Ther ex. Final exam

Your patient is nearing the end of his rehabilitation for return to sport and is performing more of his program independently at home. As you are providing education regarding precautions and recognizing signs and symptoms, you discuss how much recovery time he should allow between sessions of high-intensity plyometric drills. Based on research, how much time do you suggest? A. 15-30 minutes B. 24 hours C. 48-72 hours D. 8-12 hours

C. 48-72 hours

Each of the following is an expected outcome of conservative management of osteoarthritis of the knees except: A. Maintaining functional range of motion and strength. B. Relieving pain. C. Regenerating worn articular cartilage. D. Preventing deformity.

C. Regenerating worn articular cartilage.

During closed-chain strengthening of the quadriceps, knee ROM in which the greatest amount of patellofemoral compression occurs is: A. At all portions of the ROM (i.e., compressive forces are equal throughout the ROM). B. Between 30° of knee flexion to full extension. C. Between 60° of knee flexion to 30° of knee flexion. D. Between 60° of knee flexion to full knee flexion.

D. Between 60° of knee flexion to full knee flexion.

Which of the following PROM exercises provides the most flexion of the lumbar spine? Single knee to chest Double knees to chest Posterior pelvic tilt with patient lying supine , Posterior pelvic tilt with the patient lying supine with hips/knees at 45°/90° ,

Double knees to chest

Individuals with symptoms from an intervertebral disk lesion and individuals with osteoporosis should not do: The drawing-in maneuver. , Anterior and posterior pelvic tilt motions. , Dynamic trunk flexion exercises. Stabilization exercises in the supine position.

Dynamic trunk flexion exercises.

Your examination of a patient who sustained a soft tissue injury reveals that she experiences pain only at the end of the available ROM when you apply overpressure. Based on this finding, which of the following would be the most appropriate technique to include in the treatment plan to decrease the patient's pain? Immobilize and rest the painful structures , Grades I and II joint distraction or gliding techniques End-range joint or muscle stretching techniques to increase the mobility of the tight structures , Progressive resistance exercises to work through the pain , Not Selected

End-range joint or muscle stretching techniques to increase the mobility of the tight structures

Which of the following techniques combines the application of sustained accessory joint movements by a therapist and active end-range physiological movements performed by the patient? Facilitative mobilization techniques , Mobilization with movement techniques Manipulative thrust techniques Muscle energy techniques ,

Mobilization with movement techniques

To increase glenohumeral abduction of the shoulder: I Mobilize the head of the humerus in a medial direction. Mobilize the head of the humerus in an inferior direction. Mobilize the head of the humerus in a lateral direction. , Not Selected Mobilize the head of the humerus in a superior direction. , Not Selected

Mobilize the head of the humerus in an inferior direction.

How do you stretch the gastrocnemius

knee straight

steppage is weak ..... rocking horse is weak trindelenburg is weak

dorsiflexors glute max hip abductors

Which of the following best describes scoliosis? A transverse plane deviation of the vertebrae usually involving the thoracic and lumbar regions , A lateral curvature of the spine wherein rotation of the vertebral bodies is toward the convexity of the curve An irreversible lateral curvature with fixed rotation of the vertebrae caused by lordotic posture A collapse of intervertebral space resulting from weakness of the deep segmental muscle of the spine ,

A lateral curvature of the spine wherein rotation of the vertebral bodies is toward the convexity of the curve

You are having a patient perform manual resistance exercise in a PNF pattern, specifically the D2 flexion pattern for the upper extremity. As the patient flexes the shoulder and brings the arm overhead against your resistance, what other muscle groups at the shoulder are being strengthened? A. Abductors and external rotators B. Adductors and external rotators C. Abductors and internal rotators D. Adductors and internal rotators

A. Abductors and external rotators

Contraindications to the use of plyometrics include all of the following except: A. Individuals under 10 years or over 70 years. B. Painful joints. C. Acute inflammation. D. Unstable joints.

A. Individuals under 10 years or over 70 years.

9. Which of the following signs and symptoms in the hip region and/or lower extremity is most consistent with the finding associated with trochanteric bursitis? A. Pain along the lateral aspect of the hip joint and possibly along the lateral thigh and knee to the insertion of the iliotibial band; pain typically worsens during long periods of asymmetrical standing with more weight shifted to the involved side B. Pain that becomes evident during extended periods of sitting, with most pain experienced in the buttock region over the ischial tuberosities C. Groin and anterior thigh pain that becomes evident or is aggravated during activities that require repetitive hip flexion D. Groin pain at rest that increases with weight bearing coupled with a positive Trendelenburg sign and pain with hip abduction

A. Pain along the lateral aspect of the hip joint and possibly along the lateral thigh and knee to the insertion of the iliotibial band; pain typically worsens during long periods of asymmetrical standing with more weight shifted to the involved side

A 40-year-old teacher who has been referred to you has experienced pain along the plantar aspect of the heel for more than 6 months. It is most noticeable when getting out of bed in the morning, upon standing after sitting for longer than 1 hour, and after playing racquetball. During walking, pain is most noticeable at the terminal stance/pre-swing phase of gait. The mostly likely disorder causing these symptoms is: A. Plantar fasciitis. B. Calcaneal bursitis. C. Achilles tendinitis. D. Posterior tibialis tendinitis.

A. Plantar fasciitis.

. All of the following risk factors are common to both coronary artery disease (CAD) and osteoporosis except: A. Prolonged use of corticosteroids B. Smoking C. Sedentary life-style D. Family history

A. Prolonged use of corticosteroids

Your patient has degenerative joint disease of the knees. Although currently her left knee is asymptomatic, she has been experiencing pain and periodic "giving way" of her right knee for the past week. Her physician prescribed anti-inflammatory medication to reduce joint swelling and pain and has referred the patient to you for evaluation and treatment. The patient is experiencing significant stiffness of the knee, especially in the morning and after sitting for an extended period of time. Although she indicates that pain and swelling have decreased during the past few days since she began taking the prescribed medication, pain is still notable during walking and with movement toward the end of the range of motion (ROM) (more so in flexion than extension). Knee ROM is limited (active and passive knee flexion 100°; passive knee extension lacks 10°; active knee extension lacks 20°). Strength of knee musculature is 4/5. She exhibits an antalgic gait pattern. Which of the following interventions is most appropriate for this patient at this time? A. Quadriceps setting exercises, active ROM within pain-free ranges, resisted multiple-angle isometrics, dynamic control of the knee with bilateral closed-chain exercises, activity modification, and use of a cane during ambulation B. Ice, rest, active-assistive ROM through the pain-free range, quads and hamstring setting exercises, ambulation with crutches until pain and swelling subside C. Low-intensity stretching to increase knee flexion, static and dynamic strengthening with unilateral closed-chain exercises, stationary cycling D. Activity modification and use for an assistive device during ambulation, vigorous resistance exercises of the asymptomatic knee to improve strength, isometric resistance exercise, eccentric but no concentric resisted exercises of the involved knee, low-intensity stretching

A. Quadriceps setting exercises, active ROM within pain-free ranges, resisted multiple-angle isometrics, dynamic control of the knee with bilateral closed-chain exercises, activity modification, and use of a cane during ambulation

When applying manual resistance to the upper extremity using the D1 extension pattern (PNF), the muscle groups being facilitated (strengthened) are the shoulder extensors and the: Abductors, internal rotators, and wrist and finger extensors. Adductors, internal rotators, and wrist and finger flexors. , Abductors, external rotators, and wrist and finger extensors. , Not Selected Adductors, external rotators, and wrist and finger flexors. , Not Selected

Abductors, internal rotators, and wrist and finger extensors.

You are part of a team presenting a preoperative education program for a group of patients scheduled to undergo total knee or hip replacement during the next month at a large medical center where you are employed. As a therapist, you most likely would be responsible for presenting information on each of the following topics except: An explanation and demonstration of exercises a patient is expected to do the day of or after surgery. An explanation of early postoperative precautions, such as weight-bearing restrictions or safe and unsafe positioning. , An explanation of the administration of postoperative pain medication, such as patient-controlled analgesics. Use of assistive devices, such as a walker or crutches, for early ambulation. ,

An explanation of the administration of postoperative pain medication, such as patient-controlled analgesics.

Active ROM is not possible at a joint that has undergone: Arthrodesis. Arthroplasty. Synovectomy. , Osteotomy. ,

Arthrodesis.

Pendulum (Codman's) exercises are used most effectively: As a grade III distraction technique to increase ROM when mobility of the scapula is normal but there is chronic stiffness of the glenohumeral joint. , To stretch the shoulder musculature and increase range of motion (ROM) when a patient does not have antigravity control of shoulder movement. , As a grade II oscillation technique to inhibit pain and maintain mobility. As a strengthening exercise when a weight is held in the hand or placed around the wrist.

As a grade II oscillation technique to inhibit pain and maintain mobility.

You are treating a patient with a painful shoulder as the result of supraspinatus tendonitis from chronic impingement. There is no evidence of tendon rupture or joint instability. Acute symptoms have subsided. Each of the following is appropriate to improve active elevation of the arm at this stage of rehabilitation except: Reinforce the importance of maintaining an erect trunk during elevation of the arm. , As the patient actively elevates the arm within the pain-free range, apply an anterior glide of the head of the humerus (mobilization with movement technique). Strengthen key scapular stabilizers, such as the serratus anterior, middle trapezius, and lower trapezius, in closed-chain and open-chain positions. , Teach the patient to apply cross-fiber massage to the supraspinatus tendon while it is on a stretch, followed by isometric contractions of t

As the patient actively elevates the arm within the pain-free range, apply an anterior glide of the head of the humerus (mobilization with movement technique).

Overuse syndromes occur: As the result of repetitive, submaximal stress of a muscle or tendon. As the result of a severe blow to a muscle. , As a result of prolonged immobilization. , Only if there is impaired circulation to soft tissue.

As the result of repetitive, submaximal stress of a muscle or tendon.

To teach a patient how to manage painful symptoms related to poor posture, which of the following is most important? Awareness of the relationship between the faulty posture and pain Stretching program , Strengthening program High-repetition, low-resistance exercise program , Not Selected

Awareness of the relationship between the faulty posture and pain Stretching program

13. Your uncle called you last night after playing three games in a softball tournament yesterday. He indicated that late in the third game while trying to stretch a double into a triple, he felt a sudden sharp pain in his calf, which significantly interfered with his ability to continue running. He is able to move his foot "up and down," but both motions are painful. He is also able to walk if he "takes it slow." From the information your uncle gave you and the fact that he is a 42-year-old weekend warrior, your preliminary hypothesis is that your uncle may have sustained a(n): A. Fracture of the tibia. B. Achilles tendon rupture. C. Plantaris rupture. D. Syndesmosis injury.

B. Achilles tendon rupture.

Which one of the following ligaments of the ankle is most frequently stressed with an inversion sprain? A. Posterior talofibular B. Anterior talofibular C. Calcaneofibular D. Deltoid

B. Anterior talofibular

Older adults become less efficient during gait. A common gait deviation that contributes to this inefficiency is: A. Faster gait speed. B. Lack of hip extension. C. Exaggerated heel strike. D. Narrow step width.

B. Lack of hip extension.

Although interventions used to manage patellofemoral pain syndrome are based on an examination of each patient on an individual basis, each of the following interventions is commonly employed except: A. Strengthening the knee and hip extensors in weight-bearing and non-weight-bearing positions. B. Lateral gliding of the patella. C. Stretching the tensor fasciae latae (TFL) and iliotibial (IT) band. D. Using an insert (orthotic device) in a patient's shoe to correct excessive foot pronation.

B. Lateral gliding of the patella.

The primary value of a patient performing quadriceps setting exercises when the knee is immobilized in a long leg cast for an extended period of time is to: A. Strengthen the quadriceps muscle. B. Maintain mobility of the patella. C. Stretch the anterior portion of the knee capsule. D. Prevent a knee extension contracture.

B. Maintain mobility of the patella.

Which of the following is a consideration when designing aerobic exercise programs for an older adult population? A. Aerobic exercise is contraindicated after age 80 unless it is performed in water. B. Maximum heart rate is age-related and decreases with age. C. Blood pressure decreases because of increased peripheral vascular resistance. D. Heart rate increases, resulting in greater cardiac stroke volume.

B. Maximum heart rate is age-related and decreases with age.

2. Your patient reports a sudden onset of severe pain yesterday in the (L) posterior thigh while sprinting. Today he is unable to fully extend his (L) knee while walking because of pain. Which of the following interventions is most appropriate to use when initiating therapy today? A. Passive knee flexion/extension within the pain-free range with the hip flexed to 90° B. Passive knee flexion/extension within the pain-free range with the hip positioned in 0° extension C. Active knee flexion but no passive or active extension D. Submaximal resisted knee flexion in the prone-lying position

B. Passive knee flexion/extension within the pain-free range with the hip positioned in 0° extension

All of the following are examples of plyometric activities for the upper extremities except: A. Overhead catching and throwing a weighted ball to a rebounder. B. Performing diagonal patterns with a barbell weight. C. Dribbling a basketball. D. Swinging a weighted golf club.

B. Performing diagonal patterns with a barbell weight.

Which of the following correctly identifies biomechanical abnormalities that contribute to patellofemoral pain or patellar instability? A. Genu varum, overstretched lateral retinaculum, weakness of the vastus medialis obliques (VMO) muscle, excessive supination of the feet, weakness of the hip adductors and internal rotators B. Weakness of the VMO, tight lateral retinaculum, genu valgum, excessive external tibial torsion, excessive pronation of the feet, weakness of the hip abductors and external rotators C. Excessive internal tibial rotation, genu varum, weakness vastus lateralis muscle, tight lateral retinaculum, excessive supination of the feet, weakness of the hip adductors and internal rotators D. Excessive external tibial torsion, genu valgum, weak vastus lateralis muscle, overstretched lateral retinaculum, excessive pronation of the feet, weakness of the hip abductors and external rotators

B. Weakness of the VMO, tight lateral retinaculum, genu valgum, excessive external tibial torsion, excessive pronation of the feet, weakness of the hip abductors and external rotators

Decreasing the amount of weight bearing by immersing more of a person's body in water is a result of what property of water? Viscosity , Hydrostatic pressure , Buoyancy

Buoyancy

During the initial assessment of a patient who complains of a recent onset of "knee pain" when descending stairs and a sense of "giving way" both on the stairs and when walking, you ask several questions about recent knee injuries. Which of the following injuries would lead you to believe the patient might have injured his ACL? A. A forward fall onto his knee directly striking his patella B. A blow to the inside of his knee when his dog was jumping up to greet him C. A twisting injury when he slipped off the curb and his knee buckled inward D. A running injury resulting in pain along the inferior border of the patella and the tibial tubercle

C. A twisting injury when he slipped off the curb and his knee buckled inward

Each of the following principles is important when designing a therapeutic exercise program to correct hip muscle length/strength imbalances except: A. When stretching the hip musculature, the spine and pelvis must be stabilized against the force. B. Contraction of the muscle opposite the range-limiting muscle (i.e., contracting the antagonist of the tight muscle) to assist with the stretching maneuver has the benefit of training the antagonist muscle to function in any newly gained range. C. Because of the functional demands placed on the lower extremities, it is more important to have full hip ROM than to have "normal" strength of hip musculature. D. Strengthening exercises should include closed-chain exercises to prepare for functional activities in weight-bearing postures.

C. Because of the functional demands placed on the lower extremities, it is more important to have full hip ROM than to have "normal" strength of hip musculature.

You are seeing a patient to initiate exercises 5 days after reconstruction of the ACL with a patellar tendon autograft. During the first phase of the postoperative exercise program, your primary concern is: A. Preventing contractures at the knee. B. Preventing atrophy and reflex inhibition of the quadriceps. C. Imposing controlled loads on the knee while protecting the graft from excessive stresses. D. Preventing joint swelling.

C. Imposing controlled loads on the knee while protecting the graft from excessive stresses.

You are initiating postoperative treatment for a 78-year-old woman who sustained an intertrochanteric fracture of the proximal femur 3 days ago and immediately underwent open reduction with internal fixation (screw-plate fixation). She has been referred to physical therapy for postoperative exercise and gait/functional training (initially with minimal weight bearing on the operated side). A decision has not yet been made about whether this patient will be discharged directly to home where she lives with her husband or to a subacute skilled nursing facility. Prior to discharge from the hospital during the next few days, which of the following is the lowest priority intervention? A. Gait training with a walker and transfer/bed mobility training B. Active-assistive range of motion (A-AROM), progressing to active range of motion (AROM) of the operated hip C. Open-chain, resistance exercises for the operated lower extremity D. Closed-chain, resisted exercises for the upper extremities and sound lower extremity, emphasizing extension in functional patterns

C. Open-chain, resistance exercises for the operated lower extremity

For an individual to be able to execute functional activities, it is necessary to have the ability to maintain the position of the body in equilibrium within the environment. This state of equilibrium is called: A. Power. B. Endurance. C. Postural stability. D. Strength.

C. Postural stability.

Plyometric drills are prescribed to improve which dimension of muscle performance? A. Balance B. Flexibility C. Power D. Endurance

C. Power

Your patient describes total numbness in the tips of the index and middle fingers that has been there for 2 months. Four months ago, he sustained a Colles' fracture. While immobilized in a cast, he had experienced periods of intermittent numbness and pain. You observe atrophy in the thenar eminence and ape hand deformity. This patient most likely sustained: Mild compression of the median nerve and has excellent prognosis for Laceration of the median nerve with complete interruption; there is no chance of neurological recovery. , Chronic compression of the median nerve; there is a guarded prognosis; may require surgical intervention. A stretch injury to the median nerve with adhesions preventing normal mobility; gentle nerve mobilization should alleviate the symptoms. , Not Selected Feedback

Chronic compression of the median nerve; there is a guarded prognosis; may require surgical intervention

When designing an exercise program to return a patient to his/her prior functional level, each of the following guidelines is true except: A. Proximal stability is a requirement for controlled distal mobility. B. Coordinated segmental and global stability of the spine is needed for execution of functional tasks with safe body mechanics. C. Stability of each joint is necessary for effective function of the extremities. D. Exercises for strength and power should precede balance and stability exercises.

D. Exercises for strength and power should precede balance and stability exercises.

Hip flexor structural or functional impairment will result in a change in the normal gait cycle. The therapist should suspect hip flexor dysfunction when observing gait and noting a: A. Lengthened stride. B. Posterior lurch of the trunk at foot contact. C. Lateral shift of the trunk over the stance leg when the opposite leg swings. D. Forward flexion of the trunk during weight bearing.

D. Forward flexion of the trunk during weight bearing.

Hip flexor structural or functional impairment will result in a change in the normal gait cycle. The therapist should suspect hip flexor dysfunction when observing gait and noting a: A. Lengthened stride. B. Posterior lurch of the trunk at foot contact. C. Lateral shift of the trunk over the stance leg when the opposite leg swings. D. Forward flexion of the trunk during weight bearing.

D. Forward flexion of the trunk during weight bearing.

Which of the following is a correct statement about arthrodesis of the hip? A. It is the surgery of choice for the elderly (greater than 75 years old) patient with an intertrochanteric fracture. B. It is commonly performed arthroscopically in young, active individuals. C. It is the procedure of choice for treating severe osteoarthritis that affects both the acetabular and femoral components of the hip. D. It is considered a salvage procedure when revision arthroplasty is not an option.

D. It is considered a salvage procedure when revision arthroplasty is not an option.

Which of the following is true of resistance training for the patient with known osteoporosis? Resistance training is contraindicated for patients with known osteoporosis due to the risk of pathological stress fracture. , Safe resistance training imposes only submaximal loads—no more than the patient encounters during activities of daily living. , Only isometric exercises should be prescribed in order to eliminate torque on the bones. , Evidence has shown that resistance exercise is an essential element in the rehabilitation, conditioning, and aerobic programs of patients both at risk for and with known osteoporosis.

Evidence has shown that resistance exercise is an essential element in the rehabilitation, conditioning, and aerobic programs of patients both at risk for and with known osteoporosis.

You are modifying a home exercise program for a patient recovering from an episode of medial epicondylitis. Although pain has subsided, there is evidence of mild limitation of motion and pain when the involved muscle-tendon unit is placed on a stretch and overpressure is applied at the end of the available ROM. To fully lengthen the muscle-tendon unit typically involved in medial epicondylitis, have the patient perform a self-stretch by using the opposite hand to: Extend and ulnarly deviate the wrist and extend the fingers while the elbow is extended and the forearm is pronated. , Flex and ulnarly deviate the wrist and flex the fingers while the elbow is extended and the forearm is pronated. , Flex and radially deviate the wrist and flex the fingers while the elbow is extended and the forearm is supinated. , Extend and radially deviate the wrist and extend the fingers while the elbow is extended and the forearm is supinated.

Extend and radially deviate the wrist and extend the fingers while the elbow is extended and the forearm is supinated.

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: Internal rotators concentrically and the external rotators eccentrically. , External rotators concentrically and eccentrically. Internal rotators concentrically and eccentrically External rotators concentrically and the internal rotators eccentrically.

External rotators concentrically and eccentrically.

The difference between a lordotic posture and a slouched posture is: Only the lordotic posture has lumbar lordosis. , Flexion in both the upper lumbar and lower thoracic spine occurs with the slouched posture. Extension of the pelvis on the femurs occurs with the lordotic posture. , There is no difference; both affect the pelvis and lumbar spine the same way.

Flexion in both the upper lumbar and lower thoracic spine occurs with the slouched posture.

The typical pattern of muscle activation associated with an ankle strategy to correct forward body sway is: Gastrocnemius and hamstrings are activated simultaneously, followed by the paraspinals. , Gastrocnemius is activated first, then the hamstrings, followed by the paraspinals. Paraspinals are activated first, then hamstrings, followed by the gastrocnemius. , Not Selected Hamstrings, gastrocnemius, and paraspinals are activated simultaneously.

Gastrocnemius is activated first, then the hamstrings, followed by the paraspinals.

A properly applied and progressed therapeutic exercise program should: Follow a pre-established protocol in order to be consistent for all patients with the same diagnosis. Push the patient beyond his or her current stage of recovery in order to progress the healing process. Grade the exercise to the stage of recovery to stress the tissues safely. ,

Grade the exercise to the stage of recovery to stress the tissues safely.

You are developing an exercise program for a patient who has adhesive capsulitis of the right shoulder. You have determined that the signs and symptoms identified during your examination are consistent with stage 2, the "freezing" stage, of this disorder. In addition to maintaining mobility of joints distal to the shoulder, which of the following interventions for the shoulder is most appropriate at this time? Grades I and II joint distraction and gliding techniques, pendulum exercises, passive or active-assistive ROM within pain-free ranges, and muscle setting exercises for shoulder musculature Gentle weight bearing on the involved upper extremity to develop scapular control and active ROM of the shoulder (e.g., wand and wall-climbing exercises) , Grade III joint-mobilization techniques, self-stretching, and strengthening exercises , Low-intensity progressive resistance exercise, mobilization with movement techniques, and manual stretching of the shoulder and scapular stabilization exercises with progressive weight bearing through the upper extremity , Not Selected

Grades I and II joint distraction and gliding techniques, pendulum exercises, passive or active-assistive ROM within pain-free ranges, and muscle setting exercises for shoulder musculature

One day following onset of pain and muscle guarding in the low back region, your patient stands with lumbar flexion and a sciatic scoliosis. Repeated flexion tests increase pain into the buttock. Repeated extension done after side gliding increases the pain in the midback and decreases the pain in the buttock. You begin treatment by: Positioning the patient supine and having him bring both knees to his chest. Placing the patient in intermittent traction at less than half his body weight for 20 minutes. , Having the patient lie prone and attempting passive extension with press-ups or prone propping maneuvers after side gliding the thorax.

Having the patient lie prone and attempting passive extension with press-ups or prone propping maneuvers after side gliding the thorax.

Muscle guarding is best treated by: Applying modalities and then massaging the muscle. , Identifying and treating the cause of the guarding. Gentle muscle setting exercises with the muscle in a shortened position. , Massaging the muscle. ,

Identifying and treating the cause of the guarding.

Treating the soft tissue of the back: Is more difficult than treating the extremities because of the way it is innervated. Is usually not necessary because most back pain results from dysfunction of the facets or disks. Involves using heat rather than cold, massage rather than exercise, and principles that in general are different from those used when treating the extremities. , In principle is no different from treating soft tissues in the extremities.

In principle is no different from treating soft tissues in the extremities.

When incorporating functional patterns into ROM interventions, which of the following guidelines is correct? Incorporate the functional movement into the patient's daily activities once the pattern can be performed safely and correctly, without assistance or compensation. PROM should always be performed in anatomical planes of motion to reinforce motor learning. Mechanical assistance should not be used for assisted ROM because it will reduce motor learning. , Patients with visual impairments should always perform ROM in anatomical planes, avoiding functional patterns, so that joint alignment is maintained. ,

Incorporate the functional movement into the patient's daily activities once the pattern can be performed safely and correctly, without assistance or compensation.

In what way does mobilization with movement (MWM) differ from passive mobilization techniques? MWM: Is performed only in the midrange of available motion to ensure patient comfort. Integrates active movements by the patient during the mobilization procedure to reduce/eliminate the barrier of pain during the technique. Uses only joint distraction techniques to mobilize joints. , Not Selected Is appropriate for hypomobile or hypermobile joints.

Integrates active movements by the patient during the mobilization procedure to reduce/eliminate the barrier of pain during the technique.

Postural stability of the spine is provided by: Elasticity of passive restraints. Interaction of passive restraints and muscle control. , Interaction of muscle control modulated by the central nervous system and passive restraints. Muscle activity maintaining balance in the neutral zone.

Interaction of muscle control modulated by the central nervous system and passive restraints.

Following recovery of a posterolateral disk protrusion, your patient will be returning to a job that requires prolonged forward bending and stooping. Your instructions to the patient must include: Interruption of the flexed postures at frequent intervals by standing upright and bending backward. Advice to quit that job and find one that is sedentary. , No advice—forward bending helps maintain mobility in the spine. , Preparing for the forward bending by posterior tilting of the pelvis before bending and stooping. ,

Interruption of the flexed postures at frequent intervals by standing upright and bending backward.

Each of the following is characteristic of DOMS except: Occurs more frequently after eccentric exercise than isometric exercise. Is believed to be caused by postexercise muscle spasm. Tends to peak 48 to 72 hours after the conclusion of high-intensity exercise. , Not Selected Increased soreness seen during passive lengthening of the involved muscle groups. , Not Selected

Is believed to be caused by postexercise muscle spasm.

Aerobic exercise training (cardiorespiratory endurance) is defined as improvement in the energy utilization of the muscle by means of an exercise program. Which of the following is true of this type of training? a. It is dependent on sufficient intensity, time, and frequency of exercise. b. It requires at least 6 months of progressive training for evidence of improvement. , c. It produces significant crossover effects from one physical activity to another. , d. A person with an initial high level of fitness has more potential to improve than one with a low level of fitness.

It is dependent on sufficient intensity, time, and frequency of exercise.

Which of the following are risk factors for secondary osteoporosis? Low body weight Family history of osteoporosis , Caucasian or Asian descent , Long-term use of corticosteroids

Long-term use of corticosteroids

Your patient has an "extensor lag" of the MP joints. What does this suggest? Posterior (dorsal) sliding of the proximal phalanx on the head of the metacarpal is restricted. , Full passive MP extension is not possible. , It is possible to extend the MP joint passively through the full range of extension, but full active MP extension is not possible, owing to weakness of the lumbricales. , It is possible to extend the MP joint passively through the full range of extension, but full active MP extension is not possible, owing to weakness of the extensor digitorum.

It is possible to extend the MP joint passively through the full range of extension, but full active MP extension is not possible, owing to weakness of the extensor digitorum.

Which of the following is true of a flat low-back posture? It is the best posture for a healthy spine. , It is typically associated with tight hip flexor muscles. ,: It reduces the shock-absorbing function of the spinal curves. It should be the goal of all back rehabilitation programs.

It reduces the shock-absorbing function of the spinal curves.

During your examination of a patient's lower extremity, you have identified tightness of the gastrocnemius muscle. You are teaching a patient to perform self-ROM exercises of the ankle. In order to maintain the gastrocnemius in a relaxed position while moving the ankle into full range of dorsiflexion available, the patient should: Actively flex the toes. Keep the knee flexed. Actively extend the toes. Keep the knee extended.

Keep the knee flexed.

Fundamental techniques that every patient with spinal impairments should learn before progressing to basic and advanced training exercises include: a. Strengthening exercises for the cervical and trunk stabilizers, including the abdominals, longus colli, quadratus lumborum, and cervical and lumbar multifidus muscles. , b. Safe use of weights and elastic resistance while maintaining the spine in a neutral posture. , c. Safe stretching techniques prior to any stabilization, strengthening, or power training. , d. Kinesthetic awareness of safe spinal positions and movement, activation of deep segmental muscles, and global muscle control of spinal posture when moving the extremities or moving from one position to another.

Kinesthetic awareness of safe spinal positions and movement, activation of deep segmental muscles, and global muscle control of spinal posture when moving the extremities or moving from one position to another.

How do you stretch the soleus?

Knee bent (flexed)

A patient referred to you in your home-health practice needs to spend the next 8 weeks on bed rest because of complications of pregnancy. You design an exercise program to reduce the adverse effects of prolonged bed rest. Which of the following is least likely to occur as the result of deconditioning from prolonged bed rest? Decreased bone mineral density Orthostatic hypotension Loss of muscle mass Laxity of ligaments

Laxity of ligaments

What is the best method for determining the progression of exercise during the subacute stage of healing? Increase range of motion 10° each treatment session Increase strength training by 1 lb each treatment session , Increase endurance exercises by 3 repetitions each treatment session , Let patient response guide the progression of exercise

Let patient response guide the progression of exercise

The ability of the body to transport and use oxygen during physical and aerobic activities is an indicator of physical fitness and is measured most commonly using which unit of measure? Kilocalorie Blood pressure and heart rate Metabolic equivalents (METs) Maximum oxygen consumption (VO2 max)

Maximum oxygen consumption (VO2 max)

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: Joint adhesions: use joint-mobilization techniques. , Median nerve adhesions: use nerve-mobilization techniques. Ligamentous stress from the surgery: use cross-friction massage. , Scar adhesions: mobilize the skin around the surgical site followed by range of motion (ROM) exercises.

Median nerve adhesions: use nerve-mobilization techniques.

Muscles that typically are shortened in patients with increased thoracic kyphosis; forward head; and protracted, forward tilted scapula are the: Pectoralis major and minor, latissimus dorsi, infraspinatus, and teres minor. , Pectoralis major, teres major and minor, and serratus anterior. , Teres major and minor, subscapularis, infraspinatus, and triceps. , Pectoralis minor, subscapularis, and levator scapulae.

Pectoralis minor, subscapularis, and levator scapulae.

Individuals who become unstable or fall in condition 5 (standing on foam with eyes closed) and condition 6 (standing on foam wearing a dome) during the Clinical Test of Sensory Integration on Balance Test (Foam and Dome Test) most likely have deficits in: Proprioception. , Somatosensation. Vestibular function. Vision.

Vestibular function.

Which of the following descriptions of stretching procedures performed for several repetitions during a single treatment session and repeated over a series of stretching sessions represents the safest and most comfortable process to achieve soft tissue lengthening? Slowly apply a low-load force; maintain the end-range position for an extended time period and release the stretch force slowly. In an end-range position, apply several high-intensity, rapid-velocity stretch forces. , Apply an end-range, high-load force slowly, maintain the end-range stretch for an extended time period, and release the stretch quickly. , Not Selected In an end-range position, apply several low-intensity, rapid-velocity stretch

Slowly apply a low-load force; maintain the end-range position for an extended time period and release the stretch force slowly.

Mrs. B is an 87-year-old resident of Western Hills Skilled Nursing Facility. She sustained a compression fracture of the T12 vertebra several weeks ago when she inadvertently sat down forcefully on a hard chair. Incorporating resistance training that focuses on eccentric exercises of her quadriceps and gluteal muscles in weight-bearing positions (e.g., controlled squatting and partial lunges) represents what principle of therapeutic exercise? Reversibility of training , Specificity of training Overload principle , Not Selected Overflow principle

Specificity of training

Patients with osteoporosis are at high risk for compression fractures of the vertebral bodies. The primary segments of the spine at risk are the thoracolumbar regions. When planning intervention programs for this high-risk population all of the following are appropriate except: Instruct in safe lifting techniques that minimize trunk flexion. , Teach stabilization exercises to develop spinal stability. , Not Selected Strengthen the abdominals without adding weight-bearing stress on the vertebrae by initiating sit-up exercises. teach postural awareness and scapular stabilization techniques to decrease the progression of thoracic kyphosis.

Strengthen the abdominals without adding weight-bearing stress on the vertebrae by initiating sit-up exercises.

Your patient has rheumatoid arthritis and currently is exhibiting acute symptoms in the wrist. This patient will benefit from grade I or II mobilization techniques at this time because these techniques: Reduce preexisting deformity. Increase the ROM by stretching restrictions. , Temporarily relieve pain, thereby allowing freer motion of the wrist. Retard synovitis and the progression of the disease process, if only temporarily.

Temporarily relieve pain, thereby allowing freer motion of the wrist.

In general terms, which of the following surgical procedures is performed primarily to release a contracture and improve range of motion (ROM)? Capsulorrhaphy Débridement , Osteotomy , Tenotomy

Tenotomy

Disk lesions are more common in the 30 year to 45 year age span because: The annulus begins degenerating, loses tensile strength, and begins to tear with excessive forces. The nucleus pulposus changes in chemical composition during this time and is capable of imbibing greater than normal amounts of water, causing greater than normal pressure against pain-sensitive structures. The facets are wearing out and the entire joint complex is placed under greater stress. , This is not the most common age span for disk lesions.

The annulus begins degenerating, loses tensile strength, and begins to tear with excessive forces.

To maintain gains in ROM achieved as the result of a stretching program, it is Apply heat on a daily basis to the lengthened muscle groups. , Perform daily resistance training of the stretched muscle. , Perform daily resistance training of the muscle group opposite the stretched muscle. , Use the stretch-induced gains in ROM during functional activities as soon as able on a regular basis.

Use the stretch-induced gains in ROM during functional activities as soon as able on a regular basis.

For a patient to be able to learn good body mechanics for lifting: The abdominal muscles must be strong enough to maintain a posterior pelvic tilt. , The patient must be able to maintain a neutral spinal posture against the force being lifted. The spine needs to be braced in extension by the trunk muscles. , Emphasis should be placed on strengthening the lower extremity musculature, not the spinal musculature.

The patient must be able to maintain a neutral spinal posture against the force being lifted.

To most effectively use the phenomenon of creep in a stretching routine: The force should be great enough to cause necking. , The tissues should be warmed and the force (load) maintained as long as tolerated. A high-intensity, rapidly applied force should be used. , Not Selected The force should be repeated in a cyclic manner.

The tissues should be warmed and the force (load) maintained as long as tolerated.

When a patient is involved in a stretching program, it is recommended that you: Warm up the tissues to be stretched by engaging in light-intensity active exercise or using therapeutic heat prior to stretching. Strengthen the muscle to be stretched in order to convert nondistensible, noncontractile tissue to easily distensible contractile tissue. , Avoid strengthening the muscle that has been stretched because it is easier to achieve elongation when the muscle is weak. , Avoid active exercises for warm-up prior to stretching because it may increase excitability of the muscle tissue and prevent relaxation during stretching.

Warm up the tissues to be stretched by engaging in light-intensity active exercise or using therapeutic heat prior to stretching.