Pre-Placement Information 2016 - 2017

PCCC Dublin West, CHO 7

Address • Acorn Unit, Cherry Orchard Hospital, Ballyfermot, Dublin 10

• 2nd Floor, Rossecourt Resource Centre, Balgaddy, Lucan, Co. Dublin

• Inchicore Primary Care Centre, St. Michaels Estate, Inchicore, Dublin 8.

• Ballyfermot Primary Care Centre, Ballyfermot Road, Dublin 10. Contact Person Roseanne Freeman – Physiotherapy Manager (Laura Fitzharris from September 2015) Where to Check In Acorn Unit 10, Cherry Orchard Hospital, Ballyfermot, Dublin 10

Preferred Contact Method Phone Manager: 076 695 5259 Cherry Orchard Office 076 695 5261 Rossecourt Physiotherapy: 01 464 7857 Inchicore Reception: (01) 471 6365/6364 Ballyfermot Reception: 076 695 6033/076 695 6031 Email [email protected] ; [email protected]

How to Get Here Car Bus Ballyfermot: 18, 78A, 76, 26 (hourly) Rossecourt: 40 (Fonthill, Liffey Valley SC, Ballyfermot, Inchicore) 51D (Clondalkin village, Fonthill, Palmertown bypass) 151 (Adamstown, Nangor Road, Foxborough) 25A, 25X (Lucan and Foxborough) 239 (parts of Lucan & Liffey Valley SC) Luas/Dart NA Working Hours 08.30 – 16.30/17.00 Breaks 12.30 – 13.30 Uniform Policy Dress code: Smart, No jeans, tracksuits or sports wear. Suitable clothes and footwear for manual handling. Accommodation NA

Student Facilities

Access to Staff Room Yes in all primary care centres listed Canteen Yes (Cherry Orchard only) Staff kitchens in all primary care centres Restaurant available in Rossecourt. Changing Facilities Basic and in all primary care centres, some inclusive of showers Car/Bicycle Parking Yes in all areas Library Selection of books available Access to Dr Steevens’s library online Small library facility available in Cherry Orchard.

Study Areas Yes in all areas Internet Yes On-site Reading Resources Yes

Clinical Information

It is suggested that students familiarise themselves with the following pathologies, assessment procedures and treatment options prior to the beginning of placement.

Students are expected to utilise the physiotherapy facilities available in preparation for all placements.

Specialty Area Paediatrics (Acorn Unit / Rossecourt)

Conditions Seen • Milestone delay • Dyspraxia / Developmental Coordination Disorder • Toe walking • Osgood - Schlatter's Disease • Flat feet / Intoeing • Autism • Mild Intellectual Disability • Hypotonia • Premature babies with low tone • Developmental delay - due to hypotonia with or without diagnosis and may be gross motor or global. • Postural problems - Torticollis, Plagiocephaly, Scoliosis, Metatarsus adductus. • Benign Hypermobility Syndrome

Assessment Evaluation includes: Procedures Used • Clinical observation of the child’s mobility (method, quality and functionality), • Static posture (weight bearing alignment, sitting posture, etc.), • Dynamic posture (transitions, walking on line, walking on tip toes, etc.), • Gait pattern and any deviations and • Overall quality of movement • Administration of an evaluation tool for age appropriate skills • Physical examination, including: o range of motion o muscle tone o clonus o balance reactions (speed, effectiveness, maturity) o tolerance to vestibular stimulation o Genu valgum,varum,recurvatum or excessive calcaneal valgus in weight-bearing o clonus, heel cord or hamstring contracture, limited hip abduction (possible hip dysplasia • Ongoing conversation with parents and caregivers regarding their child’s o function and safety across environments (including frequency and pattern of falls), o overall health and activity level, o temperament and personality factors, o performance during the evaluation compared to their typical behaviour. o also elicit not-easily-observed information • Supplemental testing (as needed to identify underlying impairments): o balance challenge (e.g., step over obstacle, walk on pillow, recovery from perturbation, stance on rocker board, etc.) o strength indicators (e.g., ease of stair climbing, steadiness in squat, jumping, sustaining tip toes with or without hand support, etc.) o motor planning (e.g., novel fine motor task, climbing off couch, down stairs or off kitchen chair, complex fine motor task, etc.) o eye-hand/eye-foot coordination (e.g., catch, throw, kick; walk on a line, etc.) • Closing Conversation with family to o invite caregiver questions o communicate initial impressions and findings o provide home activity suggestions as appropriate o foreshadow next steps (test scoring and analysis of findings, consultation with other professionals, service coordinator, written report mailed to family, meeting to determine eligibility, possible development of IFSP) • Synthesize findings and write report in family-friendly language.

Treatment Options • Tots and tums • Stretches • HEP • Family involvement in care - teaching educating etc • Strengthening programme • Neuro development exercise programmes MDT Opportunities • Meeting with other members of the Early intervention Team • Participate in Meeting and Family Service Planning.

Outcome Measures • Modified Ashworth Scale • Lee Method of Gross Motor Assessment • The Developmental Coordination Disorder Questionnaire 2007 (DCDQ’07) • Quality of Movement Checklist for the School Age Children • Motor Screening by Portwood • Sensory Motor History Questionnaire (3-5) • Pediatric Balance Scale • Gross Motor Function Measure (GMFM) • Bayley Scales of Infant Develpoment – second edition BSID-II

Useful References (3 BOOKS max) • Physiotherapy for Children- By Teresa E. Pountney • American Physical Therapy Association. Guide to Physical Therapist Practice, 2nd ed. Alexandria, VA: American Physical Therapy Association, 2001. • Campbell, Suzann K., Darl W. Vander Linden, and Robert J. Palisano. Physical Therapy for Children, 2nd ed. Philadelphia: W. B. Saunders Company, 2000.

PERIODICALS • Hayes, Margo Starks, et. al. "Next Step: A Survey of Pediatric Physical Therapists' Educational Needs and Perceptions of Motor Control, Motor Development, and Motor Learning as They Relate to Services for Children with Developmental Disabilities." Pediatric Physical Therapy 11, no. 4 (Winter 1999): 64-182. • King, G. A., et. al. "An Evaluation of Functional, School- Based Therapy Service sfor Children with Special Needs." Physical and Occupational Therapy in Pediatrics 19, no. 2 (1999): 31-52. • Ryan Cieply and Todd Milbrandt. Back pain in children and adolescents. In Current Orthopaedic Practice. Nov./Dec. 2009. Vol. 20. No. 6. Pp. 627 to 633

Useful Additional Revise: Information • Early Milestones in Gross Motor Development. (Good website: http://www.health.qld.gov.au/child- youth/factsheets/CHS_Milestones.pdf ) • Normal lower and upper extremity range of motion (ROM) • Known neurological conditions (e.g intraventricular hemorrhage, periventricular leucomalasia) • Neonatal Reflexes • Tone assessment • Symptoms of low tone (e.g. clumsy, weakness, history of delayed milestones, falls, “W” sitting) • Normal lower limb variants in children (flat feet, intoeing, out-toeing, genu varum, genu valgus) • What is motor planning?

Specialty Area Domicillary home visits

Conditions Seen • Reduced mobility issues • Falls risks • Generalised OA/RA • Post hip/knee replacement • Neuro/ortho/rheumatological conditions • Recent hospital discharges • Assessment for mobility aid for use at home/outdoors

Assessment Evaluation includes: Procedures Used • Clinical observation of the adults mobility(method, quality and functionality), • Static posture (weight bearing alignment, sitting posture, etc.), • Dynamic posture (transitions, walking on line, walking on tip toes, etc.), • Gait pattern and any deviations and • Overall quality of movement • Administration of an evaluation tool for age appropriate skills • Physical examination, including: o range of motion o muscle tone/strength etc • Ongoing conversation with patients family and caregivers/home help regarding patient needs/status: o function and safety across environments (including frequency and pattern of falls), o overall health and activity level, o temperament and personality factors, • Supplemental testing (as needed to identify underlying impairments): • Closing Conversation with family to o Invite any questions

MDT Opportunities • Meeting with other members of the primary care team • Participate in primary care meetings and goal setting/problem solving.

Outcome Measures • Berg balance scale • Tinetti • Functional mobility scale • Timed up and go • Elderly mobility scale

Useful References (3 BOOKS max) • Explain pain • Carr and Shepard • NICE Guidelines for falls risk

Useful Additional Revise: Information • As per college material

Specialty Area Out- patient musculoskeletal (Rossecourt)

Conditions Seen • Reduced mobility issues/LBP • RA/OA • Biomechanical footwear issues • Chronic shoulder/neck/back pain • Multiple soft tissue injuries/ WAD etc • Chronic pain syndrome • Chronic Neurological conditions

Assessment Evaluation includes: Procedures Used • Clinical observation of the adults mobility/gait(method, quality and functionality), • Static posture (weight bearing alignment, sitting posture, etc.), • Dynamic posture (transitions, walking on line, walking on tip toes, etc.), • Observation – cardinal signs of inflammation • Gait pattern and any deviations and • Overall quality of movement • Administration of an evaluation tool for age appropriate skills • Physical examination, including: o range of motion o muscle tone/strength etc o neuro assessment • Ongoing conversation with patients family and caregivers/home help regarding patient needs/status: o function and safety across environments (including frequency and pattern of falls), o overall health and activity levels, o Temperament and personality factors, • Supplemental testing (as needed to identify underlying impairments): o Closing Conversation with family to invite any questions

Treatment Options • Assessment/treatment planning and goal setting • Rehabilitation/exercise prescription/progression. • Communication with family/carers. Education to family/carers. • Team working - MDT • Holistic approach to patient through use of physiotherapy skills – acupuncture/yoga/pilates • Setting of home exercise plans • Identifying further need for referral to member of MDT, • Referral to acute services/secondary care/specialist services • Disease prevention • Health promotion • Chronic disease management • OA/LBP exercise classes run in community setting • Pain education classes • Footwear clinic

MDT Opportunities • Meeting with other members of the primary care team • Participate in primary care meetings and goal setting/problem solving.

Outcome Measures • Pain scales • HADS • Disability outcome measures – multiple • WAD outcome measures as per department protocols • Use of multiple protocols in department • Neck disability index Useful References (3 BOOKS max) • Explain pain – David Butler • On line websites available for researching articles • Clinical Sports Medicine (McGraw-Hill Sports Medicine) by Peter Brukner/Khan

Useful Additional Revise: Information • As per college material

Specialty Area Long stay hospital units Conditions Seen • Reduced mobility issues/high dependency • Dementia/alzheimers • Care of the elderly • Chronic respiratory infections • Falls • Young people with chronic disability Assessment Evaluation includes: Procedures Used • Clinical observation of the adults mobility/gait(method, quality and functionality), • Static posture (weight bearing alignment, sitting posture, etc.), • Dynamic posture (transitions, walking on line, walking on tip toes, etc.), • Observation • Gait pattern and any deviations and • Overall quality of movement • Administration of an evaluation tool for age appropriate skills • Physical examination, including: o range of motion o muscle tone/strength etc o neuro assessment • Ongoing conversation with patients family and caregivers/home help regarding patient needs/status: o function and safety across environments (including frequency and pattern of falls), o overall health and activity levels, o Temperament and personality factors, • Supplemental testing (as needed to identify underlying impairments): • Closing Conversation with family to o Invite any questions o How to manage family member on the ward Treatment Options • Assessment/treatment planning and goal setting • Rehabilitation/exercise prescription/progression. • Communication with family/carers. Education to family/carers. • Team working - MDT • Holistic approach to patient through use of physiotherapy skills – acupuncture/yoga/pilates • Setting of home exercise plans • Identifying further need for referral to member of MDT, • Falls exercise classes MDT Opportunities • Meeting with other members of the MDT team • Participate in meetings and goal setting/problem solving re: care plan in place. Outcome Measures • Pain scales • Functional mobility scales Useful References (3 BOOKS max) • Physiotherapy in Respiratory Care Third Edition: A Problem-solving Approach by Alexandra Hough • Physical Management in Neurological Rehabilitation (Physiotherapy Essentials)Paperback– 13 Oct 2004 Useful Additional Revise: Information • As per college material

OTHER ACTIVITIES • Back exercise groups • Generalised exercise classes for hip/knee OA/LBP • Staff pilates classes • Footwear clinics run in primary care • Primary care meetings to attend • Inservice education in community and hospital linked with community care areas • Observation with paediatric physiotherapy on early intervention team and long stay units.