Advanced Practice of Evidence Based Practice: Lumbar Spine and Lower Limb

Faculty

Faculty of Business Management and Social Sciences

Version

Version 1 of 11.03.2025.

Module identifier

22M0705

Module level

Master

Language of instruction

German

ECTS credit points and grading

5.0

Module frequency

only summer term

Duration

1 semester

 

 

Brief description

In this module, current scientific findings on diagnostics, treatment and problems are theoretically deepened at a high scientific level, especially in the area of the lumbar spine and the lower extremity. Practical training includes the application of special neuromuscular, clinical test procedures/measuring instruments, from the field of sports science and concentrated treatment with manual therapy techniques. The module focuses on deepening evidence-based patient management within the framework of the therapeutic clinical reasoning process.

Teaching and learning outcomes

Block 1

  • Pain diagnosis, assessment and treatment
  • Theory of neurodynamic treatment of the lower quadrant
  • Neurodynamic differentiation procedures and treatment
  • Influences of different disciplines and settings on the patient's experience of illness and treatment

Block 2

  • Musculoskeletal imbalance, syndromes and manipulation
  • Theory of muscle balance of the lower quadrant - Lumbar instability/spinal stenosis: assessment and treatment 
  • Theory of manipulations and their (contra-)indications - Patient presentation and clinical reasoning

Block 3

  • Clinical patterns of the lower quadrant and their treatment
  • Advanced skills for functional diagnosis and treatment of the pelvic, hip, knee and foot region and the peripheral nervous system
  • Advanced clinical patterns such as lumbar spinal stenosis, hip impingement, anterior knee pain (AKP)
  • Manipulation techniques for the lumbar spine and thoracic spine

Block 4

  • Manual Therapy and Neuromusculoskeletal Science
  • Assessment and treatment of lower quadrant motor dysfunction in the context of pelvic LS hip and knee dysfunction and pain 

IFOMPT criteria: A2; D2, 3, 4, 5, 6; K1, 2, 3, 4, 5, 6, 7, 10, 11, 12; S1, 2, 3, 4, 6, 8;

Overall workload

The total workload for the module is 150 hours (see also "ECTS credit points and grading").

Teaching and learning methods
Lecturer based learning
Workload hoursType of teachingMedia implementationConcretization
60SeminarPresence-
Lecturer independent learning
Workload hoursType of teachingMedia implementationConcretization
90Work in small groups-
Graded examination
  • Portfolio exam
Ungraded exam
  • Regular participation
Exam duration and scope

Written examination (K1- 60 minutes) and a practical work sample -duration 45 minutes The K1 is weighted with 30 points and the practical examn with 70 points.

Knowledge Broadening

Students expand their knowledge of the theoretical background of muscular imbalances, neurodynamic complaints and their treatment, manipulations and various clinical patterns. They understand the neurodynamic differentiation procedure in the diagnosis of functional disorders. They know treatment principles of the lower body quadrant, neurodynamic testing and differentiation principles of the lower quadrant, their underlying theories and can interpret these against the individual background (speciality/setting) of a patient. Lumbar instabilities are known, possible testing procedures and possible applications can be performed. There is a detailed background knowledge of current evidence and literature sources regarding underlying pain mechanisms, management strategies and treatment approaches. The indications and contraindications for lumbar manipulations are known to the students. They are able to perform a safe and indication-specific manipulation setting and to discuss and justify it critically within the framework of the biopsychosocial model. The principle of motor control can be applied to the lower body quadrant. The students can carry out a finding and treatment from the point of view of the motor control principle. They understand the classification of movement dysfunctions, muscle strength classifications and management strategies in the context of the biopsychosocial model. The students are able to react according to the individual situation of the patient (speciality/setting) and initiate efficient management. Manual therapy and motor test procedures can be integrated sensibly and efficiently into the management of manual therapy treatment. Knowledge transfer services between manual therapy and neuromusculoskeletal contents

Knowledge deepening

Students will have an in-depth and detailed understanding of biomedical and biopsychosocial models in the management of lumbar back pain and lower limb pain. Students identify external evidence and review it for its utility. They expand their knowledge of clinical contexts, on the basis of which they form clinical patterns and make therapeutic decisions. They deepen their knowledge of clinical patterns of the lower body quadrant and its treatment. Beyond the deepened knowledge regarding manual therapy, they are able to incorporate neuromusculoskeletal research and science directly into patient treatment.patient (specialty/setting) to respond and initiate effective management. Manual therapy and motor test procedures can be integrated sensibly and efficiently into the management of manual therapy treatment. Knowledge transfer services between manual therapy and neuromusculoskeletal contents
/principles to enable the best possible patient-centred treatment.

Knowledge Understanding



Application and Transfer

Recognise clinical patterns and apply the skills in daily practice

The students apply external evidence in the context of functional disorders and pain in the lumbar, hip, knee and foot region as well as the peripheral nervous system in a case-related manner on patients. The students have in-depth skills to carry out the clinical examination and treatment of the lumbar spine as well as the pelvic, hip, knee and foot region. They take into account neuro-orthopaedic differential diagnoses of these regions. Students have advanced skills in the treatment techniques of mobilisation, manipulation, neurodynamics, exercises and self-management of the lower quadrant. They are able to correctly assess information on neuromusculoskeletal diagnosis as well as indications and contraindications of musculoskeletal therapy in case of complicated symptom patterns of the lower quadrant.

Communication and Cooperation

Students apply their communicative skills to obtain comprehensive information about the nature of the patient's complaints. They are able to explain cause-effect relationships coherently and comprehensively to patients, relatives, colleagues and professional representatives and to represent their therapeutic decisions. The students assume responsibility in the therapeutic team for the implementation of 

Academic Self-Conception / Professionalism

   Transfering evidence-based knowledge into manual therapy skills

Literature

  • Hengeveld, E. and Banks, K. eds., 2013. Maitland's Vertebral Manipulation: Management of Neuromusculoskeletal  Disorders-Volume 1 (Vol. 1). Elsevier Health Sciences
  • Maitland, G., Hengeveld, E. and Banks, K., Maitland’s Vertebral Manipulation, ed 7, Edinburgh, 2005.
  • Butler D (2000): The Sensitive Nervous System. Adelaide, Australia, Noigroup Publications.
  • Twomey LT, Taylor JR (2000): Physical Therapy of the Low    Back, 3rd ed. Churchill Livingstone, Edinburgh.
  • Bogduk N (1997): Clinical Anatomy of the Lumbar Spine and  Sacrum. Churchill Livingstone, Edinburgh. Frob?se I, Nellessen-Martens G, Wilke C (2009): Training in der  Therapie. Grundlagen und Praxis. 3. Auflage.
  • Elsevier, Urban & Fischer-Verlag. Hollmann W, Strüder HK (2009): Sportmedizin: Grundlagen für k?rperliche Aktivit?t, Training und Pr?ventivmedizin, 5. Auflage. Schattauer-Verlag.
  • Westerhuis, P, Wiesner, R (2018): Klinische Muster in der Manuellen Therapie, Thieme, Stuttgart, 2. Auflage.
  • Falla, D, Cook, C, Lewis, J, McCarthy, C, Sterling, M (2024): Grieve’s Modern Musculoskeletal Physiotherapy, Elsevier LTD
  • Ballenberger, N (2025): Evidenzbasierte Assessments in der Muskuloskelettalen Physiotherapie, Urban & Fischer Verlag/Elsevier GmbH
  • Aktuelle wissenschaftliche Studien, die sich mit der Modulthematik befassen, werden in die 188篮球比分_188比分直播—激情赢盈中√ eingebunden.

Applicability in study programs

  • Musculoskeletal Therapy (Manual Therapy – OMT)
    • Musculoskeletal Therapy (Manual Therapy - OMT)

    Person responsible for the module
    • Piekartz, Harry
    Teachers
    • Unknown person
    • Timpe, Timo
    • Kapitza, Camilla
    • Piekartz, Harry