dysfunctions. A90
A96
A112
B23
B24
B25
B29
B30
B32
C15
Be able to apply some physical agents in the treatment of the foot dysfunctions. A90
A96
A100
A103
A112
B32
C15
Know the therapeutic foundations of the handle of the patient with pain A70
A89
A96
A100
A103
A112
B24
B25
B29
B30
C15

Contents
Topic Sub-topic
Thematic Block I.
Functional assessment of the foot and lower limb.
Unit 0. Anatomical-biomechanical recollection of the foot and its kinetic and kinematic relationships with the lower limb.

Unit 1. Functional and neuro-orthopaedic examination of the lower limb. Generalities of the assessment process. Concept of dysfunction and biomechanical adaptation. The nervous system as an integrating structure. Heterometries, ascending and descending dysfunctional chains.
Thematic Block II.
Functional re-education and physiotherapy in inflammatory and degenerative processes of the foot. Model of tissue stress and soft tissue regeneration.
Unit 2. The fascial system as a source of pain and dysfunction. Cellular mechanotransduction.

Unit 3. Nervous system and neuromechanics. The nervous system as a source of pain and dysfunction. Evaluation and principles of neurodynamic treatment.

Unit 4. Soft tissue regeneration model based on controlled mechanical stimulus. Inflammatory response, phases and clinical implications. Ankle sprain, local and ascending implications. Chronic ankle instability. Proprioception and postural sensors.

Unit 5. Tissue stress model. Rotational theory and the windlass system. Kinetic considerations and their clinical implications. Upward and downward relationships.
Thematic Block III.
Assessment and functional intervention in the main podiatric disorders. Pain, proprioception and motor control.
Unit 6. Manifestations of tissue stress in the sole-Achilles-plantar system. Achilles tendinopathy. Local and ascending implications.

Unit 7. Tissue stress manifestations in the tibial system: medial tibial stress syndrome, tarsal tunnel and posterior tibial dysfunction. Local and ascending implications.

Unit 8. Tissue stress manifestations of plantar tissues. Local and ascending implications.

Unit 9. Tissue stress manifestations in the forefoot: metatarsalgia, predislocation syndrome, perineural fibrosis and dysfunction of the first radius. Local and ascending implications.
Practical Block I.
Functional assessment of the foot. Neuro-orthopaedic examination of the foot and lower limb.
Practical lesson 1. Examination of posture and postural sensors.

Practical lesson 2. Neurodynamic exploration of the lower limb: neural provocation test and evaluation of the potential mechanical conflict points of the peripheral nervous system in the lower limb.

Practical lesson 3. Static and dynamic assessment of the pelvis. Orthopaedic and functional tests.

Practical lesson 4. Examination of the statics and dynamics of the coxofemoral joint. Torsional alterations and rotational capacity. Exploration of the knee.

Practical lesson 5. Examination of the analytical joint mobility of the ankle-foot complex.

Practical lesson 6. Dynamic assessment: gait and functional motor control tests.
Practical Block II.
Functional re-education and physiotherapy in the main podiatric disorders.
Practical lesson 7. Joint techniques of the ankle-foot complex.

Practical lesson 8. Stretching, manual and instrumental myofascial techniques.

Practical lesson 9. Strategies for improving proprioception and motor control of the lower limb.

Practical lesson 10. Functional and proprioceptive taping.

Planning
Methodologies / tests Competencies Ordinary class hours Student’s personal work hours Total hours
Guest lecture / keynote speech A66 A69 A70 A85 A86 A96 A100 A103 A112 B23 B24 B25 B29 B30 B32 C9 21 21 42
Laboratory practice A66 A69 A85 A86 A89 A96 A100 A112 B24 B25 B29 B30 B32 C9 C15 7 14 21
Directed discussion A90 A96 A100 B23 B24 B25 B32 C9 C15 7 7 14
Case study A70 A85 A86 A90 A96 A100 A103 A112 B23 B24 B25 B29 B30 B32 C9 C15 7 21 28
Workbook A66 A69 A70 A86 B29 0 20 20
Mixed objective/subjective test A89 A96 A100 A103 A112 B23 B24 B25 B29 C9 2 18 20
Introductory activities A66 A69 A70 A90 C9 C15 2 0 2
 
Personalized attention 3 0 3
 
(*)The information in the planning table is for guidance only and does not take into account the heterogeneity of the students.

Methodologies
Methodologies Description
Guest lecture / keynote speech Oral exhibition complemented with the use of audiovisual means and the introduction of some questions headed to the students, with the purpose to transmit knowledges and facilitate the learning.
Laboratory practice Methodology that allows that the students learn sure enough through the realisation of activities of practical character, such like demonstrations, exercises, experiments and investigations.
In this matter the practical modules will centre by a part in the static exploration-dynamic of the complex articulate foot-ankle as well as his relation with the global assessment of the superjacent levels. Later they will experience some of the therapeutic technicians that give answer to the possible dysfunctions that result of the process of assessment, fundamentally consistent in the technician of taping (rigid, elastic and neuromuscular) as well as in the correct application of other physical agents.
Directed discussion Methodology that allows that the students learn sure enough through the realisation of activities of practical character, such like demonstrations, exercises, experiments and investigations.
Technician of dynamics of groups in which the students argue of free form, informal and spontaneous on a subject, especially the resolution of a problem generally of pathomechanics topic relative to clinical field, proposed and coordinated by the moderador of the debate, in this case the professor.
Case study Methodology where the students confront in front of the description of a specific situation that arouses a problem that has to be comprised, valued and resolved by a group of students, through a process of discussion.
Workbook Group of texts and documentation written that they were collected and/or edited with the aim to serve like source of profundización of the contents worked through other methodologies.
Mixed objective/subjective test Regarding questions of essay, collects open questions of development. Besides, regarding objective questions, can combine questions of multiple answer, of ordenación, of brief answer, of discrimination, to complete and/or of association.
Introductory activities After the presentation of the subject, will establish a colloquium in which it will treat of identify which are the interests of the students in relation to the topics, its possible practical utility, as well as the initial knowledges of which splits .
Activities that carry out before initiating or process of education-learning, with the purpose to know the competitions, student´s interests and/or motivations for the attainment of the aims that pretend reach, linked to a formative program. With her it pretends obtain notable information that allow to articulate the teaching to favour an effective and significant learning, that split of the previous knowledges of the students.

Personalized attention
Methodologies
Laboratory practice
Directed discussion
Case study
Description
In the laboratory practicals, the lecturer is personally in charge of individually checking that the student has carried out the practicals correctly.

In the guided discussion and clinical case studies, the lecturer is in charge of moderating the debate and proposing the questions that promote it, as well as ensuring that each student participates and benefits from the ideas that everyone contributes.

A total of 4 hours is estimated for personalised attention in the form of tutorials in which all kinds of doubts can be resolved, with special attention to the resolution of clinical cases.

Personalised attention will be given through telematic means (Microsoft Teams platform, Moodle and e-mail), at the established times and/or upon request by the student.

Assessment
Methodologies Competencies Description Qualification
Laboratory practice A66 A69 A85 A86 A89 A96 A100 A112 B24 B25 B29 B30 B32 C9 C15 The assessment of the practices of laboratory does reference fundamentally to the attitude and active participation and with exploitation of the same, what translates in the correct execution and in the degree of improvement reached in the techniques taught. 10
Case study A70 A85 A86 A90 A96 A100 A103 A112 B23 B24 B25 B29 B30 B32 C9 C15 Delivery in time and form of the resolutions of clinical cases posed along the course, and that will request with antelación sufficient for his realisation or will realise during the face-to-face hours (interactive classes). 40
Mixed objective/subjective test A89 A96 A100 A103 A112 B23 B24 B25 B29 C9 The mixed exam will consist in a combination of questions type test of only answer and one or several short questions about the assessment and/or resolution of a clinical case posed during the course. 40
Guest lecture / keynote speech A66 A69 A70 A85 A86 A96 A100 A103 A112 B23 B24 B25 B29 B30 B32 C9 Oral dissertation complemented with the use of audiovisual media and the introduction of some questions headed to the students, with the purpose to transmit knowledges and facilitate the learning. It will value fundamentally the assistance and active participation in the same, through the punctual delivery of small proofs of knowledge of immediate answer (methodology socrative) that facilitate the assimilation of the key ideas. 10
 
Assessment comments

In order to pass the subject, it will be compulsory: 

 1. Attendance at a minimum of 70% of the practical sessions. For these purposes, absences duly motivated by health issues will not be taken into account, especially in the case of suspected viriasis compatible with SARS-CoV-2 infection. 

 2. Only 20% of absences from practical sessions without providing the corresponding justification will be considered. 

 3. Obtain a mark of more than 5 points out of 10 in the mixed test.  In general, this test will have a maximum time of 1 hour. 

Given the practical and clinically oriented nature of the subject, there is no possibility of academic dispensation to exempt part-time students from attending practical and seminar classes. 

No different assessment methodologies are envisaged for the second or advanced opportunity, or for students with partial enrolment. For second and subsequent enrolment students, the qualification obtained in the continuous assessment sections of the practical and interactive block, as well as the case study, may be retained on request, provided that these were passed in previous years. Otherwise, the aforementioned sections will be assessed by means of a practical exam. 

Students who do not sit the combined exam will be given a grade of Not Committed, regardless of whether the grade obtained in the continuous assessment of the practical and interactive block and the case study is retained. Students who achieve a grade equal to or higher than 9/10 will be eligible for the mention of Honours, in accordance with the limits established in article 21 of the UDC's "Rules for assessment, review and claims for qualifications in undergraduate and master's degree courses". Honours will be awarded in all cases to the highest overall grade/s.

PLAGIARISM: Plagiarism and the use of non-original material, including material obtained from the internet, without express indication of its origin and, if applicable, the permission of its author, will be graded with a fail (0.0) in the activity. This is without prejudice to any disciplinary responsibilities that may arise following the corresponding procedure.


Sources of information
Basic Neumann, Donald A. (2017). Kinesiology of the musculoskeletal system : foundations for rehabilitation. St. Louis : Elsevier
Arnold G. Nelson, Jouko Kokkonen (2020). Anatomía de los estiramientos. Madrid: Tutor
Kirby, K. A. (2012). Biomecánica del pie y la extremidad inferior. Payson: Precisión Intracast
Kisner, Carolyn (2010). Ejercicio terapéutico: fundamentos y técnicas. Buenos Aires: Médica Panamericana,
Bové, T (2021). El vendaje funcional. Barcelona: Elsevier
Mulligan, Brian R. (2010). Manual therapy : NAGS, SNAGS, MWMs etc.. Wellington: Plane View
Fernández de las Peñas, C., Cleland J.A., Dommerholt J. (2016). Manual therapy for musculoskeletal pain syndromes : an evidence and clinical informed approach. London: Elsevier
Ricard F.; Munuera P., Oliva Pascual Vaca, A. y Rodríguez Blanco C. (2012). Medicina osteopática: miembro inferior. Alcalá de Henares: Escuela de Osteopatía de Madrid,
Butler, David S. (2009). Movilización del sistema nervioso. Barcelona: Paidotribo
Zamorano Zárate, E. (2013). Movilización neuromeníngea : tratamiento de los trastornos mecanosensitivos del sistema nervioso. Madrid : Panamericana
Vleeming, A., Mooney, V., Stoeckart, R. (2008). Movimiento, estabilidad y dolor lumbopélvico : integración de la investigación con el tratamiento. Barcelona : Elsevier Masson
Cleland, Joshua (2022). Netter, Exploración clínica en ortopedia : un enfoque para fisioterapeutas basado en la evidencia. Barcelona : Elsevier
Jon Parsons, Nicholas Marcer (2007). Osteopatía: modelos de diagnóstico, tratamiento y práctica.. Madrid : Elsevier,
Quesada Molina, C. F. (2022). Pie y tobillo : consideraciones generales y síndromes dolorosos. Madrid: Panamericana
Rueda-Sánchez, M. (2004). Podología: los desequilibrios del pie.. Barcelona: Paidotribo
Bryan, E. (2018). The Comprehensive Manual of Therapeutic Exercises Orthopedic and General Conditions. Thorofare, NJ: Slack Incorporated
Myers, Thomas W. (2021). Vías anatómicas : meridianos miofasciales para terapeutas manuales y profesionales del movimiento. Barcelona : Elsevier Masson

Complementary


Recommendations
Subjects that it is recommended to have taken before
Anatomy General/750G02103
Specific Anatomy of the Lower Limb/750G02104
Biomechanics of the Lower Limb/750G02111
Biological Basis and Physical Human Movement/750G02106
Physical Podiatry/750G02121

Subjects that are recommended to be taken simultaneously
Final Dissertation/750G02133
Practicum III/750G02136

Subjects that continue the syllabus
Final Dissertation/750G02133

Other comments
<p>As this subject is usually taken by fourth-year students, it is recommended that it be taken simultaneously with Practicum 3, so that they can apply the new knowledge to the clinical-care context.</p><p>ADAPTATION OF PRESENTATION TO THE EPIDEMIOLOGICAL SITUATION: All classroom activities will be carried out with pre-assigned seats, masks, ventilation, not allowing the consumption of food and drink and ensuring that the centre's prevention and hygiene measures established and published at: https://udc.es/es/fep/coronavirus/ are complied with.</p><p>In the event that the lecture teaching group exceeds the capacity of the classroom, rotating hybrid teaching groups will be established, where students who do not fit in the classroom will follow the telematic teaching that week and the following week will be face-to-face, and another group will follow the telematic teaching, according to the planning established by the lecturer of the subject.</p><p>Environmental considerations:</p><p>SUSTAINABLE DEVELOPMENT OBJECTIVES: To help achieve an immediate sustainable environment and comply with the objective of action number 5: "Healthy and environmentally and socially sustainable teaching and research" of the "Green Campus Ferrol Action Plan":</p><p>The delivery of the documentary work carried out in this subject will be done through Moodle, in digital format without the need to print them, in the case of being done on paper: no plastics will be used, double-sided printing will be carried out, recycled paper will be used and the printing of drafts will be avoided.</p><p>A sustainable use of resources and the prevention of negative impacts on the natural environment should be made, taking into account the importance of ethical principles related to sustainability values in personal and professional behaviour.</p><p>The full integration of students who, for physical, sensory, mental or socio-cultural reasons, experience difficulties in gaining suitable, equal and beneficial access to university life will be facilitated.</p>


(*)The teaching guide is the document in which the URV publishes the information about all its courses. It is a public document and cannot be modified. Only in exceptional cases can it be revised by the competent agent or duly revised so that it is in line with current legislation.