Movement Science Unit5-9
Which of the following is NOT a precaution for stretching interventions? A. Patient with suspected osteoporosis B. Soreness after previous session that lasted 4 hrs C. Edematous tissue D. Patient who has been on prolonged bed rest
B. Soreness after previous session that lasted 4hrs
Safe and effective stretching to increase ROM requires all of the following EXCEPT A. Proper alignment & positioning B. Stabilization of proximal attachment of msucle C. Use of gained ROM in active function D. Strengthening of agonist
B. Stabilization of proximal attachment of muscle
According to Neer's classification of rotator cuff disease, which of the following stages is seen most often in patients 25 to 39 years of age and characterized by tendonitis or bursitis but not a rotator cuff tendon rupture? A. Stage I B. Stage II C. Stage III D. Stage IV
B. Stage II
Which factors affect the amount of resistance provided by elastic resistance bands during exercise? A. Length of the muscle and stretch of the band B. Stretch of the band and speed of movement C. Stretch of the band and angle of the band in relation to the moving bone D. Angle of the band in relation to the moving bone and length of the muscle
C. Stretch of the band and angle of the band in relation to the moving bone
On examination, your patient reports that he is an avid cyclist and over the past 2 months has been experiencing numbness of the little finger and the ulnar side of his ring finger that has become painful over the past week with an inability to effectively grasp the handlebars. One area of possible nerve compression producing these signs and symptoms is: A. Carpal tunnel B. Tunnel of Guyon C. Thoracic outlet D. Tarsal tunnel
B. Tunnel of Guyon
Each of the following is a true statement about rehabilitation following dislocation of the glenohumeral joint EXCEPT: A. After an initial dislocation and a course of nonoperative management, recurrence of a dislocation is higher in older patients (greater than 40 years of age) than in younger patients (less than 30 years of age). B. Anterior dislocation is far more common than posterior dislocation. C. A compression fracture of the posterolateral margin of the humeral head is an associated lesion that may occur as the result of a traumatic anterior dislocation. D. A fall on the arm when it is positioned in flexion, adduction, and internal rotation can result in a posterior dislocation.
A. After an initial dislocation and a course of nonoperative management, recurrence of a dislocation is higher in older patients (greater than 40 years of age) than in younger patients (less than 30 years of age).
You are educating your patient about returning to functional activities following a radial head resection with an implant. What should you tell her about returning to high-demand, high- impact activities? A. Avoid these activities on a permanent basis. B. Because she had a radial head implant, she may return to these activities after 6 months. C. She may return to heavy lifting after 6 months, but not high-impact (tennis or golf) activities due to the ballistic force these activities create. D. She should have had a total elbow arthroplasty if she wanted to return to these activities.
A. Avoid these activities on a permanent basis.
The type of stretching technique that utilizes a high-speed, high-intensity, and short-duration stretch force is called a? A. Ballistic stretch B. Static stretch C. Cyclic stretch D. Mechanical stretch
A. Ballistic stretch
Following nerve injury, motor retraining exercises: A. Begin as soon as signs of voluntary muscle action are detected. B. Begin as soon as the patient tolerates electrical stimulation. C. Are used to desensitize the areas of hypersensitivity. D. Cannot be used until the chronic phase of healing in order to avoid further trauma to the nerve.
A. Begin as soon as signs of voluntary muscle action are detected.
Each of the following is a true statement about isokinetic exercise except: A. Current technology provides resistance only to concentric muscle contractions. B. It accommodates for a painful arc. C. It provides maximal resistance throughout the available ROM. D. It accommodates for muscle fatigue.
A. Current technology provides resistance only to concentric muscle contractions.
To help reduce post-stretch soreness after stretching into shld flexion, cold should be applied with the limb in which of the following positions? A. End-range shld flexion B. End-range shld extension C. Mid-range shld flexion D. Cold is not recommended after a stretch
A. End-range shld flexion
You place your patient's wrist in a splint because he is experiencing an acute episode of lateral epicondylitis. Which of the following is the least appropriate intervention while the inflamed soft tissue is healing? A. Have the patient wear a splint to immobilize the wrist continuously for at least 2 weeks or until there is no pain. B. Have the patient remove the splint several times each day and perform active or self-assisted ROM of the wrist within pain-free ranges. C. Have the patient remove the splint several times a day and perform gentle muscle- setting exercises, elongating the involved muscle-tendon unit slightly after each contraction but not beyond the pain-free ranges. D. Apply cross-fiber massage at the site of the lesion.
A. Have the patient wear a splint to immobilize the wrist continuously for at least 2 weeks or until there is no pain.
Within a week of shld sx your patient was able to do resistance exercises of shld ER and has now increased in level of resistance/weight. this improvement in muscle performance is due to what adaptive change? A. Increased recruitment of motor units B. Increased oxygen to muscle C. Hypertrophy of muscle fibers D. Fiber type transformation from slow to fast twitch
A. Increased recruitment of motor units
Which of the following is the most efficient way to neutralize the effects of muscle fatigue during an exercise session? A. Perform unresisted exercises during the rest interval between sets B. Stop all exercise and rest completely between sets C. Apply cold to the muscle/muscle groups between sets D. Massage the muscles between sets
A. Perform unresisted exercises during the rest interval between sets
The ability of soft tissue to assume a new and greater length after a stretch force is removed is called? A. Plasticity B. Viscoelasticity C. Elastiity D. Tissue memory
A. Plasticity
While instructing a patient to fully elongate the lats, you would have her place the limb in which position? A. Shld flexion, abd, ER B. Shld extension, abd, IR C. Shld extension, add, IR D. Shld flexion, add, ER
A. Shld flexion, abd, ER
Incorporating resistance training that focuses on eccentric exercises of patients quads and gluts muscles in WB positions (controlled squat & partial lunge) represents what principle of therapeutic exercise? A. Specificity of training B. Reversibility of training C. Overflow priniple D. Overload principle
A. Specificity of training
Impingement syndromes of the shoulder are associated with both intrinsic and extrinsic factors affecting the structures in the suprahumeral space and resulting in shoulder pain. Of the following contributing factors, which is classified as an intrinsic factor? A. Vascular changes in the rotator cuff tendons B. Hypertrophic degenerative changes of the AC joint C. The shape of the acromion D. Increased thoracic extension
A. Vascular changes in the rotator cuff tendons
Nonoperative management of carpal tunnel syndrome emphasizes: A. Vigorous stretching to gain mobility of the structures in the carpal tunnel. B. Activity modification and joint, nerve, and tendon mobilization. C. Strengthening exercises, especially to the muscles of the thenar eminence. D. Immobilization.
B. Activity modification and joint, nerve, and tendon mobilization.
Which of the following surgical procedures is performed for recurrent anterior instability or dislocation of the glenohumeral joint and involves reattachment and repair of the capsulolabral complex to the anterior rim of the glenoid? A. Anterior capsular shift B. Bankart repair C. Hill-Sachs repair D. Repair of a SLAP lesion
B. Bankart repair
To improve upper extremity strength, stability, and proprioception, during which of the following variations of push-ups does body weight provide the greatest resistance? A. Bilateral wall push-ups while in a standing position and leaning into and pushing away from the wall B. Bilateral push-ups in a prone position, head down on an incline board with weight on hands and knees C. Bilateral push-ups while standing and leaning on the hands on a kitchen countertop D. Bilateral push-ups in a prone position with weight on the hands and knees
B. Bilateral push-ups in a prone position, head down on an incline board with weight on hands and knees
Each of the following is an indication that muscle fatigue is occurring when a patient is exercising against resistance EXCEPT? A. Muscle tremor occurring during exercise B. Gradual increase in temp in the exercising muscles C. Patient won't be able to complete available ROM against initial level appplied D. Patient may attempt to use substitute motion/muscle groups to perform exercise
B. Gradual increase in temp in the exercising muscle
Current research shows that the "survival rate" for total elbow arthroplasty (TEA) is: A. 30%overa10-yearperiod. B. Greater for patients with RA than for those with traumatic arthritis or OA. C. Highly correlated with the type of implant (prosthesis). D. 82%overa5.5-yearperiod.
B. Greater for patients with RA than for those with traumatic arthritis or OA.
For effective shoulder function, each of the following is necessary EXCEPT: A. Appropriate movement and stability of the scapula. B. Greater mobility in the external rotators than the internal rotators. C. A balance in strength of the external and internal rotators. D. Thoracic extension and axial extension of the cervical spine.
B. Greater mobility in the external rotators than the internal rotators.
Of the following, which is the most effective way to improve muscle endurance? A. Have patient train on an isokinetic dynamometer at fast speeds B. Have patient train using dynamic exercise against submax loads over progressive longer period times C. Have patient exercise against max resistance for limited number of reps D. Have patient train using isometric exercises against resistance
B. Have patient train using dynamic exercise against submax loads over progressive longer period times
You are designing an exercise program for a patient with a history of hypertension. Which of the following types of exercise is associated with the highest risk of causing an increase in blood pressure during exercise? A. Isokinetic exercise at medium to fast velocities B. High-effort isometric exercise C. Setting exercises D. High-effort dynamic resistance exercise
B. High-effort isometric exercise
Which of the following is true about myositis ossificans (heterotopic bone formation) in the elbow region? A. The muscle most often affected in the elbow region is the biceps brachii. B. It is distinguished from traumatic arthritis of the humeroulnar joint in that passive extension is more limited than flexion. C. After the acute inflammatory period, heterotopic bone is laid down within muscle fibers and within the joint. D. Before the bony mass in the muscle has matured, the muscle should be stretched and massaged regularly to prevent a contracture.
B. It is distinguished from traumatic arthritis of the humeroulnar joint in that passive extension is more limited than flexion.
Which of the following is a true statement about an arthroscopic subacromial decompression procedure? A. It is indicated for a patient who sustains a full-thickness, traumatic tear of the rotator cuff if coupled with a repair of torn cuff tissues. B. It may or may not involve resection of the anterior acromial protuberance and contouring of the undersurface of the remaining acromion. C. It is indicated for a patient with secondary impingement syndrome due to glenohumeral joint hypermobility/instability. D. During surgery, the deltoid must be detached for adequate exposure of the suprahumeral space.
B. It may or may not involve resection of the anterior acromial protuberance and contouring of the undersurface of the remaining acromion.
Following transverse carpal ligament surgery to release impingement of the median nerve in the carpal tunnel, your patient has increased sensation of tingling when the wrist is extended. The impairment and its intervention should be: A. Joint adhesions: use joint-mobilization techniques. B. Median nerve adhesions: use nerve-mobilization techniques. C. Ligamentous stress from the surgery: use cross-friction massage. D. Scar adhesions: mobilize the skin around the surgical site followed by range of motion exercises.
B. Median nerve adhesions: use nerve-mobilization techniques.
Dominant signs of complex regional pain syndrome type I (reflex sympathetic dystrophy) that should alert you to the potential of this condition developing are: A. Pain, osteoporosis, swelling, and paresthesias. B. Pain, swelling, stiffness, and discoloration of the hand. C. Pain, muscle atrophy, stiffness, and brittle nails. D. Recent injury; pain; and red, hot, swollen tissue.
B. Pain, swelling, stiffness, and discoloration of the hand.
Your patient develops a contracture as a result of hypertonicity after a traumatic brain injury. This type of hip contracture is called a(n): A. Arthrogenic contracture B. Pseudomyostatic contracture C. Fibrotic contracture D. Myostatic contracture
B. Pseudomyostatic contracture
Your patient experiences a tingling sensation in the upper extremity while in the following position: shoulder girdle depression; slight abduction of the shoulder; elbow extension; internal rotation of the arm; pronation of the forearm, wrist, finger; thumb flexion; and ulnar deviation of the wrist. Which peripheral nerve is being placed on a stretch? A. Median B. Radial C. Ulnar D. Musculocutaneous
B. Radial
You have a patient assume a prone-lying position and prop symmetrically on his forearms. You apply manual resistance in several directions at the shoulder girdles as you ask the patient to hold (maintain) the symmetrical position. This technique is known as: A. Agonist-contraction. B. Rhythmic stabilization. C. Recurrent facilitation. D. Repeated contractions.
B. Rhythmic stabilization.
Which of the following is an inappropriate component of an exercise program 1 to 3 weeks postoperatively for a patient without preoperative rotator cuff deficiency who underwent total shoulder replacement? A. Wand exercises for active-assistive external rotation to neutral with the arm positioned near the side of the chest B. Wand exercises for active-assistive shoulder extension (combined with IR) by placing the wand behind the back and sliding it up the back C. Pendulum exercises D. Wand exercises for active-assistive elevation of the arm in the plane of the scapula to approximately 90 while in a supine or sitting position
B. Wand exercises for active-assistive shoulder extension (combined with IR) by placing the wand behind the back and sliding it up the back
Which of the following is a contraindication to implementing resistance exercise? A. Risk of pathological fx due to osteoporosis B. Joint instability C. Acute pain or inflammation D. If muscle soreness occurs after a bout of exercise
C. Acute pain or inflammation
You are asked to do "selective stretching" with a patient with a SCI. Which of the following best describes the concept of this particular technique? A. Duration and frequency of treatment session limited to 5mins B. Active and passive stretching techniques are altered C. Allow tightness of specific muscles to remain in order to optimize function D. PNF patterns are used to encourage reflexive responses
C. Allow tightness of specific muscles to remain in order to optimize function
You are having a patient perform manual resistance exercise of the lower extremity using a PNF diagonal pattern. In which of the following lower extremity patterns is ankle dorsiflexion coupled with eversion resisted? A. D1 flexion B. D1 extension C. D2 flexion D. D2 extension
C. D2 flexion
Your patient injured her ulnar nerve falling up some steps and catching herself on the medial side of her hand 2 days ago. She currently has constant tingling and decreased sensation to pressure and touch in the little finger and ulnar half of the ring finger. Your intervention during the first week of treatment will be all of the following EXCEPT: A. Protect the nerve by immobilizing the wrist in a splint. B. Teach active ROM to wrist and fingers. C. Emphasize the importance of resistive exercises to prevent muscle atrophy. D. Inform the patient about ways to protect the hand from further injury.
C. Emphasize the importance of resistive exercises to prevent muscle atrophy.
Patient had sx and 8wks of rehab for CTS. You notice their thenar eminence is almost the same size as the unaffected. What change is due to the following adaptive changes? A. Increased recruitment of motor units B. Hyperplasia of muscle fibers C. Hypertrophy of muscle fibers D. Fiber type transformation from slow to fast twitch
C. Hypertrophy of muscle fibers
If the strength of a muscle is "good" (grade4/5) and active ROM cannot be done, repetitive setting exercises will accomplish each of the following EXCEPT? A. Maintain mobility between muscle fibers B. Develop or maintain awareness of the sensation of a muscle contraction C. Increase the strength in muscle D. Enhance circulation within muscle
C. Increase the strength in muscle
Your patient has significant limitation in R shld ER. As you perform stretch interventions to improve ROM, you also need to develop strength in which of the following agonist? A. Subscapularis B. Anterior delt C. Infraspinatus D. Pec minor
C. Infraspinatus
A patient has mild joint swelling and pain during active ROM, but resisted tests of the muscles that cross the swollen joints do not cause pain. Your goal is to maintain or possibly increase strength through the available ROM. The most appropriate choice of exercise is: A. Setting exercises at the end of the ROM. B. High-velocity isokinetic exercise. C. Multiple-angle isometric exercise against resistance. D. Eccentric/concentric, closed-chain exercise against body weight throughout the ROM.
C. Multiple-angle isometric exercise against resistance
The pain associated with CRPS type I (reflex sympathetic dystrophy) characteristically is: A. Entirely psychogenic and responsive to antidepressants. B. Intermittent and related to body and head position. C. Out of proportion to the report of history of injury or precipitating event. D. Always responsive to modalities, primarily cold and electrical stimulation.
C. Out of proportion to the report of history of injury or precipitating event.
Results of numerous outcome studies have demonstrated that the most predictable outcome after shoulder arthroplasty is: A. Increased active shoulder ROM. B. Increased shoulder-joint stability. C. Pain relief. D. Improved function of the rotator cuff mechanism.
C. Pain relief.
It has been shown that after performing resistance exercise to the point of exhaustion, recovery from exercise occurs most efficiently if? A. Fatigued muscle rests completely during recovery B. Cold is applied to fatigued muscle C. Patient performs low-intensity, active exercise using fatigued muscle D. Muscle is passively stretched during recovery
C. Patient performs low-intensity, active exercise using fatigued muscle
Tennis elbow may involve all of the following structures except the: A. Extensor carpi radialis brevis B. Extensor communis C. Pronator teres D. Annular ligament
C. Pronator teres
Your patient is lying supine and you are strengthening the iliopsoas on the (R) using manual resistance. The main reason you would want to place the patient's (L) hip and knee in flexion (foot planted on the table) is to: A. Stretch the erector spinae muscles in the lumbar region of the back. B. Improve the mechanical efficiency of the iliopsoas on the (R). C. Stabilize the pelvis in a neutral to posteriorly rotated position to lessen the possibility of an anterior pelvic tilt occurring, placing stress on the low back. D. Place the pelvis in a slight anterior tilt so the trunk is more stable and the iliopsoas can generate greater tension.
C. Stabilize the pelvis in a neutral to posteriorly rotated position to lessen the possibility of an anterior pelvic tilt occurring, placing stress on the low back.
Your patient exhibits a forward head posture and excessive thoracic kyphosis. Considering the muscles that typically are weak with this faulty posture, which of the following muscles of the shoulder girdle are most important to strengthen using the exercise program you are developing for this patient? A. Pectoralis minor and levator scapulae B. Serratus anterior and levator scapulae C. Upper and lower trapezius and serratus anterior D. Upper and lower trapezius and pectoralis minor
C. Upper and lower trapezius and serratus anterior
In addition to an isokinetic dynamometer, which of the following types of resistance equipment can be used safely and effectively to improve muscle strength at fast velocities of limb movement? A. Freeweights B. Variable resistance equipment made up of a weight-cable and cam system C. Variable resistance equipment that employs pneumatic or hydraulic resistance D. Simple weight-pulley system
C. Variable resistance equipment that employs pneumatic or hydraulic resistance
A person who has been on extended bed rest has a hip contracture that places the hip in a position of ER. You note in your doc that your patient has a A. Hip flexion contracture B. Hip adduction contracture C. Hip IR contracture D. Hip ER contracture
D. Hip ER contracture
Each of the following is characteristic of delayed-onset muscle soreness EXCEPT: A. Tends to peak 48 to 72 hours after the conclusion of high-intensity exercise. B. Increased soreness during passive lengthening of the involved muscle groups. C. Occurs more frequently after eccentric exercise than isometric exercise. D. Is believed to be caused by postexercise muscle spasm.
D. Is believed to be caused by postexercise muscle spasm.
CRPS type I (reflex sympathetic dystrophy) is defined as an extremely painful multisymptom syndrome involving many systems that is: A. Responsive and easily treated with modalities. B. Primarily psychomotor, resulting in weight changes and depression. C. Easily diagnosed with universal signs and symptoms. D. Accompanied by dystrophic and vascular changes and hyperesthesia.
D. Accompanied by dystrophic and vascular changes and hyperesthesia.
Which of the following is true regarding closed-chain exercise? A. It is less effective for developing co-activation of muscle groups and dynamic stability than open-chain training. B. Muscles develop strength more quickly than with open-chain exercise. C. It is a better choice than open-chain exercise to isolate and train weak muscle groups. D. Against similar exercise loads, it causes lower levels of shear in the joint than open-chain exercise.
D. Against similar exercise loads, it causes lower levels of shear in the joint than open-chain exercise.
Your patient complains of numbness in the hand and forearm whenever working for prolonged periods at the computer; the hand also develops a puffy sensation and occasionally turns blue. Adson's maneuver reproduces these symptoms. All of the following should directly help your patient with this problem and will be part of your treatment approach EXCEPT: A. Stretch the scalene muscles. B. Teach posture correction. C. Teach relaxed diaphragmatic breathing. D. Apply mechanical traction at 20lb for 20 minutes.
D. Apply mechanical traction at 20 lb for 20 minutes.
A patient is holding a piece of elastic tubing with both hands in front of the body. Both elbows are flexed to 90, and both upper arms are held gently against the sides of the patient's chest. Instruct the patient to internally and externally rotate both shoulders simultaneously in this position. This activity strengthens the: A. Internal rotators concentrically and eccentrically. B. External rotators concentrically and the internal rotators eccentrically. C. Internal rotators concentrically and the external rotators eccentrically. D. External rotators concentrically and eccentrically.
D. External rotators concentrically and eccentrically.
Which of the following functional activities should a patient avoid for the longest period of time after rTSA? A. Reaching overhead B. Hugging with both arms C. Reaching into abduction in the plane of the scapula at a drive-through window D. Fastening a bra behind the back
D. Fastening a bra behind the back
Which of the following best describes muscle strength? A. Ability of muscle to contract repeatedly against a load B. Work produced by a muscle per unit of time C. Produce or control forces imposed during functional activities D. Force generated during a single maximum effort
D. Force generated during a single maximum effort
Which of the following is true about total elbow arthroplasty (TEA)? A. A semiconstrained, linked prosthesis allows flexion and extension of the elbow but not varus, valgus, or rotational motions. B. The typical method of fixation of the implants is all-cementless (all-biological) fixation. C. The surgical approach most often used leaves the triceps tendon intact. D. One of the more common, long-term complications after TEA is joint instability, particularly with unlinked implants or if the patient previously underwent excision of the radial head.
D. One of the more common, long-term complications after TEA is joint instability, particularly with unlinked implants or if the patient previously underwent excision of the radial head.
Muscles that typically are shortened in patients with shoulder impingement syndrome are the: A. Teres major and minor, subscapularis, infraspinatus, and levator scapulae. B. Pectoralis major and minor, latissimus dorsi, infraspinatus, and teres minor. C. Pectoralis major and minor, teres major and minor, and serratus anterior. D. Pectoralis major and minor and the subscapularis and levator scapulae.
D. Pectoralis major and minor and the subscapularis and levator scapulae.
Your goal is to increase end-range elbow flexion using joint-mobilization techniques. Which of the following techniques is appropriate? A. Stabilize the distal humerus and apply a proximal glide of the ulna B. Apply a valgus stress at the elbow C. Stabilize the humerus and apply a dorsal glide to the head of the radius D. Stabilize the distal humerus and apply an ulnar (lateral) glide of the ulna
D. Stabilize the distal humerus and apply an ulnar (lateral) glide of the ulna
After closed reduction of an anterior dislocation of the glenohumeral joint, which of the following is the safest and most effective procedure to increase mobility of the joint for external rotation of the shoulder? A. With the shoulder in the resting position, apply a grade II distraction of the humerus. B. With the shoulder in the resting position, apply a grade III anterior glide of thehumerus. C. With the shoulder placed at the end of the available range of ER, apply a grade III anterior glide of the humerus. D. With the shoulder in the resting position, externally rotate the shoulder and apply a grade III distraction of the humerus.
D. With the shoulder in the resting position, externally rotate the shoulder and apply a grade III distraction of the humerus.