Wayne State University

Eugene Applebaum College of Pharmacy and Health Sciences

Department of Health Care Sciences
Physical Therapy Program

PT 6700: Motor Learning and Motor Control

Case Report #1 Feedback & Grading Rubric (focus Posture & Balance)

Categories added from readings…

Original worksheet (black)

Larson (red)
Shumway-Cook & Woollacott chapter 11
Shumway-Cook & Woollacott chapter 5
Shumway-Cook & Woollacott chapter 7
Bohmert & Woods (Montgomery & Connelly Chapter 7)

Student name ____________________________________

Graded & Feedback from: Cathy A. Larson PT, PhD

Case Report #2 - Mobility

1. Preferred Practice Pattern (from the Guide for Physical Therapist Practice) ____

2. Diagnosis (from the referring practitioner) ____

3. Examination
o History (no protected health information) ____
o General
o Demographics
o Social history
o Occupation – employment, school, play, hobbies, etc. (social function)
o Growth & development
o Living environment
o Perception (prior health status)
o Physical function
o Psychological function
o Role
o Social and health habits
o Family history
o Medical/Surgical History
o Current Conditions or Chief Complaint (Prioritize)
o Functional Status and Activity Level
o Medications
o Other Clinical/Lab findings
o Current Equipment (assistive and adaptive devices) (orthotic,
protective and supportive devices, prosthetics)
o History of falls, circumstances that lead to fall or near-fall
o ABC scale
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 Wayne State University
Eugene Applebaum College of Pharmacy and Health Sciences
Department of Health Care Sciences
Physical Therapy Program
o Falls Efficacy scale

o Review of Systems (what was screened and results) ____

o Cardiovascular/Pulmonary (BP, edema, HR, RR)
o Integumentary (presence of scar formation, skin color, integrity)
o Musculoskeletal (gross ROM, strength, symmetry, height, weight)
o Neuromuscular (gross coordinated movements)
o Communication, affect, cognition, language and learning style

o Tests and Measures ____

o Body Structures and Function (impairments)
o Pain
o AROM, PROM
o Joint play (integrity)
o Integumentary integrity (soft tissue, fascia)
o Strength – MMT, HHD (peak force) (Muscle performance)
o Force control (ramp/slope, maintain, slow/fast release) (scaling)
o Muscle function (Motor function) – Brunnstrom stages, synergies (if
appropriate); movement patterns (Motor weakness (paresis))
o Include UEs, LEs, trunk, neck
o Tone (modified Ashworth, DTRs, clonus, etc.)
o Hypertonia (spasticity, rigidity)
o Hypotonia
o Coordination (activation, sequencing, timing)
o Involuntary movements
o Vision, sensory and vestibular (also in chapter 7) (sensory integrity)
o Cognitive impairments (arousal, attention, cognition)
o Perceptual impairments
o Aerobic capacity/endurance
o Anthropometric characteristics
o Circulation
o Cranial and peripheral nerve integrity (reflex integrity)
o Ergonomics
o Gait and locomtion
o Balance (do not use grades such as P, F, G, F+ when describing
balance unless reference a published source)
o Ventilation and respiration

o Activities
o Functional level (will accept other outcomes measures)
o TUG, ETUG, TUGDT, TUGDT-cognitive, TUGDT-manual
o FR, MDRT, Tinetti, Berg, SPPB, FAB
o Environment, home, work (functional barriers)
o Self care and home management

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 Wayne State University
Eugene Applebaum College of Pharmacy and Health Sciences
Department of Health Care Sciences
Physical Therapy Program
o Strategy level
 Alignment, Posture – COM over BOS (posture)
 ankle, hip and stepping strategies (also in chapter 7)
 self-initiated, externally produced sway, anticipatory
 static balance
• time
• resistance (HHD or manual)
• reaching within arm’s length (feed-forward) (anticipatory)
 dynamic balance
• feedback balance, equilibrium reactions
• reach beyond arm’s length (feed-forward) (anticipatory)
 protective reactions
• slow – edges of cone of stability
• fast – perturbations (risk of fall, quick, ballistic responses)
 Motor control of quiet stance
 Postural tone
 Feed-forward and feedback control (somewhat redundant from
above)
 Anterioposterior, mediolateral and multidirectional stability
 Seated and standing postural control
o Participation
o Work, job school, play, community and leisure
o Environment
o Personal Factors

4. Evaluation ____
o Body Structures and Function
o Activities
o Participation
o Environment
o Personal Factors

5. Prognosis and Plan of Care (POC) _____

o Duration/Frequency of Therapy (is this within the parameters of the Preferred
Practice Pattern according to the Guide)
o Predicted optimal level of improvement
o Goals (SMART = Specific, Measurable, Attainable, Realistic, Time limited)
o Short term goals
o Long term goals
o Anticipated Discharge Plans

6. Intervention (Procedural Interventions) _____

o Body Structures and Function
o The 5 Vs – velocity, vertical, vigor, vision, vestibular

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 Wayne State University
Eugene Applebaum College of Pharmacy and Health Sciences
Department of Health Care Sciences
Physical Therapy Program
o Strength training
o Aerobic conditioning
o Sensory organization training
o Manual therapy techniques
o Prescription, application and, as appropriate, fabrication of devices
and equipment
o Airway clearance techniques
o Integuementary repair and protection techniques
o Electrotherapy modalities
o Activities
o Balance training
o Multi-dimensional exercise programs
o Balance strategy training – ankle, hip, stepping
o Reactive balance control
o Anticipatory balance control
o Sensory and cognitive strategies
o Therapeutic exercise
o Participation
o Functional movement in the home or community
o Task and environment oriented approach
o Self care and home management
o Functional training in work, community and leisure integration or
reintegration
o Environment
o Societal resources
o Personal Factors

7. Coordination, communication, documentation _____

8. Patient/Client Related Instruction _____

9. Motor Learning Application _____

(list 2-3 motor learning concepts that you applied with your patient in each of the following
areas (if applicable)
o Measuring Motor Learning
o Schema Theory
o Explicit or Implicit Learning
o Practice concepts
o Feedback Concepts
10. Procedural interventions _____
o Re-examination
o Risk reduction
o Health, wellness and fitness
o Patient/client satisfaction

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 Wayne State University
Eugene Applebaum College of Pharmacy and Health Sciences
Department of Health Care Sciences
Physical Therapy Program
11. Criteria for Termination of Physical Therapy Services _____
o Discharge
o Discontinuation

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 Wayne State University
Eugene Applebaum College of Pharmacy and Health Sciences
Department of Health Care Sciences
Physical Therapy Program

12. References _____

(This is the minimum number. The purpose is to be evidence-based.)
o Two for examination tests and measures with specific applications to this case
o Two for intervention with specific implications for this case

General Comments:

Total grade _____/ 100

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 Wayne State University
Eugene Applebaum College of Pharmacy and Health Sciences
Department of Health Care Sciences
Physical Therapy Program

Reflection
1. On what basis was the decision to terminate physical therapy made or, if your patient
was not discharged, what criteria do you use?
2. What examination, evaluation, prognosis, intervention, coordination, communication,
documentation, patient/client related instruction or motor learning procedures would I
add to the original case reports (#1 and 2)?
3. What are the outcomes for this patient and how are they correlated to the interventions?

Final Reflection
There are several models on how to write a critical reflection. We will be using the DEAL
model developed by Ash, Clayton and Moses (2006). The components include 3 major
sections with subsections in two of them. Here is what these reflections should include (but are
not limited to):
1) Describe (in moderate detail and as objectively as possible) the activity
a. Consider your two case reports and any other times you attempted to apply the
concepts discussed in this course. Answer questions such as: Where was I?
Who else was there? When did the experiences take place? What did I or
others do (this is answered by including your two finalized case reports)?
Richness of detail will assist you with the rest of the reflection.
2) Examine the experience by perspective
a. Academic Enhancement
i. What specific concepts/ideas in this course relate to my experience with
the patients?
ii. How was I able to apply a skill, perspective or concept related to the
material in this course?
iii. How does this experience enhance my knowledge about a specific
reading, theory or concept from this course? Does it reinforce or
challenge my prior understanding? In what ways?
iv. Critically assess the outcomes of your two case reports.
b. Personal Growth
i. How did the experience make me feel (positive and /or negative)? How
did I handle my emotional responses? Do I think I should have felt
differently?
ii. What assumptions or expectations did I bring to the situation? Why?
iii. How have past experiences influenced how I responded/acted? Am I
comfortable with the influence past experiences have on me?
iv. What personal strengths/weaknesses did the experience reveal? How did
they impact the experience (positively and/or negatively)? What might I
do to build on my strengths and improve my weaknesses?
v. What personal skills did I draw on in handling this experience? What
personal skills would I have liked to have had in order to have handled it
better?
vi. Why did I, or did I not, experience difficulty working/interacting with other
people? What might I do differently next time to minimize such
difficulties?

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 Wayne State University
Eugene Applebaum College of Pharmacy and Health Sciences
Department of Health Care Sciences
Physical Therapy Program
vii. How did this situation reveal my attitudes or biases, toward other people,
toward the organization, toward society at large? Do I need to make any
changes?

3) Articulate Learning
a. What did I learn?
b. How did I specifically learn it?
c. Why does it matter? Why is it important?
d. What will I do in the future, in light of it? What ways will I use this learning, what
goals will I set because of what I’ve learned in order to improve myself and/or the
quality of my learning and/or the quality of my future experiences or service?

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