We have 16 semester hours of neuroanatomy, neurophysioloy, neurologic rehabilitation, movement science and balance/vestibular rehab, which would all fall under the realm of neurosciences. This represents 17% of didactic credit load over the course of the program. Other courses not dedicated to these areas still integrate a lot of neurological science along the way. Neuro courses are some of the most challenging courses in the program but also some of the most rewarding for many students.
PT programs should include as much neurosciences as possible, as this knowledge applies to all PT practice settings much more than you think. Some PT schools still do not require their students to really understand enough basic science in this area to help them think about what is really going on in their patients. Modern pain science in particular needs a greater focus. A large portion of the patients you see in orthopaedics will have symptoms that are primarily neurologically driven, and in my opinion the outpatient setting should really be said to focus on neuro-orthopaedics. Impairments, injuries and diseases we treat are often driven by a diverse mixture of orthopaedic, cardiopulmonary, endocrine, immunologic and neurologic dysfunction. Programs that seem to have a heavy focus on orthopaedics, manual therapy, etc. need to teach enough neurosciences for students to have an understanding of how and why these treatments might actually be effective beyond their effect on the musculoskeletal system itself. As evidence-based practice utilizes both basic and clinical sciences and continues to become more and more of a focus, better and better PTs will come out of school every year.
The more we learn about what type of PT interventions are effective and why they might be effective, the more it is becoming clear that many PT interventions that work are affecting the anatomy and physiology of the musculoskeletal system much less than they are affecting the nervous system and the way that it processes stimuli and outputs responses. There is no human behavior, no conscious bodily function and no clinical sign or symptom that is not under direct monitoring and direct control by the brain or spinal cord. The rest of the body is entirely subservient to the nervous system. The better you understand the structure and function of the nervous system, the better you can critically think and clinically reason regarding your patients in literally any clinical PT setting, or about your research and teaching in any academic PT setting.
It is my belief that the great advances made in the rehabilitation sciences in the coming decades will be largely because of increased understanding of the nervous system and how we can affect its functioning through our interventions. Genomics, cell biology and regenerative medicine are also set to eventually play a major role in our field. Those who continue to insist that musculoskeletal symptoms and movement impairments in otherwise healthy patients can be explained entirely through the traditional biomedical model and knowledge of musculoskeletal anatomy and kinesiology will continue to spin their wheels. Those areas of knowledge are critically important and as highly relevant as ever, don't get me wrong, particularly in patients with specific musculoskeletal injuries and patients who are reintroducing movement post-operatively. But those patients in pain without an obvious cause require our knowledge of neurosciences just as much, if not more, than our knowledge of the musculoskeletal system.
Essentially, try to appreciate every bit of basic and clinical science you can get your hands on. Try to integrate you knowledge of neurology, your knowledge of orthopaedics and your knowledge of other body systems together. All parts of the curriculum can become important if you can connect them. Things that seem superficially irrelevant and unnecessary are often much more applicable to all PT settings than we immediately realize.
