Unit of competency details

Descriptor 

This unit of competency describes the skills and knowledge required to deliver and monitor a therapeutic exercise program that has been developed by a physiotherapist to address requirements of individual clients with low levels of mobility or specific mobility needs

Application 

The application of knowledge and skills described in this competency unit may relate to functions delivering and monitoring a lower limb exercise program, an upper limb exercise program, a trunk exercise program or a cardio-vascular exercise program that has been developed by a physiotherapist. This could take place in a range of health settings and may involve active, assisted active or passive movement

Work performed requires a range of well developed skills where some discretion and judgment is required and individuals will take responsibility for their own outputs

Allied health assistants operate within the scope of their defined roles and responsibilities and under supervision of a physiotherapist

For training and assessment pathways, experience in workplace application of the skills and knowledge identified in this competency unit should be provided as required to support allied health professions

Pre-requisite units 

This unit must be assessed after successful achievement of pre-requisite units:

• HLTAP301B Recognise healthy body systems in a health care context
• HLTCSD305C Assist with client movement
• HLTAH301B Assist with an allied health program

Employability Skills 

This unit contains Employability Skills

Elements define the essential outcomes of a unit of competency.

The Performance Criteria specify the level of performance required to demonstrate achievement of the Element. Terms in italics are elaborated in the Range Statement.

ELEMENT 

PERFORMANCE CRITERIA 

1. Prepare for delivery of a client -specific exercise program 

1.1 Obtain information  about the client -specific exercise program  from the physiotherapist

1.2 Determine client  availability according to organisation protocols

1.3 Gather the equipment to deliver the client -specific exercise  program, in line with client needs and specifications of the physiotherapist

2. Deliver exercise program based on treatment plan

2.1 Confirm client's  understanding of exercise program based on treatment plan prepared by the physiotherapist

2.2 Obtain informed consent from the client before commencing the exercise program

2.3 Report any client misunderstanding or confusion to the physiotherapist in a timely manner

2.4 Guide the client to complete the exercise program as directed by physiotherapist

2.5 Identify and note any difficulties the client experiences completing the exercise program, using observation, knowledge of biomechanics , and knowledge of the musculo -skeletal system  and report to physiotherapist in a timely manner

2.6 Identify and manage client compliance issues, including subjective and objective reporting of client response to the program, and report to the physiotherapist in a timely manner

2.7 Provide feedback to the client to reinforce client understanding and correct application of the exercise program

2.8 Work with client to plan any follow up exercise sessions and dates

2.9 Seek assistance when client presents with needs or signs outside limits of own authority, skills and/or knowledge

2.10 Report client difficulties to the supervising physiotherapist for advice before continuing the prescribed exercise program

3. Assist with mobility and movement programs with clients  unable to actively participate

3.1 Monitor 24-hour posture management and identify any adjustment requirements according to directives form the physiotherapist

3.2 Assist physiotherapist to complete passive movement requirements

3.3 Monitor respiratory care requirements and conduct necessary action within the prescribed treatment plan and scope of role and responsibilities as defined by the organisation

3.4 Monitor action to control limb oedema and report any recommendations to the physiotherapist in a timely manner

3.5 Correctly position client according to client's condition, modesty and treatment/program activities and according to the directive of the physiotherapist

3.6 Talk to client about treatment/program activities and where possible seek feedback about comfort and understanding during the session where possible

3.7 Create a treatment/program environment that fosters clients to ask questions about progress and activities

3.8 Take appropriate and prompt action in response to any indicators of adverse reaction to the program/ treatment according to relevant organisation protocols and guidelines

4. Clean and store equipment

4.1 Clean equipment according to manufacturer's recommendations, infection control requirements and organisation protocols

4.2 Store equipment according to manufacturer's requirements and organisation protocols

4.3 Check and maintain equipment according to organisation protocols

4.4 Report equipment faults to appropriate person

4.5 Label or tag equipment faults, where possible remove from use if unsafe or not working and inform staff in line with organisation procedures

5. Document client information 

5.1 Use accepted protocols to document information relating to the exercise program in line with organisation requirements

5.2 Use appropriate terminology to document client response, outcomes and identified problems related to the therapeutic exercise program

6. Comply with supervisory requirements

6.1 Assist with exercise program according to the instruction of treating physiotherapist

6.2 Provide client progress feedback to the treating physiotherapist

6.3 Report client difficulties and concerns to the treating physiotherapist in a timely manner

6.4 Implement variations to the exercise program according to the advice of the treating physiotherapist

REQUIRED SKILLS AND KNOWLEDGE 

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge :

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

• Principles of biomechanics, including:

• mass
• force
• speed
• acceleration
• work
• energy
• power
• strength
• momentum
• force arm
• resistance arm
• axis of rotation
• cam
• pulley

• Basic musculo-skeletal anatomy, including:

• joint types and function
• major bones
• major muscles
• major joints

• Basic anatomy and physiology
• Anatomical terminology, including:

• flexion
• extension
• rotation
• abduction
• adduction
• circumduction
• inversion
• eversion
• pronation
• supination
• horizontal flexion
• horizontal extension

• Therapeutic exercise principles
• A working understanding of the basic anatomy and physiology of the skin and the principles of pressure area care
• A working understanding of the principles of 24-hour posture management

Essential knowledge  (cont ):

Knowledge of:

• A working knowledge of factors that facilitate an effective and collaborative working relationship
• A working knowledge of record keeping practices and procedures in relation to diagnostic and therapeutic programs/treatments
• A working knowledge of the equipment and materials used in different programs and treatments
• A working knowledge of the monitoring requirements for different programs and treatments
• A working understanding of the basic reaction to pain within the body
• A working understanding of the signs of adverse reaction to different programs and treatment
• Client care plans, goals and limitations of exercise therapy
• Contraindications for exercise therapy
• Disease processes relevant to the client group/s
• Infection control policies and procedures that relate to the allied health assistant's role in implementing physiotherapy mobility and movement programs
• Medical terminology required to operate effectively
• OHS policies and procedures that relate to the allied health assistant's role in implementing physiotherapy mobility and movement programs
• Relevant national and state/territory legislation and guidelines, including Australian Physiotherapy Association (APA) Guidelines
• Relevant organisation policies and procedures
• Roles, responsibilities and limitations of self and other allied health team members and nursing, medical and other personnel
• Supervisory and reporting protocols of the organisation

Essential skills :

It is critical that the candidate demonstrate the ability to:

• Apply therapeutic exercise practices
• Undertake activity analysis - breaking activities down into component parts
• Use manual handling required to assist the client

In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

• Work under direct and indirect supervision
• Communicate effectively with clients for therapeutic support
• Communicate effectively with supervisors and co-workers
• Work effectively with non-compliant clients
• Use skills in time management, personal organisation and establishing priorities

EVIDENCE GUIDE 

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit :

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• Observation of workplace performance is essential for assessment of this unit
• Consistency of performance should be demonstrated over the required range of situations relevant to the workplace
• Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible

Access and equity considerations :

• All workers in the health industry should be aware of access and equity issues in relation to their own area of work
• All workers should develop their ability to work in a culturally diverse environment
• In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people
• Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

Context of and specific resources for assessment :

• Assessment must include demonstrate workplace performance
• Relevant guidelines, standards and procedures
• Resources essential for assessment include:

• clients with exercise requirements
• equipment
• documentation
• supervisory physiotherapist

Method of assessment 

• Observation of some applications in the workplace (as is appropriate/possible)
• Written assignments/projects or questioning should be used to assess knowledge
• Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice
• Skills involving direct client care are to be assessed initially in a simulated setting (eg. laboratory). If successful, a second assessment is to be conducted during workplace application under direct supervision

RANGE STATEMENT 

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Supervision refers to :

• Instructing, advising, and monitoring another person in order to ensure safe and effective performance in carrying out the duties of their position
• The nature of supervision is flexible and may be conducted by various means including:

• in person
• through use of electronic communications media such as telephone or video conferencing

• Frequency of supervision will be determined by factors such as:

• the task maturity of the person in that position or clinical placement
• the need to review and assess client conditions and progress in order to establish or alter treatment plans in case of students and assistants
• the need to correct and develop non clinical aspects such as time management, organisation requirements, communication skills, and other factors supporting the provision of clinical care and working within a team

• A person under supervision does not require direct (immediate) and continuous personal interaction, but the method and frequency will be determined by factors outlined above

Client specific exercise programs may include but are not limited to :

• Upper limb
• Lower limb
• Trunk
• Cardiovascular
• Passive movement
• Active/functional exercise

Information may include :

• Client care plan
• Exercise plan
• Client treatment plan
• Physiotherapist instructions
• Client record
• Checklists
• Case notes
• Other forms according to procedures of the organisation

Exercise plan may include but is not limited to :

• Client details
• Movement details, including:

• direction
• range
• lever length
• complexity
• speed

• Intensity details, including:

• resistance
• repetitions
• muscle involvement

Clients may include :

• Infants
• Children
• Adolescents
• Elderly people

Settings may include 

• Hospitals
• Acute care settings in hospitals
• Community health services
• Private practice
• Client homes
• Aged care residential care settings

Principles of biodynamic movement may include :

• Mass
• Force
• Speed
• Acceleration
• Work
• Energy
• Power
• Strength
• Momentum
• Force arm
• Resistance arm
• Axis of rotation
• Cam
• Pulley

Musculo -skeletal system may include :

• Joint types and function
• Major bones
• Major muscles
• Major joints

Clinical standards , guidelines , policies and procedures may include :

• Clinical standards (state and national)
• Industry professional bodies
• Industry standards (state and national) and associated legislative requirements
• Organisation policy directives
• Privacy Act
• Relevant Australian standards
• Physiotherapy Registration Acts (state based)

Client compliance refers to :

• Ability to follow instructions or suggestions
• Willingness to follow instructions or suggestions
• Cognitive decline