Therapeutic Exercise - Final

Submaximal exercise loads are recommended for each of the following patients except a

40-year-old client who wants a conditioning program

Each of the following is a true statement about muscle strength and resistance training through the lifespan except

Although muscle strength tends to gradually decrease in middle age and older adults, weight training has been shown to be ineffective after the seventh decade of life

During ROM of the cervical spine

Always avoid grasping at the jaw

Which of the following terms is synonymous with a aerobic fitness and is associated with aspects of physical functioning that can be modified by a therapeutic exercise

Cardio pulmonary endurance

Each of the following is a true statement about isokinetic exercise except

Current technology provides resistance only to concentric muscle contractions

Which of the following passive ROM exercises provides the most flexion of the lumbar spine

Double knees to chest

You are helping a patient learn a motor skill. You set up at several variations of the same task (walking on several types of surfaces). You have the patient perform one variation of the task, you have him identify his own errors after the first repetition. Next, allow him to repeat the same variation of the task one or two more times before moving on to another variation of the task one or two more times. What term best describes this practice

Random blocked

Which of the following is not a precaution for stretching interventions

Soreness after previous session that lasted 4 hours

How does the APTA define muscle power

The work produced per unit of time

Which of the following is a true statement about the components of the patient management model described in the "guide to a physical therapist practice"

Therapeutic exercise is classified as a procedural intervention

When instructing a patient to perform isometric contractions, which of the following best describes the most appropriate sequence

Gradual 2 second development of tension, 6 second maintenance of maximum contraction, gradual 2 second decrease in tension

A long axis traction of the humerus provides which direction of gliding

Inferior

You've been doing AROM for the left hip adductor's and wish to challenge your patient to work this muscle group against gravity. Which of the following positions would you place them in

Left side lying

Actin and myosin are the two predominant proteins in which part of the muscle

Myofilaments

Which of the following terms best describes movement that a patient can control actively/voluntarily

Physiological Movement

Interventions to improve impaired mobility include all of the following except

Proprioceptive exercises

Movements of joint play can include any of the following except

Subluxation

In order to maintain the web space of the hand, it is important to maintain which of the following motions of the CMC joint of the thumb

Abduction and extension

Which of the following is true regarding closed chain exercises

Against similar exercise loads, it causes lower levels of shear in the joints than open chain exercises

Which of the following is a correct method to use an overhead pulley system safely and effectively for self assisted shoulder ROM exercises to avoid compression of the head of the humerus against the undersurface of the acromion process during shoulder abduction to an overhead position

Extend the elbow and point the thumb toward the ceiling when grasping the handpiece

The normal accessory joint movement of roll occurs with which of the following

Sliding

The safest form of stretch that yields the most long-term changes is the

Static stretch

Of the following which is the best definition of an 8 RM

The greatest amount of resistance (load) a patient can lift or lower through the available ROM for 8 repetitions (no more, no less).

The initial resting position of the femur to mobilize the joint is

30° hip flexion, 30° abduction, slight external rotation

The type of stretching technique that utilizes a high speed high intensity in short duration stretch force is called

Ballistic stretch

Self-feeding, hand to mouth, requires functional ROM of any of the following motions except

Forearm pronation

Which component of a resistance exercise program should be modified during the program to produce training induced improvement in muscle endurance

Loads and repetitions

Which of the following is not a benefit of using CPM

Long term functional gains

Which of the following best describes ROM exercises

Passive, assisted, or active movement of a body segment through the available range of motion

The ability of soft tissue to assume a new and greater length after a stretch force is removed is called

Plasticity

The concave convex rule says

Sliding direction is dependent on whether the moving joint surface is convex or concave

Each of the following is an indication that muscle fatigue is occurring when a patient is exercising against resistance except

Temporary loss of sensation in the exercising muscles

Which of the following statements about stretching is true

To stretch the posterior tibialis you dorsiflex and evert the foot and ankle

Which of the following is a contraindication to passive ROM exercises

When movement of a body segment is disruptive to the healing process

A sustained a joint play technique that has an amplitude large enough to place a stretch on the joint capsule is described as which of the following

Grade III

Which of the following components of patient management is within the scope of practice of a PTA

Implementation of appropriate interventions

If the strength of a muscle is a grade of 4/5 and active ROM cannot be done, repetitive setting exercises well accomplish each of the following except

Increase the strength of the muscle

While instructing a patient to fully elongate the latissimus dorsi muscle, you would have her place the limb in which position

Shoulder flexion, abduction, and external rotation

Which of the following is an example of task specific functional training

Sit to stand activities with a weighted backpack to improve strength for transfers

Which of the following positions offers the greatest protection of control of the upper extremity when performing self assisted shoulder flexion AAROM using a dowel rod

Supine

Patient satisfaction is an important area for outcome assessment in PT went following the patient management model. There are several determinants of patient satisfaction that, if included in the gathering and analysis of data, may help clinics to improve the quality of care being provided. Each of these has been shown in the literature to be determinants of patient satisfaction except

The chronicity of the patient's condition (higher satisfaction with a patient's having chronic conditions)

If a patient, who is in a prone-lying position with a cuff weights around his ankle, flexes his knee from a fully extended position to a fully flexed position, what type of contraction will occur in which muscle group

The knee flexors contract concentrically from 0° to 90°, and then the extensors contract eccentrically from 90° to 150° of flexion

To use the phenomenon of creep and a stretching routine most effectively

The tissue should be warmed and the force maintained as long as tolerated

Indications for AROM exercises can be any of the following except

To maintain general extremity strength and a region where there is acute inflamed tissue

Using the MMT testing grading scale, how would you record the muscle strength of a patient who is unable to provide resistance against gravity

3/5 (insert eye-roll)

You were having a patient performed manual resistance exercise in a PNF patterns, specifically the D2 flexion pattern for the upper extremity. As the patient flexes his shoulder and brings his arm overhead against your resistance, what other muscle groups at the shoulder of being strengthened

Abductors and external rotators

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 most effective process to achieve plastic lengthening of soft tissues

Apply and end range low load force slowly, maintain the end range position for an extended time, and release the stretch force slowly

To strengthen the posterior tibialis using manual resistance, have the patient assume a long sitting position on a table or a mat. Support and hold the lower leg with one hand and

Apply resistance to the plantar and medial surfaces of the foot at the first metatarsal as the patient plantar flexors and inverts the ankle and foot

Substitute motions by the patient during resistance exercise usually can be avoided by which of the following

Applying alignment and stabilization principles used for manual muscle testing MMT

To improve UE strength, stability, and proprioception, during which of the following variations of push-ups does body weight provide the greatest resistance

Bilateral push-ups while in a fully prone position on the floor with weight on the hands and toes

Helping a patient acquire the ability to shift his weight from side to side in a standing position by means of manual guidance by the therapist is called

Concurrent feedback

When applying a stretch, you first feel some resistance, as you maintain the stretch, you feel as though you can move into a greater range using the same amount of force. This describes what mechanical property of connective tissue

Creep

Which progressive resistance exercise program does the following describe? Three sets of 10 repetitions of exercises, with the first set performed at 50% of 10 repetitions maximum, the second set at 75% of 10 repetitions maximum, and the third set at 100% of 10 repetitions maximum

DeLorme

All of the following can cause impaired ROM except

Early movement after surgery

Which type of muscle contraction is sometimes called the lengthening contraction

Eccentric

Mr. J underwent a repair of a torn biceps brachii two days ago. During passive ROM exercises, which combination of motions should you avoid at end range to protect the healing tissue

Elbow extension, shoulder extension, forearm pronation

The common substitution for shoulder internal and external rotation to watch for in a patient positioned supine for self ROM is

Elbow flexion and extension

To help reduce post stretch soreness after stretching into shoulder flexion cold should be applied with the limb in which of the following positions

End range shoulder flexion

Which of the following is a goal of passive range of motion exercises

Enhance movement of synovial fluid for articular cartilage nutrition

The best way to develop effective treatment procedures is to use which of the following

Evidence-based practices

With the patient in a supine position, you are passively stretching the hamstrings of the R lower extremity. To provide effective stabilization and minimize unwanted movement you should

Extend the L hip and knee and keep the L leg flat on the table to prevent a posterior pelvic tilt as you stretch the R hamstrings

During active ROM exercises, which of the following structures is most elongated with full active extension and ulnar deviation of the wrist if the fingers remain relaxed

Flexor carpi radialis

Which of the following is a false statement about joint mobilization

Grade IIII mobilizations can be used safely and effectively to increase the ROM during an acute flare of arthritis when there's loss of motion

You are treating a patient with weak hip abductors (muscle grade is 2/5). Which of the following ROM exercises is most appropriate to prevent tightness of the hip ADductors And maintain the current level of strength of the hip ABductors

Have the patient perform his active hip abduction through the available ROM while positioned in the supine position as you support the weight of the leg

Your goal is to improve lower extremity proprioception, balance, and strength. Which of the following close chain exercises is the most challenging

Have the patient stand on 1 foot on a piece of foam and maintain balance

Of the following, which is the most effective way to improve muscle endurance

Have the patient train using dynamic exercise against submaximal loads over progressively longer time periods

A person who has been on extended bed rest has a hip contracture that place is the hip in a position of lateral rotation you note in your documentation that your patient has a

Hip external rotation contracture

The goal of this exercise is to increase the flexibility of the pectoralis major muscle. You teach the patient to stay in facing a corner with the shoulders abducted and 90°, elbows flex to 90°, and hands and forearms placed on the walls. You tell the patient to relax in to the stretch by leaning into the corner for 30 seconds, pushes forearms into the walls for a count of six, then relax and lean forward towards the corner again and hold for 30 seconds. The self stretching technique the patient is using is

Hold relax/contract relax

Following surgery and eight weeks of rehabilitation for carpal tunnel syndrome, you notice that the patients thenar eminence is almost the same size as that of the uninvolved hand, this changes due to which of the following adaptive changes

Hypertrophy of muscle fibers

The most effective results of a continuous passive motion CPM can be expected

If the device is applied as early as possible after surgery for at least 4 to 8 hours per day

Within one week of beginning resistance exercise of the shoulder external rotators as a component of a rehabilitation program after a shoulder injury, your patient, Mr. Kg, is able to increase the level of resistance by using a heavier grade of elastic tubing. This improvement in muscle performance is due primarily to which of the following adaptive changes

Increased recruitment of motor units

Select the most widely used and clinically relevant method of objective, reproducible strength testing

Isokinetic testing

The PT has finished applying shoulder joint mobilization techniques and just asked you to instruct the patient in interventions to maintain the new ROM. You could choose from any of the following except

Isometric strengthening of targeted muscle groups

Which of the following is an incorrect statement about hypo mobility

It is usually associated with joint instability

Indications for joint mobilization include the following except

Joint effusion

During your examination of a patient's LE, you have identified tightness of the gastroc muscle. You were teaching a patient to perform self ROM exercises of the ankle in order to maintain the gastroc in a relaxed position with moving the ankle into full range of dorsiflexion available the patient should

Keep the knee flexed

You were asked to do selective stretching with a patient with a SCI. You allow tightness of which of the following muscle groups to optimize the function of trunk stability for long sitting

Low back extensors

To increase terminal knee extension, position the patient prone so the lower leg is not supported on the treatment table. The patient relaxes while the lower leg and foot hang off the end of the table. The therapist adds a cuff weight around the ankle. What type of stretching procedure is being applied

Mechanical

Joint mobilization techniques are thought to be safer than passive angular stretching using physiological ROM to increase mobility of capsular and ligamentous structures because

Mobilization techniques direct forces specific to the involved capsular and ligamentous tissues without causing compressive damage to the articular cartilage

A type of joint mobilization that includes an isometric muscle contraction to cause accessory movement of the joint is

Muscle energy

Climbing stairs is an example of which of the following

OKC and CKC exercise

Select the guiding principle of exercise prescription that is demonstrated by applying a load to a muscle that exceeds the metabolic capacity of the muscle

Overload principle

Mr. Z is a 68-year-old gentleman who underwent abdominal surgery three months ago. Since his surgery he has had difficulty walking. You determine that during the period of bed rest and modified activity his legs have become quite weak, contributing to his difficulty walking. The AROM of his lower extremities is within normal limits. You determine that the 10 RM (repitition max) for the hip extensors and quadriceps bilaterally is only 20 pounds. after a brief warm up on a stationary bicycle, you have Mr. Z perform the following progressive resistive exercise regimen, 10 repetitions of hip and knee extension against 20 pounds, 10 repetitions against 15 pounds, and 10 repetitions against 10 pounds with a rest between each set of 10 repetitions. This approach to PRE is known as

Oxford regimen

You test the muscle strength of the middle deltoid and determine it to be a 2/5. The goal of an exercise you were having a patient do is to increase muscular endurance of the middle deltoid. Of the exercises described, which is most appropriate to meet the goal at this point in the exercise program

Place the patient in a supine position on a large mat, as you support the weight of the arm, have the patient abduct through the full ROM as many times as possible against a minimal amount of manual resistance

Of the following choices which is the most appropriate application of the hold relax method of muscle inhibition and elongation of the gastroc muscle? Extend the patient's knee, stabilize the lower leg, and:

Placed the patient's ankle and as much dorsiflexion as is comfortable, have the patient isometrically contract the plantar flexors against resistance for 6 to 10 seconds. Then have the patient relax as you passively dorsiflex the ankle

Your patient develops a contracture as a result of hypertonicity after a traumatic brain injury. This type of hip contracture is called a

Pseudomyostatic contracture

The principle of resistance training that suggests adaptive changes are transient unless a person participates in a maintenance program is which of the following

Reversibility principal

What are the primary differences between the slow twitch muscle fibers and the fast twitch muscle fibers

Slow twitch fibers are designed for endurance, fast twitch fibers are designed for speed strength and power

Miss V is an 87-year-old resident of Western Hills skilled nursing facility. She sustained a compression fracture of the T 12 vertebrae several weeks ago when she inadvertently sat down forcefully on a hard chair. Incorporating resistance training that focuses on eccentric exercises of her quads and gluteal muscles in weight-bearing positions represents what principle of therapeutic exercise

Specificity of training

Which is the safest (for protection of the long arch of the foot) and most effective way to apply a long duration self stretch of the gastroc soleus muscle group

Stand on a solid wedge for an extended period of time (5°, 10°, or 15° angle)

When a patient is involved in a stretching program, it is recommended that you

Strengthen the muscles that have been stretched through the newly gained range immediately after stretching

Which factors affect the amount of resistance provided by elastic resistance bands during exercise

Stretch of the band and angle of the band in relation to the moving bone

Which of the following forms of resistance training is most appropriate for a nine-year-old child with weakness of the elbow musculature as a result of an elbow sprained, followed by several weeks of elbow immobilization combined with daily active non-resisted range of motion

Underhanded bilateral toss of a weighted ball

Safe and effective methods for applying passive joint mobilization techniques include all the following except

Use of the thumbs to deliver the treatment force is preferred to reduce contact surface for patient comfort

To maintain gains in ROM achieved as a result of a stretching program, it is recommended to

Use the stretch induced gains in range of motion during functional activities on a regular basis

You were treating a patient who sustained an anterior dislocation of the glenohumeral joint. When it is permissible for the patient to begin self assisted or active ROM of the involved shoulder within pain-free ranges, which of the following exercises places is the most stress on the anterior aspect of the capsule at the end range of external rotation, therefore posing the greatest risk of re dislocating the involved shoulder

Wand exercises while lying in the supine position with both shoulders abducted to 90° (upper arms supported on the treatment table)And both elbows flexed to 90°

What is the safest and most effective way of stretching the multi joint flexor digitorum profundus

With the wrist stabilized in a neutral position, first extend the DIP joint, then the PIP joint, then the MCP joint of each finger (for stretching multi joint muscles, begin stretch at most distal joint first)

The type of stretch technique that has a low velocity in short duration is called a

cyclic stretch

Which of the following best describes the rule of tens when applied to isometric exercise

10 second contraction, 10 repetitions, 10 second rest

You are trying to decide if it is time to increase resistance while strength training your patient. Current recommendations are to increase if they can do which of the following volumes without fatigue

6 to 12 repetitions, 2 to 3 sets