Rehabilitation Curriculum Course Description This course will focus on rehabilitation and patient...

Rehabilitation Curriculum

Course Description

This course will focus on rehabilitation and patient care. Topics include complications to inactivity, positioning, transfers, body mechanics, gait, assistive devices, adaptive equipment, fall prevention, wheelchairs, total joint arthroplasty, prosthetics and orthotics, range of motion and exercise.

Course Objectives

The general objective of this course are to provide nursing assistance with education concerning rehabilitation and patient care. Upon successful completion of this course, the student should be able to:

1. Describe the role of the rehabilitation team and nursing assistant with patient care.

2. Identify complications from immobility.3. Demonstrate levels of assistance, patient positioning

and transfers.4 .Demonstrate good body mechanics during tasks.5. Demonstrate the ability to safely assist patients

during ambulation and transfers.6. Demonstrate the proper use of assistive devices with

ambulation.

Course Objectives Continued

7. Identify the demonstrate the basic phases of gait.8. Identify possible factors related to falls in the elderly.9. Identify wheelchair components and their function.10. Demonstrate the use of adaptive equipment.11. Demonstrate and identify through analysis of case

studies and laboratory experience compliance with orthopedic precautions.

12. Identify the use of orthotics and prosthetics.13. Describe the benefits of exercise.14. Demonstrate the anatomical planes of motion.15.Demonstrate skilled technique when performing

rom.

What is Rehabilitation?

A process in which an individual is assisted in reaching their highest level of function and ability.

The Rehabilitation Team

PHYSICAL THERAPISTOCCUPATIONAL THERAPISTSPEECH -LANGUAGE PATHOLOGIST

RESPIRATORY THERAPIST

PHYSCIAL THERAPIST

Evaluate and treat people with health problems resulting from injury or disease.

PTs assess joint motion, muscle strength, endurance, balance, mobility and function.

Develop a plan of care appropriate for the patients needs.

Provide instruction and education to the patient and caregivers.

Progress the patients mobility and function to the fullest possible level.

Occupational Therapist

Evaluate and treats people with problems arising from developmental deficits, physical illness or injury, emotional or cognitive disorders.

Develops a plan of care to restore self care, work and leisure skills.

Assists the individual in acquiring the knowledge, skills, and attitudes needed for the performance of activities of daily living (ADL)

Speech-Language Pathologist

Evaluate and treat individuals with speech, language, cognition, voice disorders.

Evaluate and treat individuals with swallowing disorders.

Treatments include, physical strengthening exercises, instructive repetitive practice, use of audio-visual aids and the introduction of strategies to facilitate functional communication and swallowing.

Respiratory Therapist

Evaluate and treat individuals with breathing disorders.

Disorders include: asthma, bronchitis, emphysema, COPD, heart attach, stroke or trauma, complications at birth, and other disorders.

The Role of the Nursing Assistant and Rehabilitation

PROM, AAROM, AAROMPOSITIONING PREVENT COMPLICATIONS SUCH AS

PRESSURE ULCERS AND CONTRACTURESMOBILITY TO INCREASE THE INDIVIDUALS

ABILILTIES OR TO MAINTAIN CURRENT ABILITIES

BATHING AND PERSONAL CARE PROCEDURES

ENCOURANGE THE INDIVIDUAL TO PERFORM ADLS TO THE FULLEST EXTENT POSSIBLE

Complications from Inactivity

Weakness and limitations in mobilityContracturesDisuse osteoporosisPressure UlcersDecreased cardiovascular and respiratory

functionDecreased gastrointestinal system functionBladder infections and incontinenceDepression

Complications form Inactivity

Weakness and limitations in mobility

Muscles become weak and atrophy, how can this effect the individual?


Contractures Muscle contractures are a result of

prolonged immobility and or improper positioning leading to joint stiffness and decreased range of motion.

What can be done to prevent muscle contractures?


Disuse osteoporosis

Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue leading to fragility and risk of fracture.

How can this effect the individuals mobility?

Complications of Inactivity

Pressure Ulcers Pressure ulcers are lesions caused by

unrelieved pressure to any part of the body, especially portions over boney areas.

What areas of the body could be at risk?


Decreased cardiovascular and respiratory function

The heart must work harder to pump blood through the body.

The lungs do not expand as fully resulting in decreased efficiency with respiration.

How could this prevent an individuals participation during ADLs?


Gastrointestinal system function

Appetite may decrease, causing weight loss. Peristalsis slows down, causing indigestion

and constipation. Risk of choking and aspiration due to

improper positioning.

What position would be best during meals?


Bladder infection and incontinence

Decreased ability for the bladder to empty completely.

Decreased ability to transfer to toilet or commode.

How could increased activity benefit an individual during transfers?


Depression

Can occur from physical and mental inactivity.

How can increased activity benefit an individuals quality of life?

The Nursing Assistant and Patient Care

A Study of 599 older adults ( age 85 and above) noted the prevalence of disability, defined as inability to perform one or more ADLs, was 64% for women and 55% for men.

The prevalence of disability defined as inactivity was 92% for women and 98% for men.

Note the significant difference between ability and functional activity.

Resnick 2004


Encourage increased participation in ADLs.Motivate and provide immediate

reinforcement for performing a dressing task.Encourage participation in regular care

activities.Promote activity, mobility and independence

in daily activities.Promote increased involvement and

socialization with others.


You are making a difference by encouraging and

Supporting your patients!

How can you encourage increased participation during ADLs with your patient?

Levels of Assistance, Positioning, Transfers

Levels of Assistance

IndependentIndependent with adaptive deviceSetupSupervision or stand by assistanceCueing


Minimum Assistance

Moderate Assistance

Maximum Assistance


Minimum Assistance

Patient performs 75% or more of activity.

Levels or Assistance

Moderate Assistance

Patient performs 50% to 74% of activity.


Maximum Assistance

Patient performs 25 % to 49 % of activity.

Body Alignment and Positioning of the Patient

Body Position Fowler’s Prone Supine Lateral Sim’s Sitting


Fowler’s PositionA semi-sitting positionHead of the bed is raised between 45 and 90

degreesKeep the spine straightSupport the head with a pillowSupport the arms with a pillow

Body alignment and Positioning of the Patient

Prone On the abdomen, head to one side with a

small pillow under the headPillow under the abdomen to relieve pressure

to the chest and backPillows under the lower legs to prevent

pressure on the toes


Supine Position The bed is flatPatient positioned on their backThe head and shoulders are supported by a

pillowSmall pillow under lower legs relieves

pressure on the ankles and heelsElevate knees to relieve pressure on the low

back


Lateral PositionThe bed is flatUpper leg is in front of the lower leg

supported by a pillowPillow positioned along the patients backPillow under the upper hand and arm


Sim’s PositionLeft side-lying positionUpper leg flexed, not resting on lower legPillow supporting upper leg and thighPillow supporting head and shoulderPillow supporting upper arm and hand


Sitting90-90-90!Back and buttocks against the back of the

chairFeet flat on the floor or footplates of

wheelchairDo not allow back of knees to rest against the

chair


Always follow the patients individual plan of care for positioning and mobility.


Lifting and Moving Patients in Bed Precautions

FrictionShearing


FrictionOccurs when the skin is rubbed against

another surface.

ShearingOccurs when the skin moves in one direction

and other structures remain fixed.

Give examples of how friction or shearing can happen.


Before Positioning of the PatientFollow the patients plan of careAsk a coworker for helpPractice good hygieneIdentify the patient and explain the

procedure to the patientPrivacy and drapingLock the bed wheelsRaise the bed for proper body mechanics


Turning the Patient Towards YouCross the patient’s far arm over their chest.

Bend the elbow of the near arm, bringing the hand to the head of the bed.

Place one hand on the patient’s far shoulder and one on the patient’s hip.

Gently roll the patient toward you in a smooth motion

Put up side rails and utilized pillows for comfort and support


Turning the Patient Away from YouHave the patient bend his knees and cross their armsPlace your one arm under the patients head and

shoulders The other hand and forearm under the patient’s low

backKeep your back straight and bend your body at the

hips and kneesGently pull the patient toward youRoll the patient slowly and carefully away from you

by placing one hand on the patient’s shoulder and one under the hips.


Moving the Patient to the Head of the BedLift top bedding and expose draw sheetNursing assistant on each side of the patientGrasp the draw sheet or place one arm under

the patient’s thighs and other under the shoulders

On the count of three move the patient smoothly towards the head of the bed

Use pillows for comfort and positioning


Logrolling the PatientMay be indicated for patient’s that have had

spinal injury or surgeryPlace a pillow between the patient’s legsThe patient’s arms are crossedUsing a turning sheet Roll the patient towards youTurn the patient as a unit

Transfers

Transfer GuidelinesKnow your patients required level of assistanceKnow the method of transferUse a transfer belt unless contraindicatedNever pull on a patient’s arms or shouldersAlways lock the wheels on the bed and

wheelchairAlways have the patient wear nonskid footwearPrepare the area…be aware of tubes, orthotics

or other equipment in the area

Transfers

Transfer Guidelines ContinuedTransfer the patient to their strongest sideAlways explain the procedure to the patient

and test the patients understandingStand close to the patientEncourage appropriate body alignmentAllow the patient to assist as much as

possible

Transfers

Transfer BeltAlways apply over clothingTighten the belt snugThe belt should not cause discomfort or

restrict breathingBe able to slide your open hand under the

beltDo not position the buckle over the spine

Transfers

Bed to ChairHave the chair positioned along the bed wheels

locked Stand in front of the patientPatient seated at the edge of the bedPatients feet flat on the floorGrasp the transfer belt from underneathBrace your knees against the patients kneesAsk the patient to push down on the mattress and

stand on the count of three.Pull the patient to a standing position

Transfers

Bed to Chair ContinuedSupport the patient in a standing positionTurn the patient and ask the patient to grasp

the far arm of the chairContinue to turn the patient to the front of the

chairGently lower the patient as you bend your kneesMake sure the patient is properly positioned

and comfortableRemove the transfer belt

Bed to Chair with Two AssistantsNursing assistance on each side facing the

patientPatient seated at the edge of the bedPatients feet flat on the floorEach assistant grasps the transfer belt from

underneath. The other hand grasps the belt from the back

Nursing assistant closest to the chair has room to pivot to allow patient access to the chair

Brace your knees against the patients knees

Transfers

Transfers

Bed to Chair with Two Assistance ContinuedAsk the patient to push down on the mattress

and stand on the count of three.Pull the patient to a standing positionBoth nursing assistance assist the patient to

turn slowly and smoothly towards the chairGently lower the patient as you bend your

kneesMake sure the patient is properly positioned

and comfortableRemove the transfer belt

Transfers

Sliding-Board Transfers

Slide-boards are used with patients with good upper body strength and sitting balance.

Requires wheelchair with removable arm rests and swing away leg rests.

Patients must have clothing on their lower body to prevent friction and shearing

Transfers

Mechanical liftUsed for transfers of heavy patients with

decreased ability.Mechanical lifts vary in style and function.Make sure you are trained in the use of the

mechanical lift at your facility.Always check slings, straps, hooks and chains

for safety.Make sure the patient’s weight does not

exceed the recommendation of the manufacture.

Transfers

Case studyMr. Jones recently underwent spinal surgery

and requires assistance for bed mobility and transfers. Per MD orders Mr. Jones is not to twist or turn his back. Which method would be best to assist Mr. Jones to a side lying position?

Body Mechanics, Ambulation and Mobility

Body Mechanics

Body Mechanics

The way we move during an activity.Proper body mechanics involves good posture, balance and using stronger body parts for work.

Good body mechanics reduces your risk for injury.

Body Mechanics

Body Alignment

The way the head, neck, trunk, arms and legs align with each other.

Good alignment is essential for efficient safe function and movement.

Body Mechanics

Base of Support

Is the area in which an object rests.

In standing a wide base of support gives you greater stability.

Body Mechanics

Rules for Good Body MechanicsIt is easier to pull, push or roll an object than to liftAvoid jerky movementsUse the larger leg and arm musclesKeep the work as close to your body as possibleKeep the work at a comfortable height to avoid

bendingKeep your body in good physical condition to

reduce injuryKeep your body in good alignment with a wide base

of support

Body Mechanics

Lifting

Use the strong muscles of the legs for lifting.Bend at the knees and hip, keep your back

straight.Lift straight upward in a smooth motion.

Body Mechanics

Reaching

Stand directly in front of and close to the object.

Avoid twisting or stretching.Maintain good alignment and base of support.Be cautious of moving heavy objects.

Body Mechanics

Pivoting

Place one foot slightly ahead of the other.Turn both feet at the same time, pivot on the

heel of one foot and toe of the other.Maintain good alignment and base of support.

Body Mechanics

Avoid Stooping

SquatAvoid bending at the waistUse the strong muscle of the leg to return to

upright position.

Ambulation and Mobility

AmbulationThe act of walking.

GaitThe way in which a person walks.


Normal Gait Pattern

Repeats a basic sequence of limb motions that serve to progress the body along a desired path while maintaining weight-bearing stability.


Gait is divided into two phases

Stance – The entire time the foot is on the floor.

Swing – When the foot is off the floor.


Body Alignment and Posture

The patient must be able to stand straight on one leg as he swings the other leg to take a step.


Gait TipsStand on the patients affected sideUse a gait belt if the patient requires assistancePatient should stand as erect as possibleFeet should be 4 to 6 inches apartWith each step the heel should land on the floor

firstProper foot wearPrepare the area, clear walkwaysSafe use of assistive device


Gait Tips Continued

Allow adequate timeEncourage large even stepsAllow the patient to do as much as they canWhen turning, avoid sharp pivots or twisting Make shorter steps when turning


Gait Tips ContinuedAvoid letting the upper body get ahead of the

lower bodyDo not lean upper body too far forwardDon’t rushIf your patient shows signs of illness notify

the nurseNever leave your patient unattended


Assistive Devices for Ambulation

CrutchesCanesWalkers


Crutches

Typically not recommended for older adultsLofstrand crutches have a cuff that surrounds

the forearmPlatform Crutches permit weight-bearing on

the forearm


Canes

Quad canes have four prongs and offer a wide base of support.

Single pronged cane are for assisting with balance

Canes are used on the strong side of the bodyThe patient will use a two point or three point

gait


Two Point GaitCaneAffected legUnaffected leg

Three Point GaitCane, affected legUnaffected legWhen there is no affected leg, weight bearing

is equal on both legs.


Weight bearing is the amount of weight that may be applied on an extremity.

Non-weight bearingToe touchPartial weight bearingWeight bearing as toleratedFull weight bearing


Non-weight bearing: lower extremity not to bear weight and usually not permitted to touch the ground.

Toe touch: the patient can rest the toes of the involved lower extremity on the ground for balance, but not weight bearing.


Partial weight bearing: A limited amount of weight bearing, such as five pounds, unless a specific amount is confirmed by the MD.

Weight bearing as tolerated: The amount of weight bearing may vary from minimal to full, depending on the patients tolerance.

Full weight bearing: Full weight bearing is permitted.


Walkers

StandardWheeledplatform


Disorders Which Can Affect Gait

StrokeMultiple sclerosisHuntington’s diseaseParkinson’sArthritisAmputationsOrthopedic issues


Stroke (Cerebral vascular Accident)

A blockage or hemorrhage of a blood vessel leading to the brain, causing inadequate oxygen supply and damage to brain tissue.

May result in hemiplegia, loss of body control, dysphagia (swallowing issues), Aphasia, speech impairments, Changing emotions, impaired memory, urinary incontinence or frequency


Multiple Sclerosis

A chronic degenerative disease of the CNS which destroys the myelin sheath the surrounds the nerves.

May result in muscle weakness, visual impairments, tremors, numbness, speech issues, dizziness, memory and judgment, bowel and bladder dysfunction.


Huntington’s Disease

A hereditary disease of the CNS characterized by brain deterioration and loss of control over voluntary movements, speech impairments, mental deterioration.


Parkinson’s Disease

A progressive nervous disease associated with the destruction of brain cells that produce dopamine.

May result in tremors, stiff muscles, slow movement, stooped posture and impaired balance, mask-like expression, swallowing issues, memory and speech, bladder impairments


Arthritis

Acute or chronic inflammation of the joint resulting in pain and stiffness.


Amputations

Patient may have a prosthesis.


Orthopedic Issues

An injury or disorder or recent surgery of the musculoskeletal system.

Fall Prevention, Adaptive equipment,

Wheelchairs

Fall Prevention

Falls are not part of the normal aging process. But are due to an interaction of factors.

Falls are due to:Impairments in mobilityUneven steps, shuffling gait, unsafe use of

assistive device

Fall Prevention

Falls are due to: Transfers difficulty with moving from sitting to

standing Drop sitting Landing too close to the edge of the seat

Fall Prevention

Falls are due to:Impaired standing balanceLeaning off centerLoss of balance when attempting to stand Loss of balance when bending or reaching

Fall Prevention

Falls are due to:

Multiple medications

Fall Prevention

Falls are due to:

Postural hypotensionCheck blood pressure

Fall Prevention

Falls are due to:

Impaired visionImpaired hearingImpaired position senseImpaired cognition

Fall Prevention

Falls are due to:

Improper footwearFoot deformities

Fall Prevention

Falls are due to:

Environmental hazardsObjects in walkwayInadequate lightingUnsafe stair management

Adaptive Equipment

Adaptive Equipment

Devices or equipment designed and fabricated to improve performance in activities of daily living.

Adaptive Equipment

Bathing and ToiletingLong handled spongeCurved bath brushHand held showerGrab barsTub seat/benchRaised toilet

Adaptive Equipment

Dressing

Dressing stickSock aidsReachersButton and zipper aidLong-handled shoehornElastic shoe laces

Adaptive Equipment

Eating

Comfort grip curved utensilsScoop dishPlate guardsDrinking mugs with large handles or covers

Wheelchair

The wheelchairPostural support- The surface that is in

contact with the user’s body.

Mobility base – Consists of the tubular frame, arm-rests, foot supports, and wheels.

Wheelchair

Wheelchair Brakes

Brakes must be engaged during a transferInspect the brake mechanism for safety

Wheelchair

Seat Belts

Prevents fallsAssists in positioningCheck POC for seat belt use

Wheelchair

Drive wheels – the large wheels used for propulsion

Outer rim – used by the patient to propel the wheelchair

Projections – for patients with decrease ability to grasp

Wheelchair

Armrests

Full lengthDesk lengthRemovable or fixedAdjustable height

Wheelchair

Footrests/Leg-rests

Fixed or removablePivoting or non-pivotingElevating leg-restsCalf supports

Wheelchair

Tilt in Space

A fixed back to seat anglePermits changes in orientation for pressure

relief and or different activities

Wheelchair

One Arm Drive

Applying pressure to one rim turns the wheelchair

Pump lever to provide propulsion

Wheelchair

Wheelchair Size

Seat depthSeat widthBack heightArmrest heightSeat to footplate lengthFootplate size

Total Joint Arthroplasty, Prosthetics and Orthotics

Total Joint Arthroplasty


Also know as total joint replacementOver 400,000 procedures a year Primary candidates are people with chronic

joint pain from arthritisPurpose of surgery is to relieve pain and

restore function


Total Knee Arthroplasty

Portions of the knee joint are replaced with metal and plasticComponents shaped to allowContinued motion of the knee.


Total Knee Arthroplasty

Multidisciplinary teamorthopedic surgeon, nursing staff, rehab

team


Total Knee ArthroplastyRehabilitation Phase 1: Inpatient acute care

Promotion of ROMIndependence with bed mobility, transfers

and gaitRestoration of safety and independence with

ADLs


Continuous Passive Motion (CPM)A machine that performs PROM exercise on

the affected knee joint.

Often prescribed by orthopedic surgeons

Protocol varies always check with patients poc.


Total knee ArthroplastyRehabilitation Phase II: Skilled Nursing FacilityGoals are the same as Phase IEducation of family members and caregiversPlanning of homecare needs


Total Knee ArthroplastyRehabilitation Phase III: Outpatient Home

HealthFocus on safety in home Progression of ROM, transfers, gait and ADLs


Total Hip Arthroplasty

The hip joint is preplaced by a prosthetic implant.


Total Hip Precautions

Patients should not:Flex the hip more than 90 degreesCross the affected leg over midlineInternally rotate the hip

Check weight-bearing precautions


Total Hip Arthroplasty

Rehabilitation Phase I: Inpatient acute care

Education regarding precautions with transfers and movements

Postoperative exercises: Ankle pumps, quad sets, gluteal sets, heel slides.


Total hip precautions

Rehabilitation Phase II: Skilled Nursing FacilityReinforce total hip precautionsIncrease independence with gait and

transfersPrepare for safety in homeProgress to outpatient home health care


Equipment Needs

Raised toilet seatTub bench or seatAdaptive equipment to assist with ADLsWalker, crutches or cane

Prosthetics and Orthotics


Prosthesis - An artificial extension that replaces a missing body part.

Orthotic- a device that serves to protect, restore or improve function.


Principal Lower Limb Prosthetics

Partial footBelow kneeAbove kneeKnee and hip disarticulation


Partial Foot

Trans-metatarsal AmputationPatient bears most weight on the heelDecreased time on the affected foot during

gaitPlastic socket fixed to a rigid plateProtects amputated ends


Below Knee

Tibia and Fibula is transectedKnee joint is intactProstheses include a foot-ankle assembly and

socket Limb fits into a custom molded socket


Above Knee

Amputation between the femoral epicondyles and greater trochanter

Prosthesis consists of foot-ankle assembly, shank, knee unit, socket and suspension device


Hip Disarticulation

Amputation of the femur and or part of the pelvis

Prosthesis has hip, knee and foot assemblies Plastic molded socket to support weight on

remainder of pelvis


The Rehabilitation Team

Works closely with the physician and prosthetist

Trains the patient to don, use and maintain the prosthesis

Prosthesis and Orthotics

Lower Limb OrthosesFoot orthoses (FO)Ankle foot orthoses (AFO)Knee ankle foot orthoses (KAFO)Hip knee ankle foot orthoses (HKAFO)


Foot Orthosis

May be an internal modification in the shoe or external modification

Can enhance function by relieving pain and improving the quality of gait


Ankle- foot orthoses

orthosis consists of the shoe and plastic or metal component

Most AFOs prescribed to control ankle motion by limiting plantar-flexion and or dorsi-flexion, or by assisting motion

Provides stability


Knee ankle foot orthosesConsists of shoe, ankle control, knee control

and superstructureMost KAFOs include a pair of uprights and

knee hinges


Hip knee ankle foot orthoses

Addition of a pelvic belt band and hip joints converts the KAFO to an HKAFO

Hip joint is usually a metal hinge which prevents abduction, adduction and hip rotation

Exercise and Range of Motion

Exercise

What is Exercise?

A physical activity done to improve or maintain one or more components of physical health.

Exercise

Why Exercise?Increased strengthIncreased balanceIncreased enduranceIncreased flexibilityIncreased skill in an activityIncreased independence

Exercise

Forms of Exercise

AerobicIsometricActiveResistive

Exercise

Aerobic- sub maximal, rhythmic, repetitive exercise of large muscle groups, during which the needed energy is supplied by inspired oxygen

Exercise

Isometric- Exertion during which the muscle does not change length.

Exercise

Active- Exercise that is performed without any assistance.

Exercise

Resistive- Training with resistance to movement to increase muscle strength through the use of weights, bands, ones own body weight.

Range of Motion

Range of motion exercises are performed to prevent the development of contractures, muscle shortening, and tightness in capsules, ligaments and tendons.

Range of motion exercises enhance mobility and provide sensory stimulation with is beneficial to the patient.

Range of Motion

AROM – carried out independently by the patient

PROM – ROM performed without the assistance of the patient

AAROM- Carried out by the patient with assistance to facilitate normal muscle function.

Range of Motion

Anatomical Planes of MotionsFlexionExtensionAbductionAdductionOppositionInternal rotationExternal rotation

Range of Motion

Anatomical Planes of Motion Continued

SupinationPronationInversionEversion

Range of Motion

Range of Motion General Guidelines

Check the POC or ask the nurse of rehab team

Explain the procedure to the patientMake sure the patient is comfortably

positionedEncourage the patient to assist if able and

indicatedExpose only the body part you are exercising

Range of Motion

Range of Motion General Guidelines Continued

Support each joint by placing one hand above and one hand below the joint.

Watch the patients face for gestures which indicate discomfort. Stop! Reposition or use a lighter touch and or contact the nurse or rehab team

Only move the joint within its available range, never push past the point of resistance

Perform 3 to 5 repetitions slow and controlled ROM significantly improves joint functioning

Range of Motion

Precautions

Fractures or dislocationsOrthopedic precautionsWounds or pressure ulcersCombative or resistant patientsSpasticity or rigidity

Disclaimer

This workforce solution was funded by a grant awarded under the President’s High Growth Job Training Initiative as implemented by the U.S. Department of Labor’s Employment and Training Administration. The solution was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership. This solution is copyrighted by the institution that created it. Internal use by an organization and/or personal use by an individual for non-commercial purposes is permissible. All other uses require the prior authorization of the copyright owner.

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Rehabilitation Curriculum Course Description This course will focus on rehabilitation and patient...

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