Unit MEDICAL AND SURGICAL SCIENCES

PHYSICAL AND REHABILITATION MEDICINE

Code	GP002590
CFU	3
Teacher	Mauro Zampolini
Teachers	Mauro Zampolini
Hours	24 ore - Mauro Zampolini
Learning activities	Caratterizzante
Area	* scienze della terapia occupazionale
Academic discipline	MED/34
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Rehabilitation network standards. Levels of intervention and pricing. New Essential Levels of Care and involvement in the organization of rehabilitation. Budget Processes in Rehabilitation. Rehabilitation project and its articulation. Definition of objectives and decision-making. Criteria for defining the outcome.
Reference texts	• Sandrini G., Dattola R. - Compendio di Neuroriabilitazione – Verduci Editore, 2012 • Basaglia N. - Medicina Fisica E Riabilitazione - PRINCIPI E PRATICA, 2009 • Braddom Randall L. Medicina Fisica & Riabilitazione, Delfino Antonio editore, 2005 • Cisari C., Molteni F. - Stroke. Clinica e Riabilitazione, Edi Ermes 2005 • Valobra Giorgio N., Trattato di Medicina Fisica e Riabilitazione UTET, 2000
Educational objectives	To develop competences regarding rehabilitation standards, process and outcome indicators as well as criteria for appropriateness of rehabilitative pathways.
Prerequisites	General knowledge of Physical and Rehabilitative Medicine
Teaching methods	Class Lectures
Other information
Learning verification modality	Oral examination with exposition of group works
Extended program	GP003460 - PHYSICAL AND REHABILITATION MEDICINE 2 Didactic Program Rehabilitation standard • New lea • Prosthetic prescription • Standard in rehabilitation • Define the structural standards • Define the commitment of resources for beds • Define quality standards • Lombardy standardDELIBERATION N ° X / 1185 Sitting on 20/12/2013 • Standard in SicilySuppl. ord. to the OFFICIAL JOURNAL OF THE SICILIAN REGION (page I) no. 54 of 21-12-2012 (n. • Standard in Lazio The National Context (The lines of address) • History of Rehabilitation in Umbria • The current situation • Standard in rehabilitation The international rehabilitation panorama Rehabilitation 2.0 The definition of the rehabilitation project • Goal Setting • Participation in the care process (Shared Decisions) • The outcome based on the person • Future perspectives The history of Rehabilitation in Italy • GUIDELINES of the Minister of Health for Rehabilitation activities (Official Gazette No. 124, May 30, 1998) • SOCIO-SANITARY INTEGRATED PATH MODEL • GUIDELINES of the Minister of Health for Rehabilitation activities (Official Gazette No. 124, May 30, 1998) STRATEGY OF THE REHABILITATION INTERVENTION • GUIDELINES of the Minister of Health for Rehabilitation activities (Official Gazette No. 124, May 30, 1998) STRATEGY OF THE REHABILITATION INTERVENTION • GUIDELINES of the Minister of Health for Rehabilitation activities (Official Gazette No. 124, May 30, 1998) STRATEGY OF THE REHABILITATION INTERVENTION • GUIDELINES of the Minister of Health for Rehabilitation activities (Official Gazette No. 124, May 30, 1998) STRATEGY OF THE REHABILITATION INTERVENTION • GUIDELINES of the Minister of Health for Rehabilitation activities (Official Gazette No. 124, May 30, 1998) STRATEGY OF THE REHABILITATION INTERVENTION • GUIDELINES of the Minister of Health for Rehabilitation activities (Official Gazette No. 124, May 30, 1998) STRATEGY OF THE REHABILITATION INTERVENTION • GUIDELINES of the Minister of Health for Rehabilitation activities (Official Gazette No. 124, May 30, 1998) STRATEGY OF THE REHABILITATION INTERVENTION • GUIDELINES of the Minister of Health for Rehabilitation activities (Official Gazette No. 124, May 30, 1998) STRATEGY OF THE REHABILITATION INTERVENTION Types of intervention of the rehabilitation program • GUIDELINES of the Minister of Health for Rehabilitation activities (Official Gazette No. 124, May 30, 1998) • High rehabilitation specialization, • Spinal Units, • Severe Cerebrovascular Units, • Severe Units of Disability Evolving Age • Acquired Neuropsychological Turbe Rehabilitation Unit • GUIDELINES of the Minister of Health for Rehabilitation activities (Official Gazette No. 124, May 30, 1998) • Intensive rehabilitation, Levels of intensiveness of rehabilitation • National Rehabilitation Address Plan 1. Rehabilitation: analysis of the Italian situation. 2. The role of Rehabilitation: the establishment of the bio-psycho-social model 3. interdisciplinarity in rehabilitation 4. Rehabilitation in the continuum of care. a) Clinical governance b) Single Rehabilitation Program c) places of care 5. Research in rehabilitation 6. Health expenditure and rehabilitation 7. Conclusions Rehabilitation in Umbria • History and current events • The Umbrian rehabilitation network • History of Rehabilitation in Umbria • History of training in rehabilitation • Regional Physiotherapy School (Perugia, Trevi, Città di Castello, Umbertide) (from the 80s) • School of University Physiotherapy (Perugia> Foligno) since 2000 • School of Specialization in Physical Medicine and Rehabilitation from the 90s • Innovation through regional resolutions • DGR - 3 July 2002, n. 893. • Definition of criteria and procedures for the use and provision of services referred to in point f) of Annex 2A and point c) of Annex 2B of the Prime Ministerial Decree of 29 November 2001. Definition of essential assistance levels. • Spinal Unit Routes • DGR 27 February 2002, n. 193 • Addresses to the USL and hospitals of Umbria on procedures and procedures for taking care of patients with spinal cord injury; • Regional guidelines on the prescription paths of aids and prosthetics • DGR - March 19, 2003, n. 333 • REHABILITATION PROJECT • ENVIRONMENTAL ADAPTATIONS • MULTIDISCIPLINARY PRESCRIPTION • THE RECYCLE OF AUXILIARIES • AUXILIARY CENTER o Testing and training • TECHNOLOGICAL AIDS • Definition of regional organizational lines on home rehabilitation • RD 1.1 Extensive extra-hospital rehabilitation • RD 1.2 residences for vegetative states and minimally conscious states. • Others • Binding document on the treatment and rehabilitation programs of the person with amyotrophic lateral sclerosis • Dgr 8 February 2008 • Chronicity management concept • Multidisciplinary scheduled visits • Decision flow diagram • Myelascioni routes • DGR 250 2-3-2009 PDTA of rehabilitation interest In course of definition • Arthroplasty pathways (defined) • Multiple sclerosis • Stroke • Parkinson's (not started) • Heart failure • Post Infarction • COPD The assistance-rehabilitation network in Umbria • Model interaction • Disability: degrees and management • Appropriate setting The model of the rehabilitation department • Neighborhoods • AO Terni - USL Umbria Agreement 2 • Physiatrist rehabilitation project (FT and logo) • Triage of discharge • Drainage with rehabilitation project when indicated • Territory activation or hospital rehabilitation • Taking charge directly at the territorial level • RAO rehabilitation • Future perspectives PDTA of rehabilitation interest In course of definition • Arthroplasty pathways (defined) • Multiple sclerosis • Stroke • Parkinson's (not started) • Heart failure • Post Infarction • COPD Appropriate setting The model of the rehabilitation department Neighborhoods Agreement AO Terni - USL Umbria 2 Physiatrist rehabilitation project (FT and logo) Triage of discharge Drain with Rehabilitation Project when indicated Activation of the territory or hospital rehabilitation Direct recruitment at the territorial level RAO rehabilitation Future perspectives Regional rehabilitation network • Binding guidelines for the rehabilitative therapeutic diagnostic pathway of the elderly patient hospitalized for femoral fracture 1. State of vegetation and SMC 2. REGIONAL REGULATORY FRAMEWORK 3. DCR n. 647/1999, dated 01/03/1999: Regional health plan 1999-2001. 4. DGR n. 314/2003, session of 23/07/2003: Regional health plan 2003-2005. 5. DGR n. 1251/2003, session of 03/09/2003: Guidelines to improve the quality of nursing care. 6. DGR n. 1147/2004, session of 28/07/2004: guidelines for extended rehabilitation. 7. DGR n. 895/2008, session of 14/07/2008: Regional Health Plan 2009-2011. 8. DGR n. 363/2009, session of 23/03/2009: Authorization of the Structures for individuals with Minimum Responsibility: specific minimum requirements. 9. DGR n. 1570/2009, session of 09/11/2009: Guidelines for the implementation of the organizational model of the 2009-2011 Regional Health Plan on hospital rehabilitation and extra-hospital rehabilitation. 10. DGR n. 1090/2010, session of 26/07/2010: Extensive rehabilitation facilities outside the hospital: specific minimum requirements - remuneration systems. 11. DGR n. 1114/2010, session of 26/07/2010: Establishment of the regional rehabilitation network. 12. DGR n. 297/2012, session of 19/03/2012: Transposition agreement between the Minister of Health, the Region and the Autonomous Provinces of Trento and Bolzano on guidelines for assistance to people in a vegetative state and a state of minimum awareness. 13. Regional law n. 18/2012, 12/11/2012: Regulation of the regional health service. 14. DGR n. 1444/2012, session of 11/19/2012: Agreement between the Minister responsible for family and regional policies, the Autonomous Provinces of Trento and Bolzano, the Provinces, Municipalities and Mountain Communities, pursuant to Article 8, paragraph 6 of the Law of 5 June 2003, n. 131 on the use of resources for the financing of actions for family policies. Scientific technical reference framework • Ministry of Health guidelines for rehabilitation activities ". Measure 7 May 1998, Permanent Conference for Relations between the State, the Regions and the Autonomous Provinces of Trento and Bolzano. • "Protocol of minimum rehabilitation assessment of the person with severe acquired brain injury" S.I.M.F.E.R. - Italian Society of Physical and Rehabilitative Medicine - Section for the rehabilitation of the Traumatized Cranio Encefalico and of the Gravi Cerebrolesioni Acquisite - 1998 et seq. mod .; • Proceedings and final document of the jury of the 1st National Consensus Conference "Methods of rehabilitative treatment of the traumatized cranial brain in acute phase, criteria of transferability in rehabilitation facilities and indications to appropriate pathways" - Modena 20-21 June 2000 • International Classification of Functioning, Disability and Health (ICF), of the World Health Organization, published in May 2001. http://www.who.int/classifications/icf/en/ • "Guidelines for the organization of an integrated system of assistance to traumatized patients with myelol- lection and / or brain-injury" - Conference of the Regional State Conference of 4 April 2002 - Repertoire of Acts n. 1427; • Zampolini M. "The GISCAR study on severe acquired brain injuries. Methodological aspects and preliminary data "Italian Journal of Rehabilitative Medicine, 2003; 17: 15-30; • Boldrini P., Maietti A., Basaglia N., "Design and implementation of a regional register of serious brain-injuries acquired in Emilia-Romagna" Europa Medicophysica, 2004; 40 (Suppl.1 to No.3): 9-11; • "The integrated care pathway in patients with Acquired Cerebrovascular Severity (Traumatic and Non-Traumatic) Acute and Post-Acute Phase" funded by the Ministry of Labor, Health and Social Policies - 2005 finalized research project pursuant to art. 12 and 12 bis of Legislative Decree 502/92; • 2nd National Consensus Conference "Rehabilitation and assistance needs of people with severe Acquired Cerebrovascular Disease (GCA) and their families, in the post-hospital phase", Verona 2005; • "National Reference Guidelines - Treatment of Lesser and Strict Cranial Trauma" ASSR, 2006; • United Nations Convention on the Rights of Persons with Disabilities, December 2006 • Ministry of Health - Vegetative State Commission - Final Document - December 21st 2006; • "Protocol of minimum rehabilitation assessment of the person with severe acquired brain injury". S.I.M.F.E.R. Italian Society of Physical and Rehabilitative Medicine, Section for the Rehabilitation of the Traumatized Cranio Encefalico and of the Gravi Cerebrolesioni Acquisite, Committee for the elaboration of the minimum protocol for the GCA, Revision 2007. • Final document of the working group established with D.M. of October 15, 2008 at the Ministry of Health and Social Policies, entitled "Vegetative Status and Minimum Consciousness. Epidemiology, scientific evidence and care models. " • White Paper on Vegetative and Minimal Conscious States. The point of view of the associations representing the family members, outcome of the Permanent Seminar of discussion on Vegetative States and of Minima Conscience, established by the Ministry of Labor, Health and Social Policies in May 2008. • White Paper on civil invalidity in Italy. A study in the Northern and Central Regions, Franco Angeli, Milan 2009, which presents the results of the project "Volunteering and Disability in Italy: the definition of care needs and the identification of socio-health paths with the language of the ICF ", Funded by the Ministry of Health. • 3rd National Consensus Conference "Good clinical practice in hospital rehabilitation of people with severe acquired brain injuries" Salsomaggiore Terme 5-6 November 2010. • Ministry of Health. White paper on vegetative states and minimum consciousness - The point of view of associations representing family members. Date of publication: October 18th 2010 • "REHABILITATION ADDRESS PLAN" - Rehabilitation Work Group - Ministry of Health GU 2-3-2011, CSR Agreement of 10 February 2011; • Dossier 224-2012 edited by the Health and Social Agency of Emilia-Romagna entitled "The integrated care path in patients with severe brain injury acquired. Acute and post-acute phase. Comparative analysis of regional organizational models. " • Leonardi, M. (2012). Results of the CCM National Project "Functioning and Disability in SV and SMC" (www.salute.gov.it). • Leonardi M (2015) Results of the CCM National Project "Model of social health integration in the care of patients with a conscience disorder. Project ASSIGNMENT "(www.salute.gov.it). Budget processes • The organization • Work processes • Central area services • Health-care macro-products • GOVERNMENT ORGANIZATION AND FLOWS • ORGANIZATION AND PLAN OF COST CENTERS • PLAN OF PRODUCTIVE FACTORS • ORDERS OF EXPENDITURE AND PLAN OF PRODUCTION FACTORS • COST CENTERS AND PLAN OF PRODUCTION FACTORS • drugs • ORGANIZATION AND ALIGNMENT INFORMATION • ORGANIZATION AND MINISTERIAL REPORTING • LENDER REPORTING • PROGRAMMING AND CONTROL BUDGET • PROGRAMMING PHASE • STAGE OF TRADING • POST NEGOTIATION PHASE • OBJECTIVES OF CASCADE TRADING
Obiettivi Agenda 2030 per lo sviluppo sostenibile

DIAGNOSTIC-THERAPEUTIC REHABILITATION PATHWAYS IN ORTHOPEDIC MEDICINE

Code	A000920
CFU	1
Teacher	Giuseppe Rinonapoli
Teachers	Giuseppe Rinonapoli
Hours	8 ore - Giuseppe Rinonapoli
Learning activities	Caratterizzante
Area	* scienze della fisioterapia
Academic discipline	MED/33
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Knowledge of the diagnostic-therapeutical pathways in orthopaedic rehabilitation.
Reference texts	Slides of the lessons
Educational objectives	To form professionals in order to give them the ability to manage with advanced skill in assistential, management, formative and scientific research process in Orthopaedic and Traumatology rehabilitation field.
Prerequisites	The students must have pass propedeutical exams listed in the rules of the Corso di Laurea, in order to understand the lessons.
Teaching methods	Frontal lessons
Other information	www.unipg.it
Learning verification modality	Written or oral exam
Extended program	General concepts of rehabilitation in Orthopaedics. Osteoarthritis and prosthetic surgery. Management, discharge planning and rehabilitation setting in patients operated of hip and knee prosthesis. The shoulder and rehabilitation pathways, the knee and rehabilitation pathways, traumatology and rehabilitation pathways. Osteoporosis and hip fracture management.

PRINCIPLES OF REHABILITATION SCIENCE

Code	GP003461
CFU	2
Teacher	Luca Collebrusco
Teachers	Luca Collebrusco
Hours	20 ore - Luca Collebrusco
Learning activities	Caratterizzante
Area	* scienze dell'ortottica e dell'assistenza di oftalmologia
Academic discipline	MED/48
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Integrated Rehabilitation model. EBM / EBP in Rehabilitation Sciences. Outcomes in Rehabilitation. Placebo and Nocebo in Rehabilitation. The management of Chronicity. The importance of the guidelines, the medical evidence and research in rehabilitation. The outcome assessments of Rehabilitation. The emerging Rehabilitation intervention approaches
Reference texts	Manuale di management per le professioni sanitarie 4/ed ISBN: 9788838646133 Author: Carlo Orlandi Rob Herbert., Physical Therapy Based on Evidence, Edition Edra 2014 White Paper on Chronic Pain, edited by HPS - Health Publishing & Services Srl, 2014
Educational objectives	The student will have acquired theoretical and practical skills necessary to create an integrated approach that involves all rehabilitation professionals for improving the quality of health care services.
Prerequisites	Have the basics of biomedical statistics, health legislation and epidemiology in medicine
Teaching methods	Frontal lessons
Other information
Learning verification modality	Written Verification
Extended program	- Integrated Rehabilitation model - EBM / EBP in Rehabilitation Sciences - Outcomes in Rehabilitation - Placebo and Nocebo in Rehabilitation - The management of Chronicity - The emerging Rehabilitation intervention approaches

REHABILITATION PROCESSES INTEGRATED IN THE OPHTHALMOLOGICAL FIELD

Code	GP003463
CFU	1
Teacher	Carlo Cagini
Teachers	Carlo Cagini
Hours	8 ore - Carlo Cagini
Learning activities	Caratterizzante
Area	* scienze dell'ortottica e dell'assistenza di oftalmologia
Academic discipline	MED/30
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Pathophysiology of vision and eye diseases . Clinical characteristics and laboratory examinations for the diagnosis of eye diseases • Low vision: definition • central and peripheral Low Vision • Rehabilitative strategies in low vision
Reference texts	Paliaga G.P., I vizi di refrazione. Diagnosi e correzione, Ed Minerva Medica, Torino 2002 Carta F., Carta A., Neuroftalmologia, Edizioni Essebiemme, 2005. Miglior M., Oftalmologia Clinica, Monduzzi Editore, Bologna 2006. Jack J. Kanski: Oftalmologia clinica Edizione: 6 Editore: Elsevier 2008
Educational objectives	Pathophysiology of ocular eye impairment in course of neurological diseases; specific diagnostic pearls
Teaching methods	face-to-face
Learning verification modality	face-to-face
Extended program	Pathophysiology of vision and eye diseases. Clinical characteristics and laboratory examinations for the diagnosis of eye diseases • Low vision: definition • central and peripheral Low Vision • Rehabilitative strategies in low vision

UROLOGICAL REHABILITATION

Code	GP003462
CFU	1
Teacher	Elisabetta Costantini
Teachers	Elisabetta Costantini
Hours	8 ore - Elisabetta Costantini
Learning activities	Caratterizzante
Area	Scienze biologiche, mediche e chirurgiche
Academic discipline	MED/24
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Urinary incontinence Frequency urgency syndrome Chronic urinary retention Relapse cystic Interstitial cystitis Genital prolapse Sexual dysfunctions Consequences of prostatectomy interventions
Reference texts	Trattato di Medicina Interna. Malattie del Rene, delle vie urinarie e dell'apparato genitale maschile. Autori: Albertazzi-Porena. Editore Piccin.
Educational objectives	The objectives are to provide a thorough insight into the issues of pathophysiology, functional anatomy, clinical and pelvic floor therapy. Furthermore to offer an updated and complete review of both the diagnostic techniques and procedures and the wide range of rehabilitation treatments available today
Prerequisites	Knowledge of the anatomy and physiology of the urinary and male genital system are indispensable in order to understand the topics of the lessons.
Teaching methods	Lectures by using audio-visual material. Introducing videos about the subject.
Other information	Students ' attendance is mandatory
Learning verification modality	The assessment includes final written and oral exam For informations on the support services Per informazioni sui servizi di supporto agli studenti con disabilità e/o DSA visita la pagina http://www.unipg.it/disabilita-e-dsa
Extended program	The first approach to care these symptoms, when the diagnostic framing provides for it, is a rehabilitative type, which is a conservative type that improves the quality of life of the person, minimizing invasive interventions. In addition, rehabilitation is recommended in support of surgical and / or pharmacological approaches. An integral and fundamental part of rehabilitation is the information, the perception of the area to be treated and the education to the correct movements in the various daily activities that help to prevent a relapse. The rehabilitation treatment must include a first visit with the therapist, the session includes anamnestic collection, patient support with scientific material to display the area to be treated and the various therapeutic approach possibilities. Visit for a functional evaluation. Knowledge of anatomy of the urogenital apparatus, as well as physiotherapy techniques in general: stretching and chinesiterapia. Rehabilitation techniques are: Chinesiterapia: contraction and relaxation exercises of pelvic muscles Ownocitive gymnastics: awareness exercises of the subject being treated and their management in daily life activities Postural gymnastics: Many mild and initial disorders can be assisted by a correct alignment of the spine Biofeedback: Device that registers patient activity and translates into comprehensible and correctable signals from the patient Functional electrical stimulation