MASTER OF CARDIO-PULMONARY

PHYSIOTHERAPY

RS1

KLE UNIVERSITY,
BELGAUM, KARNATAKA, INDIA, 590010

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 ORDINANCE GOVERNING
MASTER OF CARDIO-PULMONARY
PHYSIOTHERAPY COURSE
2015 - 2016

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 CONTENT
1. Preamble
2. Objectives
3. Career Opportunities
4. Professional Recognition
5. Eligibility
6. Fitness Certificate
7. Total Intake of students
8. Course Fees Structure
9. Course Duration
10. Medium of instruction
11. Commencement of course
12. Course location
13. Course structure
14. Clinical Placement
15. Methods of Training
16. Monitoring Process
17. Attendance
18. Dissertation
19. Guide
20. Assessment
21. Schedule of Examination
22. Scheme of Examination
23. Criteria for question paper setting/ Answer sheet evaluation
24. Criteria for Examiners
25. Number of Appearances
26. Criteria for passing
27. Declaration of class
28. Course contents
29. Graded responsibility in care of patients and operative work
30. Appendix

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 1. PREAMBLE

This course has an international reputation and is a dynamic course which is based
on contemporary best practice. It creates the opportunity for physiotherapists
currently working in the cardio-respiratory area to be challenged both academically
and clinically. A high level of expert tuition is provided for all units and clinical
placements. This course focuses on the integration between evidence-based
practice and current clinical practice. Clinical reasoning is fundamental to all
assessment, treatment, management and rehabilitation for both cardio-vascular and
pulmonary disorders. It is designed to enhance knowledge, skill and clinical
competencies in clinical practice, research and issues related to cardio-vascular
and pulmonary problems. Physiology of various cardio-vascular and pulmonary
disorders and their rehabilitation are integrated into clinical practice. Throughout the
course students review the literature critically and apply this information in the
evaluation and management of cardio-vascular and pulmonary disorders. Research
projects are completed in cardiopulmonary physiotherapy and manuscripts are
submitted to a peer-review journal.

2. OBJECTIVES

The objectives of this programme are to:

1. Provide students with detailed training in cardio-pulmonary physiotherapy theory
and practice, including the use of other physiotherapy modalities.
2. Ensure that students practice from cardio-pulmonary physiotherapy, whilst
integrating western medical information as appropriate, to ensure that graduates
are safe and competent in the practice of cardio-pulmonary physiotherapy.
3. Provide students with quality clinical experiences in hospitals and complementary
health clinics from Year One of the program.
4. Provide students with opportunities for research and higher degree in cardio-
pulmonary physiotherapy on the completion of their undergraduate degree.

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 3. CAREER OPPORTUNITIES

Physiotherapists with degree in master of cardio-pulmonary physiotherapy are in

demand and graduates with this qualification are recognized throughout India and
internationally. As there is a shortage of highly qualified physiotherapists with
cardio-pulmonary specialization, employment opportunities are excellent. This
qualification is recognized and commands increasing employment remuneration.
They can be employed in teaching institutions and also can practice in private
setups.

4. PROFESSIONAL RECOGNITION

Graduates who are registered with the Indian Association of Physiotherapists can
apply to have this qualification listed. The award of Master of cardio-pulmonary
physiotherapy qualifies graduates for membership of the cardio-pulmonary
physiotherapy Interest groups in India as well as abroad.

5. ELIGIBILITY

A candidate who has passed Bachelor of Physiotherapy (B.P.T./B.Ph.T/B.P.Th.) or

any equivalent degree examination of a recognized Indian university by law in India
or any other degree course in physiotherapy recognized as equivalent by KLE
University or Indian Association of Physiotherapists and who has scored not less
than 50% of maximum marks in prescribed qualifying examination shall be eligible
for the MPT in Cardio-pulmonary Physiotherapy.

6. FITNESS CERTIFICATE
Every candidate before admission to the course shall submit to the principal of the
institution a certificate of medical fitness from an authorized medical officer that the
candidate is physically fit to undergo the MPT course and does not suffer from any
contagious disease. Student with disability should produce disability certificate
issued by the duly constituted district medical board.

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 7. TOTAL INTAKE OF STUDENTS
The total intake of students per year will be 4 per academic year.

8. COURSE FEES STRUCTURE

The tuition fees and other fees structure will be as per the notifications by KLE
University from time to time. The fees structure is different for resident Indians, non
resident Indian and foreign students.

9. COURSE DURATION
The course of study including submission of dissertation on the topic registered
shall be of 24 months (Two years) duration from the commencement of academic
term.

10. MEDIUM OF INSTRUCTION

Medium of instruction shall be English for theory lectures, practical, laboratory
works and clinical teaching.

11. COMMENCEMENT OF COURSE

The course will commence from August 1st of every year

12. COURSE LOCATION

This course is offered at KLEU Institute of Physiotherapy, Belgaum 590010,

Karnataka, India.

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 13. COURSE STRUCTURE

Sl.No. Subject Teaching Hours

Theory Practical / Total
Clinical
1 Paper-I Physiotherapy Research, 150 250 400
Biostatics & Ethics
2 Paper-II Basic science & 150 250 400
Physiotherapeutics
3 Paper-III Clinical, physical and 150 250 400
functional diagnosis in Cardio-
vascular and pulmonary
Physiotherapy
4 Paper-IV Cardio-vascular and 150 300 450
pulmonary Physiotherapy
5 Paper-V Recent advances and 150 300 450
Evidence Based Practice in cardio-
vascular and pulmonary
Physiotherapy
6 Clinical Training - 1200 1200
7 Seminars - - 350
8 Journal Club - - 200
9 Research Club - - 150
Total Teaching Hours 4000

14. CLINICAL PLACEMENT

Teaching clinics operate 48 weeks per year, and students will be required to attend
clinical sessions on a rotation basis to maintain a public service and provide
continuity of patient care.

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 15. METHODS OF TRAINING
Post graduate students shall be trained to acquire responsibilities in the
management of patients with ethical standards of practice. They will be made to
actively involve themselves in seminars, case presentations, journal presentations,
and clinical discussions with reflective practice. Every candidate will be given
training in teaching of undergraduate students. They are specially trained to
perform research activities in their specialty.

16. MONITORING PROCESS

Every candidate shall maintain a work diary and record of his/her participation in the
training programs conducted by the department such as journal reviews, seminars,
etc. The work diary shall be scrutinized and certified by the Head of the Department
and Head of the Institution, and presented in the university practical examination if
called for. Special mention may be made of the presentations by the candidate as
well as details of experiments or laboratory procedures, conducted by the
candidate. The presentations will be assessed by the faculty members and peers
using relevant checklists.

17. ATTENDANCE
A candidate pursuing M.P.T. Cardio-pulmonary course shall study in the concerned
department of the institution for the entire period as full time student. No candidate
is permitted to work in any other hospital/clinic/college etc., while studying post
graduates course. No candidates should join another course of study or appear for
any other examination conducted by this university or any other university in India
or abroad during the period of registration. Each year shall be taken as a unit for the
purpose of calculating attendance. Every student shall attend symposia, seminars,
conferences, journal review meetings and lectures during each year as prescribed
by the department/college/university and not absent him/her without valid reasons.
Candidate who has put in a minimum of 80% of attendance in the theory and
practical assignments separately shall be permitted to appear for M.P.T in Cardio-
pulmonary examination. Candidate who has put in a minimum of 80% of attendance
in first year of M.P.T in cardio-pulmonary shall only be eligible to submit the

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dissertation. Any student who fails to complete the course in the manner stated
above shall not be permitted to appear for the University examination.

18. DISSERTATION
Every candidate pursuing M.P.T. course is required to carry out work on a selected
research project under the guidance of a recognized postgraduate teacher. The
results of such a work shall be submitted in the form of a dissertation.
The dissertation is aimed to train a postgraduate student in research methods and
techniques. It includes identification of the problem, formulation of a hypothesis,
review of literature, getting acquainted with recent advances, designing of a
research study, collection of data, critical analysis, and comparison of results,
drawing conclusions and evaluation of research project.
Every candidate shall submit to the Registrar (Academic) of the university in the
prescribed proforma, a synopsis containing particulars of proposed dissertation
work within 6 months from the date of commencement of the course on or before
the dates notified by the university. The synopsis shall be sent through the proper
channel.
Such synopsis will be reviewed and the university will register the dissertation
topic. No change in the dissertation topic or guide shall be made without prior
approval of the university.
The dissertation should be written under the following headings.
1. Introduction
2. Aims or objectives of study.
3. Review of literature.
4. Material and methods.
5. Results.
6. Discussion
7. Conclusion
8. Summary
9. References
10. Tables
11. Annexure.

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The written text of dissertation shall not be less than 50 pages and shall not exceed
100 pages excluding references, tables, questionnaires and other annexure. It
should be neatly typed in double line spacing on one side of paper (A4 size, 8.27” x
11.69”) and bound properly. Spiral binding should be avoided. The guide, head of
the institution shall certify the dissertation.
Four copies of dissertation thus prepared shall be submitted to the registrar
(evaluation), three months before final examination on or before the dates notified
by the university.

The examiners appointed by the university shall value the dissertation. Approval of
dissertation work is an essential precondition for a candidate to appear in the
university examination. The dissertation shall be valued by the evaluator
(examiners) apart from the guide out of which one is external outside the university
and one internal from the same university. Any one-evaluator acceptance other
than the guide will be considered as a precondition for eligibility to take up the
examination.

TIME PLAN FOR DISSERTATION

Event Probable date
Orientation 1st week of August
Workshop on research methodology 2nd week of September
Proposal writing/protocol writing 2nd Week of October
Synopsis review 2nd Week of January
Submission of synopsis 15th February
Ethical clearance 20th February
Data collection to start 1st week of March
1st review of data 30th June
2nd review of data 30th September
3rd review of data 23th December
Thesis presentation 30th January
Submission 28th February

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 19. GUIDE
Criteria for recognition of MPT teacher / guide
MPT (Cardio-pulmonary PT) with five years teaching experience working on a full
time position at a recognized institution.
2. The age of guide / teacher shall not exceed 65 years.
3. The guide student ratio should be 1: 3.
4. Relaxation for the criteria one and two notwithstanding above in view of acute
shortage of teachers, the persons having three years post MPT teaching
experience working on a full time basis may be considered as P.G. teachers.
Similarly persons with maximum age of 66years may be considered for being guide
and examiner in cases of acute shortage of examiners until further amendments by
the University in this regard.
Change of Guide
For change of guide in extra ordinary situations, a suitable guide will be provided
from within the concerned department or HOD of the department will be given the
responsibility. In absence of both, the registered PG may be allotted under the
senior most professor or Head of the institute with prior permission from the
university.

20. ASSESSMENT
The final assessment of the student in this course will be by written, oral and
practical examination at the completion of the every year. However, the student
should submit the research dissertation prior to appearing for the 2 nd year university
examination. Student’s dissertation should be accepted by the examiners prior to
appearing for the 2nd year examination.

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 21. SCHEDULE OF EXAMINATION
The examination for MPT (Cardio-pulmonary PT) course shall be held at the end of
every academic year. The university shall conduct two examinations in a year such
as.
i. Regular
ii. Supplementary at an interval of six months between two examinations. Not more
than two exams shall be conducted in the academic year. To be eligible to write the
second year exams, the candidate should have cleared the first year exams.

22. SCHEME OF EXAMINATION

Type of Assessment Maximum Marks

1st MPT 2ND MPT

Theory 300 200

Clinical 100 150

Dissertation ---- 50
Practical
Microteaching ---- 25

Viva-Voce 50 25

Total 450 450

Grand total 900

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Written Examination (Theory)
A written examination consisting of five question papers, each of three hours
duration & each paper carrying 100 marks.
Particulars of Theory question paper & distribution of marks are as follows;

Paper Subject Marks

I Physiotherapy Research, Biostatistics & 100

Ethics
II Basic science & Physiotherapeutics 100

III Clinical, physical and functional diagnosis in 100

cardio-vascular and pulmonary
Physiotherapy
IV Cardio-vascular and pulmonary 100
Physiotherapy
V Recent advances and Evidence Based 100
Practice in Cardio-vascular and pulmonary
Physiotherapy

Clinical Examination (Practical)

A clinical examination of first year MPT consisting of 100 marks and second year
MPT consisting of 150 marks with total of 250 marks that is aimed at examining
clinical skills and competency of the candidates for undertaking independent work
as a neurological physiotherapy specialist

Viva-Voce Examination (Practical)

A Viva-Voce examination of both 1st and 2nd year MPT consisting 150(50+100) that
is aimed at examining depth of knowledge, logical reasoning, confidence & oral
communication skills with special emphasis on dissertation work. The marks of
Viva-Voce examination shall be included in the clinical examination to calculate the
percentage and declaration of results.

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PATTERN OF MODEL QUESTION PAPER
Theory three hours question papers in all 5 subjects
Type of questions – 100 Marks each paper (No choice)
1. Multiple choice questions (MCQ) [20question]-20 marks
2. Long Essay (2 Questions) – 2 x 20 = 40 Marks
3. Short Essay (4 Questions) – 4x 10 = 40 Marks

1st MPT Practical / Clinical – 150 Marks

Note : All cases for clinical examination should be on patients & not on models.
Day 1
1. Case (1) – 1 x 50 = 50 Marks (SPECIALIZATION CASE)
2. Case (2) – 1x 50 = 50 Marks (NON SPECIALIZATION CASE)
Viva – Voce - 50 Marks

2ND MPT Practical/clinical-250 Marks

Day 1
1. Long case- 1x 100=100- (SPECIALIZATION CASE)
2. Short case- 1x50=50 (SPECIALIZATION CASE)
Day 2
Viva-Voce - 25 Marks
Dissertation - 50 Marks
Micro teaching - 25 Marks

23. CRITERIA FOR QUESTION PAPER SETTING/ ANSWER SHEET

EVALUATION
For all theory subjects question paper setter and answer sheet evaluator must have
minimum of 5 years of postgraduate teaching experience.

24. CRITERIA FOR EXAMINERS

There shall be two examiners, one of them external, outside the university and the
other internal preferably from the same college or as decided by the University.

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 25. NUMBER OF APPEARNACES
Candidate registered for two years post graduate degree course should qualify in
the examination within four years of date of admission. The candidate has to
reregister for the course it he/she fails to complete within stipulated time.

26. CRITERIA FOR PASSING

Minimum of 50% of total marks in theory aggregate and minimum of 50% of total
marks in clinical and Viva-Voce aggregate will be required for declaring a candidate
pass.

27. DECLARATION OF CLASS

First class with distinction – 75% & above in aggregate provided the candidate
passes the examination in 1st attempt.
First class – 60% & above in aggregate provided the candidate pass the
examination in 1st attempt.
Pass – 50% of maximum marks in theory aggregate and 50% of maximum marks in
clinical and Viva-Voce aggregate.

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28. COURSE CONTENT
Paper-I Physiotherapy Research, Biostatistics & Ethics Theory - 150 Practical -250
Learning objectives:
On successful completion of this unit, it is expected that students will be able to:
1. Understand basic research methodology and terminology.
2. Evaluate different types of statistical designs.
3. Explain research methods relevant to research in cardio-vascular and
pulmonary physical therapy and related health fields.
4. Describe the main differences between qualitative & quantitative research.
5. Discuss the advantages and disadvantages of the different methodologies
6. Recognize the significance of consent, confidentiality and other ethical
considerations in relation to research.
CONTENTS:
A) PHYSIOTHERAPY RESEARCH & BIOSTATISTICS
Content Hours
1. Principles of research 02
2. Review of scientific methods. 03
3. Research question, Research design, Quantitative and qualitative 04
research paradigms.
4. Sampling design, Data sampling and methods of data collection, 04
Probability
5. Measurement & scaling techniques. 03
6. Introduction to Biostatistics 02
7.Source and presentation of data 06
8.Measures of location, average and percentile 04
9.Measures of central tendency 05
10.Variability and its measures 08
11.Normal distribution and normal curve 04
12.Demography Study 04
13.Measures of population and statistics 04
14. Data analysis: descriptive and inferential statistics, correlations 10
and hypothesis testing.

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 15. Quantitative data analysis: revision of descriptive and inferential 10
statistics, correlations and hypothesis testing, general linear model,
power and effect.
16. Analysis of variance and covariance multivariate designs, 10
nonparametric data analysis and selection of nonparametric tests.
17. Qualitative data analysis: major qualitative methodologies,
techniques in data collection and analysis. 10
18. Role of computers in research. 02
19. Protocol writing, Manuscript writing 06
B) ETHICS
1.Introduction, History & General Principles of ethics involving human 02
participants.
2.Ethical consideration in physiotherapy practice- State, National & 10
international rules & regulations governing physiotherapy practice.
3.Ethical review procedures- protocol writing, ethical committee. 06
4.Informed consent process, Plagiarism 06
5.Good clinical practices (GCP) 05
6.Ethical codes and conduct for physiotherapy profession. 04
7.International classification of function (ICF)- Introduction, History, 06
classification, components, coding & benefits of ICF
8.Influence of values & valuing on patient care 04
9.Documentation skills- History, examination, treatment planning, 06
organization & execution.

Recommended reading:
1. Domholdt, E. (2000) Physical therapy research: Principles and applications,
2nd ed. WB Saunders, Philadelphia, USA.
2. Kuzma, J. W., & Bohnenblust, S. E. (2004). Basic statistics for the health
sciences. (5th ed.). Boston: McGraw Hill.
3. Munro, B. H. (1997). Statistical methods for health care research (3rd ed.).
Philadelphia: Lippincott.

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4. Coakes, S. J., & Steed, L. G. (2003). SPSS: Analysis without anguish:
Version 11.0 for Windows. Milton, Australia: John Wiley & Sons Inc.
5. Jenkins, S., Price CJ, & Straker L. (1998). The researching therapist. A
practical guide to planning, performing and communicating research.
Edinburgh: Churchill Livingstone.
6. Campbell, M.J., & Machin, D. (1993). Medical statistics: A commonsense
approach (2nd ed.). Chichester, UK: John Wiley.
7. American physical therapy association: Guide to physical therapy practice,
2nd edition 2001.
8. Professionalism in physical therapy: History, practice and development by
Laura Lee Swisher and Catherine G.Page,(Elsevier publication 2005)
9. International classification of functioning, disability and health: Short
version.(IT’S publication)
10. Effective Documentation for physical therapy professionals by Eric Shamus
and Debra (McGraw Hill Company 2004).
11. Physical therapy Documentation: From examination to outcome by Mia
Erickson, Ralph Utzman (Slack incorporated 2008)
12. Writhing SOAP notes with patient / Client management formats by Ginge
Kettenbach PhD, PT,3rd edition 2004,F.A.Davis company ,Philadelphia.
13. Practical Evidence Based Physiotherapy, Rob Herbert, Gro Jamtvedt, Judy
Mead, Kare Birger Hagen Elsevier Butter Worth Heinemann; Oxford UK
(2005)
14. Guide to Evidence Based Physical Therapy Practice by Dianne V. Jewell,
PT, PhD, Virginia Commonwealth University, Virginia.
15. Introduction to Research in Health Sciences – Polgar S, Churchill
Livingstone, London, 1988
16. Handbook of Research Method – Sproull, Screcrow Press, 1998.
17. Elements of Research in Physical Therapy, Currier D. P, Williams & Wilkins,
Baltimore, 1990, Ed 3.
18. Public Power and Administration – Wilenski, Hale and Iremonger, 1998.
19. Public Therapy Administrations and Management – Hickik Robert J.
20. Management Principles for Physiotherapists – Nosse Lorry J.

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 Paper-II Basic sciences and physiotherapeutic Theory - 150 Practical -250

Learning objectives
On successful completion of this unit it is expected that the student will be able to
1. Understand the advance application of biomechanics on human body and its
function.
2. Carry out exercise testing, should be able to prescribe and document the
exercise specific to the individual client
3. Learn to analyze work and work related problems and advice modifications
accordingly
4. Perform and interpret independently electrophysiological investigations
5. Plan, introduce and observe the therapeutic modalities and methods of
applications to the patients
6. Apply the knowledge of methods of rehabilitation in a clinical setting. .

A) BASIC SCIENCES (75)

Content Hours
I. BIOMECHANICS 15
• Basic concepts in biomechanics
• Biomechanics of bone, cartilage, tendon & ligaments,
muscles & peripheral nerves.
• Biomechanics of respiration and circulation.
• Biomechanics of integrated function- Gait, Posture, Activities
of daily living, Hand function.
II. EXERCISE PHYSIOLOGY 10
• Energy systems- energy sources, energy transfers, energy
expenditure at rest & various physical activities.
• Fitness, Exercises testing & prescription & documentation
• Effect of exercises on various systems & their adaptation.
• Influence of environmental factors on muscle work &
acclimatization.
• Obesity, weight control, nutrition & caloric balance.

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 III. ERGONOMICS 15
• Introduction & History of ergonomics
• Work plan management
• Fatigue, Assessment of fatigue, work rest regimes
• Job/ Task/Site analysis
• Work hardening programme
• Work related injuries, Educational programme for prevention
of work related injuries
IV. ELECTROPHYSIOLOGY
• Nerve muscle physiology 10
• Instrumentation & principles of electrophysiological
techniques
• Kinesiological EMG, EMG biofeedback
• Clinical electrophysiological testing- EEG, SSEP, VEP,
BAER, LR
V. Pain gate theories, Mechanism of pain control 05
VI. Motor development concepts, Motor Control and its training 05
techniques.
VII. Recovery of function and neural plasticity, Electrical 15
excitability of muscle and nerve and composition of peripheral
nerves, Muscle Plasticity in response to electrical stimulation, Neural
Control of locomotion
B) PHYSIOTHERAPEUTICS (75)

• Principles, Indication & contraindication & application of 05

various schools of manual therapy
• Principles of sports injury, prevention & management 05
• Principles, instrumentation and application of 05
electrotherapeutic modalities
• Assessment & clinical examination- Musculoskeletal system, 10
cardiovascular & respiratory system, obstetrics & gynecology,
pediatric and neurological assessment.
• Various neurological approaches in clinical practice, 05
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 Facilitation & inhibition techniques
• Bladder and bowel management 05
• Motor learning , Biofeedback 05
• Cardio-respiratory physiotherapy- disorders & physiotherapy 05
management
• Cardio-pulmonary resuscitation, monitoring systems & critical 05
care management
• Physiotherapy in obstetrics and gynecology conditions 05
• Physiotherapy in common dermatological conditions 05
• Allied therapies- Magnetotherapy, Acupuncture, Naturopathy, 05
Yoga & pranayama
• Rehabilitation principles & application in - Burns 10
rehabilitation, Geriatric rehabilitation, Cancer
rehabilitation, Pulmonary rehabilitation, Cardiac rehabilitation, Hand
rehabilitation.
Recommended reading:

1. Scientific basis of human movement – Gowidtzke, Williams & Wilkins,

Baltimore, 1988 .3rd edn

2. Basic Biomechanics of the musculoskletel system – Margerat Nordin. And

Victor H frankle 2nd edition.

3. Kinesiology – Brunnstrom Signe – FA Davis, Philadelphia. 1966

4. Clinical biomechanics of spine – White AA and Panjabi JB, Lippincott,

Philadelphia 1978.

5. Joint structure and function- A comprehensive analysis - Pamela K Levangie

and Cynthia C Norkin , Jaypee publishers 2006

6. Kinesiology: Application to pathological motion – Soderberg , Williams &

Wilkins. 1997

7. Textbook of work physiotherapy – Guyton, Prim books , Bangalore 1991 8 th

edition

8. Handbook of physiology in ageing – Masoro CRC press 1981.

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9. Kinesiology : The mechanics and pathomechanics of human movement –

Carol Oatis, williams and wilkins, lippincott 2008.

10. The Physiology of joints - Kapandji and Matthew J Kendal, Churchill

livingstone 2008.

11. Kinesiology of human body under normal and pathological condition- Arthur

Steindler, 5th edition, 1977.

12. Industrial therapy - Glenda l key 1st edition, Mosby publication

13. Exercise physiology - Mc Ardle, Katch and Katch (lippincott), William and

wilkins. 2000.

14. Clinical exercise testing and prescription Theory and applications – Scott O

Roberts and Peter Hanson , CRC Press .1997

15. Exercise physiology : Exercise ,Performance, and Clinical Applications –

Robert A Roberts and Scott O Roberts .1997

16. Electromyography in clinical practice – Michael J Aminoff 3rd edition,

Churchill livingstone

17. The ABC of EMG: A practical Introduction to Kinesiological

electromyography – Peter Conrad, Noroxon Inc, USA, 2005.

18. Clinical Neurophysiology – U. K. Misra & Kalita, 2nd Ed, Churchill Livingstone

19. Electrodiagnosis in Diseases of Nerve & Muscle: Principles & Practice – Jun

Kimura, Oxford University Press

20. Hand Rehabilitation – Christine – Churchill Livingstone, London, 1995

21. Cardiac Rehabilitation - Amundsen IR, Churchill Livingstone, London, 1988

22. Pulmonary Rehabilitation: Guidelines to Success – Hoidkins, Butterworth,

Boston, 1984

23. Physical Therapy of the Cancer Patient – Mc Garyex Charles, Churchill

Livinstone, New York, 1989

24. Physiotherapy in Obstetrics & Gynaecology – Polden & Mantle, Jaypee

Brothers, New Delhi, 1994.

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 25. Obstetrics & Gynecologic Physical Therapy – Wilder Elnine, Churchill

Livingstone, New York, 1994.

26. Cardiopulmonary Physiotherapy – Irwin, C.V., Mosby, st. Louis, 1990

27. Motor Relearning Program for Stroke – Carr, Aspen Publication, Rock Ville,

1987

28. The neural basis of motor control – Black I, Churchill Livingstone, London,

1987

29. Grieve’s Modern Manual Therapy: The vertebral column – Jeffery Boyling &

Grad Dip Man Ther, Churchill Livingston

30. Physical Rehabilitation – Susan B O S Sullivan & Thomas J Schmitz, Jaypee

Publication, 4th Ed

31. Physical Agents in Rehabilitation: From Research to Practical, Michell H

Cameron, 2nd Ed, Saunders & Elsevier, 2003

32. Sports & Physical Therapy – Bernhardt Donna, Churchill Livingstone,

London, 1995

33. Darcy A. Umphred: Neurological rehabilitation, Mosby, Sydney, 5th Edition.

Paper-III Clinical, Physical and Functional diagnosis in Theory - 150 Practical -250

cardio-vascular and pulmonary physiotherapy

Learning Objectives:
On successful completion of this unit, it is expected that
students will be able to:
1. Elicit and interpret clinical signs and symptoms of cardio-vascular and pulmonary
diseases & interpret clinical tests and special investigations commonly used in the
diagnosis of conditions.
2. Generate a primary diagnosis and a list of differential diagnoses consistent
with typical presentations.

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3. Identify normal & pathological anatomy on diagnostic images in various cardio-
vascular and pulmonary disorders.
CONTENTS:

A
1. GENERAL:
 Review of Anatomy, Embryology and Epidemiology of cardio-vascular,
pulmonary and lymphatic pulmonary system. (15)
 Role of cardio respiratory therapist in patient assessment. (01)
 Patient clinician interaction and communication with assessment findings.
(01)
 Confidentiality, concern and universal precautions. (01)
 A detailed and comprehensive cardio-respiratory health history. (03)
 Assessment standards, common scales, questionnaire indices used for
patients with cardio-pulmonary dysfunction. (04)

B
2. Detailed assessment of cardio- vascular and pulmonary symptoms
(dyspnea, cough, sputum production, hemoptysis, clubbing, cyanosis,
chest pain, syncope, fever, night sweating, headaches, altered
sensorium, personality changes, snoring. (04)
3. Vital signs assessment (05)
1. Obtaining vital signs, clinical impressions
2. General clinical presentation
3. Temperature
4. Pulse including the peripheral pulses
5. Blood pressure
6. Respiratory rate
4. Fundamentals of physical examination with diagnosis in cardiovascular
and respiratory physiotherapy (10)
1. Examination of head and neck
2. Lung topography – thoracic cage landmarks
3. Examination of Thorax/ pulmonary system

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 4. Examination of Precordium/cardiac system
5. Examination of Abdomen
6. Examination of Extremities
5. Assessment of neonatal and pediatrics patients – new born, critically ill
infants, older infants and child (02)
6. Comprehensive geriatric assessment – age related sensory deficits,
cardio- respiratory deficits and diagnostic tests, standard scales and
questionnaires used in geriatric assessment (05)
7. Nutritional assessment of patients with cardio- respiratory diseases (02)
8. Fitness assessment –(10)
1. Anthropometric and biophysical measurement and body
composition
2. Flexibility tests and standards
3. Muscle strength and standard
4. Endurance tests and standards
5. Agility tests and coordination tests
9. Exercise testing and standardization and interpretation –(12)
1. TMT protocols- Maximal and submaximal protocols
2. Field protocols
3. Bicycle protocols
4. Step test protocols
5. 6, 9 and 12 minute walk tests
6. Protocols for pediatric and geriatric population

C – Investigation and their interpretation and clinical relevance in cardio-

pulmonary physiotherapy
1. Clinical laboratory studies – hematology, microbiology, urine analysis,
histology, pathology (03)
2. Pulmonary function tests – normal values (10)
a. Spirometry, arterial blood gas analysis and its interpretation in cardio
– respiratory physiotherapy, capnography and pulse oximetry and its
relevance in cardio- pulmonary physiotherapy

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3. Clinical application of chest radiograph – chest x-ray, examination, views;
computed tomography, magnetic resonance imaging, lung scans - PET
scan. Evaluation of chest radiography – clinical and radiographic findings in
cardio- pulmonary disorders and its relevance cardio-pulmonary
physiotherapy (10)
4. Laboratory and bedside interpretation of ECG findings – interpretation of
common dysrhythmias and its importance in cardio-respiratory physiotherapy
and various ECG patterns in lung disease (08)
5. Cardio respiratory monitoring in critically ill patients including patients with
artificial airways(10)
1. Ventilator assessment and evaluation of oxygenation in ICU
2. Assessment of cardiac output in ICU
3. Assessment of haemodynamic pressures in ICU
4. Clinical diagnosis in cardio- respiratory disorders in intensive care
6. Blood flow studies-arteriography, venography, Color Doppler, ANS testing
and interpretation used in cardio- respiratory physiotherapy and edema
evaluation and interpretation. (03)
7. Cardio respiratory assessment and diagnosis of patient on mechanical
ventilator and interpretation of graphical forms, weaning modes and indices
(11)
8. Risk factor stratification, disability evaluation with reference to cardio
vascular and pulmonary disorders (03)
9. Psychological evaluation with reference to stress and anxiety in cardio-
pulmonary disorders, Evaluation of stress and anxiety using various scales
and questionnaires (03)
10. Effects of normal and abnormal response to exercise on various systems
with emphasis on cardiovascular and pulmonary systems (12)
1. Age related changes in cardiovascular and pulmonary system
2. Oxygen Debt, oxygen deficit, lactate threshold
3. VO2 max, METs – its importance in calculating energy expenditure
and physical activities

26
 4. calculating energy expenditure using calorimetry method, various
formulae and equations with emphasis on its importance in
prescribing exercise in various patient population
11. Evaluation and diagnosis of sleep and breathing disorders (02)

RECOMMENDED READING:
1.Robert MBerne, Matthew N Levy (2001)-“Cardio-vascular physiology”, 8th edition,
Mosby.
2.John B.West-“Respiratory Physiology-the essentials”,6th edition, Lippincott
Williams and Wilkins.
3. Macleod’s Clinical Examination-10th edition.
4. Andrews Davies and Carl Moores (2003)-“The Respiratory System”, illustrated by
Robert Britton, Churchill Livingstone.
5. George G.Burton,John E Hodgin,Jeffrey J Ward( 1997 )-“Respiratory Care-A
Guide to Clinical Practice” 4th edition,Lippincott Williams and Wilkins, A Wolters
Kluwer Company.
Paper-IV Cardio-vascular and pulmonary Theory – 150 Practical -300

physiotherapy

Learning objectives:
On successful completion of this subject, it is expected that students will be able to:
1. Develop a management plan, generally including some lifestyle factors, in co-
operation with the Clinical Supervisor and consider a prognosis that reflects on
the patient’s problem.
2. Manage a patient in consultation and co-operation with the clinical supervisor,
identifying the presenting problem, developing a basic working diagnosis and
selecting a treatment regime that considers the presenting problem with some
consideration for ethical, practical and pragmatic concerns.
3. Maintain legal (accurate, clear and legible) patient histories, write basic referral
letters and recognize the need of further referral in conference with Clinical
Supervisor and peers.

27
4. Discuss the Common exercise prescriptions and their clinical use, and
the sequence of treatment and how to advise different sorts of patients.

CONTENTS:
1 A. Principles of exercise prescription and exercise program adherence.
1. Components of physical fitness and Basic principles of exercise program
design. (12)
2. The art of science of exercise prescription in various patient population
(05)
3. Bioenergetics of exercise and training (03)
4. Warm ups, stretching and cool down and its importance (02)
5. Exercise program adherence and factors affecting exercise adherence.
(01)
6. Different forms of training methods. (05)

B.
1. Designing cardio-respiratory exercise programs for cardiac and
pulmonary patients, geriatric and general population. Essentials of a
C.R. exercise workout, Aerobic training. Methods and modes,
personalized programs. (10)
2. Designing Resistance exercise programs. (05)
 Types of resistance training and developing respiratory
exercise program including calisthenics.
 Resistance exercise program for children and older adults.

3. Designing flexibility and stretching programs. (02)

4. Designing weight management (weight loss and weight gain) and
Body composition programs. (03)
5. Application of exercise prescription principles in various cardio-
pulmonary disorders including edema management. (05)

28
C.
1. Nutrition and cardio-vascular and pulmonary diseases including diabetic
population- Role of carbohydrates, proteins, fats, vitamins in health and
disease. (05)
2. Diet prescription in diabetic, hypertensive, cardio-metabolic syndromes,
obesity and cancer patients according to calorie expenditure. (05)
3. Exercise prescription/ physical activity in a high risk cardiac patient including
L.V Dysfunction, chronic heart failure, myocardial ischemia. (07)
4. Exercise prescription in prevention of CAD, obesity, renal dysfunction,
diabetes mellitus, hypertension. (08)

2. CARDIO-VASCULAR DISORDERS AND PHYSIOTHERAPY

MANAGEMENT INCLUDING EXERCISE PRESCRIPTION IN: (25)
 Myocardial infarction
 Acquired heart conditions
 Hypertension, hypotension
 Rheumatic fever, rheumatic heart disease and non- rheumatic valvular
diseases.
 Diseases of myocardium ,pericardial diseases, cardiomyopathies
 Vascular diseases, peripheral vascular diseases and lymphatic diseases
 Tumors of heart
 Athlete heart
 Congestive cardiac failure
 Cardiac arrhythmias
 Congenital heart diseases
 Cardiac transplantation
3. PULMONARY DISORDERS AND PHYSIOTHERAPY MANAGEMENT
INCLUDING EXERCISE PRESCRIPTION IN: (25)
 obstructive pulmonary diseases
 Restrictive pulmonary diseases
 Infective lung diseases
 Occupational lung diseases

29
  Lung cancer
 Chest wall deformities and spinal cord injury
 Diaphragmatic diseases
 Sleep apnea/ hyperventilation syndrome
 Respiratory disorders in children, cystic fibrosis
4. Common emergency conditions in cardio-respiratory system in adults and
children and ethical issues in intensive care (02)
5. Cardio-pulmonary problems and complications in various neuromuscular
disorders, facilitatory and inhibitory techniques and pnf techniques in various
pulmonary disorders, manual techniques for various pulmonary disorders.
(02)
6. Physical agents used in various cardio-vascular and respiratory disorders
(02)
7. Cardio-vascular and pulmonary pharmacology- Indications, contraindications
and effects. (02)
8. Body positioning: art and its physiological importance in general and in
ICUs(02)
9. Aerosol therapy- Principles and its role in physiotherapy.(02)
10. Humidifiers and Atomizers role in physiotherapy. (02)
11. Stress, Importance of exercise in stress management and various stress
coping strategies , relaxation techniques including yogic postures and yogic
breathing in various lifestyle disorders and other cardio-vascular and
pulmonary conditions (05)
12. Importance of Patient education and counseling in various cardio-vascular
and pulmonary disorders in cardio- respiratory conditions, CBR in cardio
vascular and respiratory conditions (03)
RECOMMENDED READING:

1. Richard d Branson/Robert L Chatburn-“Respiratory Care Equipment”,J B

Lippincott Company.
2. N R Malentyre/R D Branson-“Mechanical Ventilation”,Saunders.
3. Joanne Watchie(1995)-“Cardio-Pulmonary Physical Therapy”,Saunders.

30
4. Hillegass and Sadowsky(2001)-“Essentials of Cardio-Pulmonayr Physical
Therapy”,Saunders,Elsiviers.
5. Michael L.Pollock and Donald H Schmidt-“ Heart disease and Rehabilitation”.
6. Scot Irvin, Lan Stiphen Tecklin(2004)-“Cardio-Pulmonary physical therapy-a
guide to practice”, Mosby .
7. Frances J Brannon, Margaret W Foley, Julie Ann Stars, Lauren M Saul(1998)-
“Cardio-Pulmonary Rehabilitation-Basic Theory and Application”,F A Davis
Company.
8. George G.Burton,John E Hodgin,Jeffrey J Ward( 1997)-“Respiratory Care-A
Guide to Clinical Practice” 4th edition, Lippincott Williams and Wilkins, A Wolters
Kluwer Company.

Paper-V Recent advances and Evidence Based Theory - 150 Practical -300

Practice in Cardio-vascular and pulmonary

physiotherapy

Learning Objectives:
On successful completion of this subject it is expected that students will be able to-
1. Understand and apply the information regarding recent advances in cardio-
pulmonary physiotherapy for patient care.
2. Search the evidences available for assessment and management of
cardiopulmonary conditions.
3. Apply the evidences available for the management of various cardio-
pulmonary conditions.
CONTENTS:
I. GENERAL:
 Optimizing treatment prescription: relating treatment to the underlying
pathophysiology of cardio-vascular and pulmonary disorders- an evidence
based practice (15)
 Documentation of the data , Report writing –prescription of exercises (05)

31
 Importance of creating awareness in community, Patient education and
psychological counseling in various cardio-vascular and pulmonary
disorders- evidence based practice (10)
 Recent advancement in Cardio- pulmonary resuscitation (basic and
advanced) (05)
2. Bronchial hygiene- Physiological basis and clinical application, evidence
based practice and recent advances of airway clearance techniques,
including Facilitating airway clearance with coughing techniques. (13)
3. Care of a dying patient. – ethical issues and recent guidelines (02)
4. Cardiopulmonary training in various patient populations. Athletes,
Geriatric and pediatric population (05)
5. Medical gas therapy including oxygen therapy: physiological basis,
modes of administration, and home delivery care- an evidence based
practice and recent advances including hyperbaric oxygen therapy. (05)
6. Aerosal therapy- An Evidence based practice in chest physiotherapy. (05)
7. Recent advances and evidence based practice in Exercise testing,
planning, principles of exercise prescription and PT management in
cardio- vascular and pulmonary conditions. (05)
8. Recent advances and evidence base practice in cardio-respiratory
physiotherapy and exercise prescription in special populations like
cancer, renal conditions, burns, abdominal surgeries, Diabetic mellitus
patients. (10)
9. Recent advances in the use of physical agents and PT management in
wounds, ulcers, grafts and incisions and vascular disorders. (05)
10. Evidence based practice of core muscle strengthening, resistance
training, endurance training, and other training methods in cardiac and
pulmonary rehabilitation (10)
11. Pilates- school of thought for cardiopulmonary conditions. (05)
12. Physiotherapy management in oncology- Evidence based practice and
recent advances. (05)

32
 13. Recent advances and evidence based practice in Respiratory
physiotherapy training techniques and respiratory physiotherapy devices.
(05)
14. Evidence based practice and recent advances in improving Cardio-
respiratory fitness training in all populations including general, pediatric
and geriatric population. (15)
15. Evidence based practice and Recent guidelines in cardiac rehabilitation
and pulmonary rehabilitation (10)
16. Role of exercise and quality of life and cardio-pulmonary rehabilitation,
health status measurements and recent advances. (10)
RECOMMENDED READING:

1.Froelicher /Myers-“Exercise and heart’ published by Saunders.

2. Jean Jobin,Francois Maltais,Pierrie Le Blanc,Clermont ,Simard-“Advances in
Cardio-Pulmonary Rehabilitation”
3.Scot Irvin,Lan Stiphen Tecklin(2004)-“Cardio-Pulmonary physical therapy-a guide
to practice”,Mosby .
4.Frances J Brannon,Margaret W Foley,Julie Ann Stars,Lauren M Saul(1998)-
“Cardio-Pulmonary Rehabilitation-Basic Theory and Application”,F A Davis
Company.
5. Cynthia Coffin Zadai-“Pulmonary management in Physical therapy”,Churchill
Livingstone.
6. Barbara A Webber and Jennifer A Pryor-“Physiotherapy for respiratory and
cardiac problems”, Churchill Livingstone.
7. George G.Burton,John E Hodgin,Jeffrey J Ward ( 1997 )-“Respiratory Care-A
Guide to Clinical Practice” 4th edition, Lippincott Williams and Wilkins, A Wolters
Kluwer Company.
RECOMMENDED JOURNALS
1. Physical Therapy (APTA, America)
2. Physiotherapy (CSP, London)
3. American Journal of Physical Medicine & Rehabilitation
4. Physiotherapy (Canada)

33
5. Australian Journal Of Physiotherapy
6. Journal of Indian Association of Physiotherapy
7. Clinical Kinesiology
8. Journal of Biomechanics
9. Pediatric Physical Therapy
10. Journal of Rehabilitation Research & Development
11. Archives Of Physical Medicine & Rehabilitation
12. Clinical Rehabilitation
13. Gait & Posture
29. GRADED RESPONSIBILITY IN CARE OF PATIENTS AND OPERATIVE
WORK
Category I year MPT II year MPT

O 30 cases -

A 30 cases 40 cases

PA 125 cases 95 cases

PI 50 cases 90 cases

Key: O- Observes
A- Assisted a more senior physiotherapist
PA- Performed procedure under direct supervision of a senior specialist
PI- Performed independently
The case assessment books should be submitted before appearing for the exams.
Teaching activities – UG Teaching
Learning activities – Self Learning, Use of computers and library
Participation in departmental activities
a) Journal presentations Minimum 4 in 2 years
b) Seminars Minimum 4 in 2 years
c) Clinical Presentations Minimum 30 in 2 years
d) Special clinics Minimum 20 in 2 years
e) Community work /camps/ field visits Minimum 4 in 2 years
f) Clinical rounds Minimum 250 in 2 years
g) Dissertation work Minimum 200 hrs in 2 yrs

34
h) Participation in conferences/ Minimum 2 in 2 years
Presentation of paper
i) Paper presentation Minimum 1in 2 years
j) Technique demonstration Minimum 2 in 2 years

35
 30. APPENDIX
MODEL CHECK-LIST FOR EVALUTION OF CRITICAL APPRAISAL
OF RESEARCH ARTICLE
Name of the Student:
Name of Faculty/Observer:
Date:
SL Items for observation during presentation Poor Below Average Good Very
No (0) Average(1) (2) (3) Good (4)
01 Article chosen
02 Extent of understanding of scope and objectives
of the article by the candidate
03 Whether cross reference have been consulted
04 Whether other relevant publications consulted
05 Ability to respond to questions on the article
06 Audio-visual aids used
07 Ability to defend the article
08 Clarity of presentation
09 Level of Interaction form audience
10 Overall Performance
Total Score

_____/40
Remark

Signature of expert

36
 MODEL CHECK-LIST FOR EVALUATION OF REVIEW OF LITERATURE
Name of the Student:
Name of Faculty/Observer:
Date:
SL Items for observation during presentation Poor Below Average Good Very
No (0) Average(1) (2) (3) Good (4)
01 Whether relevant publications consulted
02 Whether relevant references have been
consulted
03 Competence of preparation
04 Clarity of presentation
05 Extent of understanding by the presenter
06 Ability to respond to questions
07 Time scheduling
08 Appropriate use of audio-visual aids
09 Level of Interaction from audience
10 Overall Performance
Total Score

_____/40
Remark

Signature of expert

37
 EVALUATION OF CLINICAL PRESENTATION
Name of the student:
Name of the faculty/observer:
Date:
SL Items for observation during presentation Poor Below Average Good Very
No (0) Average(1) (2) (3) Good (4)
01 Competence of history

02 Whether all points elicited

03 Clarity of presentation
04 Logical order
05 Mentioned all positive & negative points of
importance
06 Accuracy of general physical examinations
elicited correctly
07 Major signs elicited appropriately
08 Diagnosis done appropriately
09 Investigations required, Interpretation of
investigations
10 Aims and Treatment
Total Score

____/40
Remark

Signature of expert

38
 EVALUATION OF DISSERTATION
Name of the student:
Name of the faculty/observer:
Date:
SL Items for observation during presentation Poor Below Average Good Very
No (0) Average(1) (2) (3) Good (4)
01 Selection of topic

02 Need of the study

03 Statement of hypothesis
04 Review of literature
05 Selection of research design and ethical
clearance
06 Selection of appropriate sample size and
sampling technique
07 Selection of appropriate statistical tool
08 Selection of appropriate outcome measures and
quality of protocol
09 Logical sequence of presentation
10 Answer questions asked by evaluators
Total Score

____/40
REMARK

Signature of expert

39
 EVALUATION OF THERAPY/DEMONSTRATION SESSIONS
Name of the student:
Name of the faculty/observer:
Date:
SL Items for observation during presentation Poor Below Average Good Very
No (0) Average(1) (2) (3) Good
(4)
01 Competence of Preparation

02 Clarity of presentation

03 Logical order

04 Accuracy of technique demonstration

05 Extent of Understanding by Presenter

06 Time Scheduling – 3 hrs.

07 Ability to respond to questions

08 Supervision & clearing doubts

09 Level Interaction form audience

10 Overall performance

Total Score

___/40
Remark

Signature of expert

40
 EVALUATION OF CLINICAL WORK IN WARD / OPD
Name of the student:
Name of the unit head:
Date:
SI. Items for observation during Poor Below Average Good Very
No. presentation Average Good
0 1 2 3 4
1. Regularity of attendance
2. Punctuality
3 Interaction with colleagues and
supportive staff
4 Maintenance of case record
5 Presentation of cases during
rounds
6 Investigations work up
7 Bedside manners
8 Rapport with patients
9 Patience education to patience’s
relatives , follow up and home
care
10 Overall quality of ward work
Total score

___/40

Remark

Signature of Posting Incharge

41
CONTINOUS EVALUATION OF DISSERTATION WORK BY GUIDE / CO-GUIDE
Name of the student:
Name of the faculty:
Date:
SI. No.
Point to be considered Poor Below Average Average Good Very good

0 1 2 3 4

1 Periodic consultation with guide

/ co-guide
2 Regular collection of case
material
3 Depth of analysis/ discussion
4 Departmental presentation of
findings
5 Quality of final output
6 Others
Total Score

Remark

Signature of Guide

Signature of Co-guide

42