MSII Finale

Each of the following is an indication that muscle fatigue is occurring when a patient is exercising against resistance except: A.Muscular tremor occurring during the exercise. B.A gradual increase in temperature (sensation of warmth) in the exercising muscles. C.The patient may not be able to complete the available ROM against the initial level of resistance applied. D.The patient may attempt to use a substitute motion and muscle group to perform the exercise.

A. A gradual increase in temperature (sensation of warmth) in the exercising mms.

Each of the following is a true statement about muscle strength and resistance training through the life span except: A.Although muscle strength tends to gradually decrease in middle-aged and older adults, weight training has been shown to be ineffective (does not lead to adaptive strength gains or functional improvement) after the seventh decade of life. B.During the early and middle childhood years prior to puberty, muscle strength increases linearly and is reasonably similar (as little as a 10% difference) in boys and girls. C.During puberty, although greater muscle hypertrophy occurs in boys than girls as the result of resistance training, relative training-induced strength gains are comparable between the sexes. D.During late adulthood, muscle atrophy occurs to a greater extent in type II than type I muscle fibers.

A. Although mms strength tends to gradually decrease in middle-aged and older adults, weight training has been shown to be ineffective (does not lead to adaptive strength gains or functional improvement) after the 7th decade of life

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 mms. contractions

Your goal is to improve lower extremity proprioception, balance, and strength. Which of the following closed-chain exercises is the most challenging? A.Have the patient stand on one foot on a piece of foam and maintain his balance. B.Have the patient kneel in an upright position on a piece of foam and shift his weight from side to side. C.Have the patient stand on the floor on one leg and maintain his balance. D.Have the patient stand on the floor with weight equally distributed on both feet and throw and catch a ball.

A. Have the patient stand on one foot on a piece of foam and maintain his balance

Within 1 week of beginning resistance exercise of the shoulder external rotators as a component of a rehabilitation program after a shoulder injury, your patient, Mr. K, 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? A.Increased recruitment of motor units B.Increased oxygen to the muscle C.Hypertrophy of muscle fibers D.Fiber-type transformation from slow twitch to fast twitch

A. Increased recruitment of motor units

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? A.Specificity of training B.Reversibility of training C.Overflow principle D.Overload principle

A. Specificity of Training

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

Each of the following is correct about precautions that should be taken after repair of a full-thickness rotator cuff tear associated with chronic impingement except: A.After a traditional open repair for a massive cuff tear, postpone active ROM exercises until about 2 weeks postoperatively to avoid avulsion of the deltoid that was detached and reattached during the procedure. B.When the patient is lying in the supine position during the early postoperative days, place a folded towel under the humerus to position the arm slightly anterior to the frontal plane of the body to minimize anterior translation of the head of the humerus and the potential for impingement. C.Before initiating active elevation of the arm in the sitting or standing positions, restore strength in the rotator cuff muscles, especially the supraspinatus and infraspinatus muscles, to prevent superior translation of the head of the humerus during active elevation of the arm. D.Delay weight-bearing/closed-chain exercises on the operated upper extremity for about 6 weeks.

A.After a traditional open repair for a massive cuff tear, postpone active ROM exercises until about 2 weeks postoperatively to avoid avulsion of the deltoid that was detached and reattached during the procedure.

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).

To strengthen the posterior tibialis using manual resistance, have the patient assume a long sitting position on a table or mat. Support and hold the lower leg with one hand and: A.Apply resistance to the plantar and medial surfaces of the foot at the first metatarsal as the patient plantar flexes and inverts the ankle and foot. B.Apply resistance to the plantar and lateral surfaces of the foot at the fifth metatarsal as the patient plantar flexes and everts the ankle and foot. C.Apply resistance to the dorsal and medial surfaces of the foot at the first metatarsal as the patient dorsiflexes and inverts the ankle and foot. D.Apply resistance to the dorsal and lateral surfaces of the foot at the fifth metatarsal as the patient dorsiflexes and everts the ankle and foot.

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

John is a 25-year-old active athlete and outdoorsman who suffered a severe lateral ankle injury 5 years ago, resulting in progressive subtalar arthritis, pain, and instability of the ankle and hindfoot. His quality of life and ability to work are now restricted due to the pain and instability despite repeated sessions in therapy. The surgical procedure of choice for John is most likely: A.Arthrodesis (fusion). B.Arthroplasty (TAA). C.Brostrom procedure. D.Watson-Jones procedure.

A.Arthrodesis (fusion).

Pendulum (Codman's) exercises are used most effectively: A.As a grade II oscillation technique to inhibit pain and maintain mobility.? B.As a strengthening exercise when a weight is held in the hand or placed around the wrist. C.To stretch the shoulder musculature and increase ROM when a patient does not have antigravity control of shoulder movement. D.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.

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

Which of the following is true regarding aquatic therapy equipment? A.Buoyancy equipment placed anteriorly will facilitate posterior movements of the trunk in the vertical position. B.Buoyancy equipment used for supine positioning is ideal to assist with stabilization needed for eccentric manual resistance exercises. C.Nonbuoyant equipment used underwater provides resistance opposite the direction of movement. D.Using equipment to increase the surface area of an extremity underwater decreases resistance.

A.Buoyancy equipment placed anteriorly will facilitate posterior movements of the trunk in the vertical position.

Each of the following is true about postoperative management after primary total knee arthroplasty (TKA) except: A.Based on the design of the prosthesis, the use of grade III posterior joint gliding techniques may be an appropriate intervention to increase knee flexion after cruciate-excising TKA but not after cruciate-retaining TKA when stretching is permissible. B.If the TKA involved cementless fixation, weight-bearing recommendations vary widely from weight bearing as tolerated while using a walker or crutches to touch-down weight bearing for 4 to 6 weeks after surgery. C.Although straight-leg-raising exercises for the operated lower extremity are initiated in supine and prone positions as soon as possible during the early postoperative period, they often are delayed for several weeks in side-lying positions to avoid varus/valgus stresses on the operated knee. D.Participation in high-impact physical activities should be avoided after TKA, as it may contribute to mechanical loosening of the implanted prosthesis over time.

A.Based on the design of the prosthesis, the use of grade III posterior joint gliding techniques may be an appropriate intervention to increase knee flexion after cruciate-excising TKA but not after cruciate-retaining TKA when stretching is permissible.

Your patient has rheumatoid arthritis and is complaining of pain in her ankles and feet when walking. You observe her gait and notice short steps and poor push-off. This is consistent with what deformity in rheumatoid arthritis? A.Everted calcaneus and pronated forefoot B.Inverted calcaneus and pronated forefoot C.Everted calcaneus and supinated forefoot D.Inverted calcaneus and supinated forefoot

A.Everted calcaneus and pronated forefoot

Each of the following is an expected improvement after total ankle arthroplasty for advanced arthritis except: A.Increased mediolateral stability of the ankle. B.Alleviation of pain. C.Sufficient range of motion of the ankle for functional activities. D.Decreased joint deformity.

A.Increased mediolateral stability of the ankle.

A patient with a history of recurrent dislocation of the patella underwent a surgical procedure for realignment of the extensor mechanism. Considering the position of immobilization postoperatively, you would expect to find each of the following impairments when it is permissible to begin exercises except: A.Lack of full or almost full passive knee extension. B.Quadriceps lag. C.Lack of full knee flexion. D.Weakness of the quadriceps and hamstrings.

A.Lack of full or almost full passive knee extension.

If a patient who has an inflammatory muscle disease such as polymyositis engages in a vigorous resistance training program, it is possible that irreversible progressive deterioration, rather than improvement, in muscle strength can occur. The term that best describes this phenomenon is: A.Overwork weakness. B.Progressive muscle fatigue caused by overtraining. C.Muscle overload. D.Delayed-onset myopathy.

A.Overwork weakness.

Meyer and Leblanc provided an algorithm for clinical decision making for aquatic therapy intervention for patients with stable congestive heart failure and/or left ventricular dysfunction. All of the following are true in this algorithm except: A.Patients with decompensated congestive heart failure should participate in aquatic exercise for cardiac rehabilitation. B.Patients with left ventricular dysfunction should not rely on how they feel in the water as an indicator of tolerance for aquatic exercise. C.Patients with congestive heart failure who tolerate sleeping supine may be able to tolerate a half-sitting position if immersion is not above the xiphoid process. D.Patients with Q-wave myocardial infarcts should wait 6 weeks and exercise upright in a water level that does not exceed the xiphoid process.

A.Patients with decompensated congestive heart failure should participate in aquatic exercise for cardiac rehabilitation.

Which of the following statements is true regarding the temperature range of water (26°-33°C) recommended for aquatic exercise? A.Perform cardiovascular exercise at the low end of this range. B.Patients with multiple sclerosis should exercise in temperatures at the high end of this range. C.Perform intense aerobic exercise at the high end of this range. D.If a patient has an acute, painful injury, perform exercise at the low end of this range.

A.Perform cardiovascular exercise at the low end of this range.

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

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/preswing 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.

Which of the following is true about postoperative precautions and the rate of progression of rehabilitation after surgery for glenohumeral instability? A.Progress upper extremity weight-bearing exercises more slowly/cautiously after surgery for posterior instability than for anterior instability. B.Progress exercises more slowly/cautiously if the origin of the instability was traumatic versus atraumatic. C.Progress exercises more slowly/cautiously after an arthroscopic capsular shift involving imbrication and suturing the capsule than after an arthroscopic thermally assisted capsular shift. D.Progress ROM into internal rotation more slowly/cautiously after surgery for anterior instability than for posterior instability.

A.Progress upper extremity weight-bearing exercises more slowly/cautiously after surgery for posterior instability than for anterior instability.

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

Following a severe (grade 3) inversion sprain, your patient complains of pain just distal and lateral to the knee joint. The pain is likely the result of: A.Subluxation of the proximal tibiofibular joint. B.Tear of the lateral collateral ligament. C.Tear of the lateral head of the gastrocnemius. D.Referred pain from gait deviations due to sore ankle joints and ligaments.

A.Subluxation of the proximal tibiofibular joint.

Your patient has only 50° of passive and active knee flexion (but full passive extension) 2 weeks after removal of a cast for a fracture of the tibia. The bone is now radiologically healed. Each of the following techniques will be of value to increase the range of knee flexion except: A.The hold-relax technique, with isometric contraction of the hamstrings with the knee at 45°, followed by relaxation, then passive movement into more flexion. B.Low-load, long-duration self-stretching of the quadriceps. C.Posterior glide of the tibia. D.Caudal glide of the patella.

A.The hold-relax technique, with isometric contraction of the hamstrings with the knee at 45°, followed by relaxation, then passive movement into more flexion.

Which of the following special tests may be used to confirm or rule out a rupture of the Achilles tendon during a physical examination of a patient? A.Thompson test B.Anterior drawer of the ankle C.Talar tilt test D.Test for Homan's sign

A.Thompson test

After a musculoskeletal injury of the lower extremity, you develop an aquatic exercise program for your patient. An aquatic exercise program is the least effective for: A.Transfer of training to land-based functional activities. B.Reducing risk of reinjury during the early stage of rehabilitation. C.Enabling early weight bearing. D.Increasing ROM.

A.Transfer of training to land-based functional activities.

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

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

Of the following, which is the most effective way to improve muscle endurance? A.Have the patient train on an isokinetic dynamometer at fast speeds only B.Have the patient train using dynamic exercise against submaximal loads over progressively longer time periods C.Have the patient exercise against maximal resistance for a limited number of repetitions D.Have the patient train by using isometric exercises against resistance

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

Which of the following is true regarding isokinetic exercise? A.Joint compressive forces increase with increased velocity of exercise. B.Load is dependent on the velocity of limb movement through the arc of motion. C.Slow-velocity training is more appropriate for carryover to functional activities than medium and fast velocities. D.Depending on the type of isokinetic dynamometer used, the rate of limb movement may range from 0° to 500° per minute.

B. Load is dependent on the velocity of limb movement through the arc of motion

Mr. Z is a 68-year-old man who underwent abdominal surgery 3 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 ROM of his lower extremities is within normal limits. You determine that the 10 RM for the hip extensors and quadriceps bilaterally (measured on a bilateral leg press unit) is only 20 lb. After a brief warm-up on a stationary bicycle, you have Mr. Z perform the following PRE regimen: 10 repetitions of hip and knee extension against 20 lb; 10 repetitions against 15 lb; and 10 repetitions against 10 lb with a rest between each set of 10 repetitions. This approach to PRE is known as: A.Circuit weight training. B.Oxford regimen. C.DeLorme regimen. D.DAPRE regimen.

B. Oxford regimen

If a patient, who is in a prone-lying position with a cuff weight around his ankle, flexes his knee from a fully extended (0°) position to a fully flexed (150°) position, what type(s) of contraction will occur in which muscle group(s)? A.The knee flexors contract concentrically through the full ROM. B.The knee flexors contract concentrically from 0° to 90°, and the knee extensors contract eccentrically from 90° to 150° of flexion. C.The knee flexors contract eccentrically from 0° to 90°, and the knee extensors contract concentrically from 90° to 150° of flexion. D.The knee flexors contract eccentrically throughout the full ROM.

B. The knee flexors contract concentrically from 0-90 degrees and the knee extensors contract eccentrically from 90-150 deg of flexion

When an exercise involves using the same muscle group to lift and lower a constant load, such as flexing and extending the elbow while standing and holding a weight, which of the following is correct about the effect of this exercise on the tension generated by the musculature? A.Greater muscle tension develops when the weight is lowered (controlled by an eccentric contraction) than when it is lifted and controlled by a concentric contraction. B.When the weight is lowered (controlled by an eccentric contraction), fewer motor units are recruited, and thus less tension is generated, than when the weight is lifted (controlled by a concentric contraction). C.The same tension is generated in the muscle during the lifting and lowering phases of the exercise because the greatest resistance (load) is imposed by the weight at the same point in the ROM. D.Greater energy expenditure is necessary during the eccentric phase of the exercise than during the concentric phase.

B. When the weight is lowered ( controlled by an eccentric contraction), fewer motor units are recruited, and thus less tension is generated, than when the weight is lifted ( controlled by a concentric contraction).

Each of the following is true about patellar tendon versus hamstring tendon autografts for anterior cruciate ligament reconstruction except: A.A longer healing time and a more slowly progressed rehabilitation program are required with a hamstring tendon graft than a patellar tendon graft. B.A patellar tendon graft rather than a hamstring tendon graft is appropriate for the skeletally immature patient. C.Anterior knee pain and difficulty kneeling are somewhat frequent complications with a patellar tendon graft but not with a hamstring tendon graft. D.A patellar tendon graft involves bone-to-bone fixation, whereas a hamstring tendon graft involves tendon-to-bone fixation.

B.A patellar tendon graft rather than a hamstring tendon graft is appropriate for the skeletally immature patient.

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

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

Decreasing the amount of weight bearing by immersing more of a person's body in water is a result of what property of water? A.Viscosity B.Buoyancy C.Surface tension D.Hydrostatic pressure

B.Buoyancy

In an aquatic environment, manual resistance exercises of the extremities typically involve which type of muscle contractions? A.Eccentric, closed-chain (distal segment fixed) B.Concentric, closed-chain (distal segment fixed) C.Isometric D.Concentric, open-chain (distal segment moving)

B.Concentric, closed-chain (distal segment fixed)

During initial evaluation of a patient with a complaint of low back pain, you perform a standing posture alignment screening and discover that his left leg appears shorter than the right as you compare iliac crests, greater trochanter, head of the fibula, and medial malleolus. What related possible foot deformity should you look for while still in standing? A.Excessive right foot pronation compared to the left B.Excessive left foot pronation compared to the right C.Excessive left foot supination compared to the right D.Hallux valgus on the right

B.Excessive left foot pronation compared to the right

A patient underwent a triple arthrodesis of the hindfoot 12 weeks ago and is now allowed to ambulate without the rigid boot. The patient has been referred to you for exercises to improve range of motion and strength of the operated lower extremity and to reestablish a normal gait pattern. Which of the following interventions is inappropriate to include in your treatment plan to restore this patient's function? A.Passive stretching of the plantar flexors B.Grade III medial and lateral sustained glides to increase inversion and eversion C.Grade III sustained posterior glides of the talus on the tibia to increase dorsiflexion D.Closed-chain training to improve lower extremity control

B.Grade III medial and lateral sustained glides to increase inversion and eversion

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.

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 a true statement about surgical repair of the rotator cuff and postoperative management? A.Regardless of the size of the cuff tear, the shoulder is immobilized in an abduction splint for a period of time after surgery. B.If the size and severity of the tears are similar, rehabilitation after repair of an acute, traumatic cuff tear typically progresses more rapidly than after repair of an atraumatic tear associated with chronic impingement. C.Detachment of the deltoid from its proximal insertion is a necessary component of a traditional open repair or an arthroscopically assisted repair (mini-open). D.The quality of the patient's tissues (tendon and bone) has little to no impact on the progression of rehabilitation.

B.If the size and severity of the tears are similar, rehabilitation after repair of an acute, traumatic cuff tear typically progresses more rapidly than after repair of an atraumatic tear associated with chronic impingement.

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.

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.

A surgical procedure for a repair of a chondral defect of the medial femoral condyle involves the following: harvesting multiple plugs of intact articular cartilage along with some subchondral bone of the patient's own tissue from a donor site (typically a non-weight-bearing portion of the joint surface) and implanting the plugs (using a press fit) into the site of the articular lesion. This procedure is called: A.Autologous chondrocyte implantation. B.Osteochondral autograft transplantation. C.Microfracture. D.Debridement and lavage.

B.Osteochondral autograft transplantation.

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

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.

To selectively strengthen the flexor digitorum superficialis using manual resistance exercise, position the patient's forearm in supination and wrist in neutral on a table; then: A.Stabilize the MCP and PIP joints in neutral, then apply resistance to the distal phalanx as the patient flexes the DIP joint. B.Stabilize the MCP and DIP joints in neutral, then apply resistance to the middle phalanx as the patient flexes the PIP joint. C.Stabilize the PIP and DIP joints in neutral, then apply resistance to the proximal phalanx as the patient flexes the MCP joint. D.Without additional stabilization, apply resistance to the distal phalanx and ask the patient to flex the MCP, PIP, and DIP joints simultaneously.

B.Stabilize the MCP and DIP joints in neutral, then apply resistance to the middle phalanx as the patient flexes the PIP joint.

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 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 internal rotation) 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 internal rotation) by placing the wand behind the back and sliding it up the back

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

It has been shown that after performing resistance exercise to the point of exhaustion, recovery from exercise (recovery from fatigue) occurs most efficiently if: A.The fatigued muscle rests completely during recovery. B.Cold is applied to the fatigued muscle. C.The patient performs low-intensity, active exercise using the fatigued muscle. D.The muscle is passively stretched during recovery.

C. The patient performs low-intensity, active exercise using the fatigued mms.

When a person is standing in chest-deep water, the percentage of weight bearing is approximately what percentage of body weight? A.10% B.20% C.33% D.50%

C. 33%

Which of the following is a contraindication to implementing resistance exercise? A.Risk of pathological fracture 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 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

All of the following are true of the repetition maximum (RM) except: A.RM can be used to document a baseline for a muscle group's dynamic strength. B.A 1-RM can be mathematically calculated from a patient's ability to perform multiple reps at a reduced load. C.Establishing a 1-RM involves trial and error and so has been determined to be invalid for use in research studies for resistance training. D.RM is an effective way to determine an appropriate exercise load to begin and progress strength training.

C. Establishing a 1-RM involves trial and error and so has been determined to be invalid for the use in research studies for resistance training

A patient had surgery and 8 weeks of rehabilitation for carpal tunnel syndrome. You notice that the patient's thenar eminence is almost the same size as that of the uninvolved hand. This change is due to which of the following adaptive changes? A.Increased recruitment of motor units B. Hyperplasia of muscle fibers C. Hypertrophy of muscle fibers D. Fiber-type transformation

C. Hypertrophy of mms fibers

If the strength of a muscle is "good" (grade 4/5) 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 an awareness of the sensation of a muscle contraction. C.Increase the strength in the muscle. D.Enhance circulation within the muscle.

C. Increase the strength of the mms.

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

Which of the following is a true statement about glenohumeral arthroplasty? A.Hemiarthroplasty is most often performed using an arthroscopic approach. B.The primary indication for glenohumeral arthroplasty is limited mobility of the shoulder. C.A reverse total shoulder arthroplasty (rTSA) is an appropriate design for a patient with marked instability of the glenohumeral joint and a rotator cuff that is not repairable. D.For adequate exposure of the joint during surgery, the muscle that routinely must be released (and reattached prior to closure) is the anterior deltoid.

C.A reverse total shoulder arthroplasty (rTSA) is an appropriate design for a patient with marked instability of the glenohumeral joint and a rotator cuff that is not repairable.

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

Which of the following is true about managing a tear of the medial or lateral meniscus? A.A tear of the peripheral portion (outer zone) of a meniscus does not lend itself well to surgical repair because this portion of the meniscus is avascular and does not heal well. B.A potential complication of a medial meniscus repair is intraoperative damage to or postoperative entrapment of the saphenous nerve. C.After meniscus repair, initially avoid knee flexion beyond 60° to 70° during weight-bearing exercises for about 2 months because flexion beyond this range can displace the repaired meniscus in a posterior direction. D.After meniscus repair, the knee is immobilized in approximately 45° of flexion.

C.After meniscus repair, initially avoid knee flexion beyond 60° to 70° during weight-bearing exercises for about 2 months because flexion beyond this range can displace the repaired meniscus in a posterior direction.

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: A.Reinforce the importance of maintaining an erect trunk during elevation of the arm. B.Teach the patient to apply cross-fiber massage to the supraspinatus tendon while it is on a stretch, followed by isometric contractions of the muscle. C.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). D.Strengthen key scapular stabilizers, such as the serratus anterior, middle trapezius, and lower trapezius, in weight-bearing and non-weight-bearing positions.

C.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).

Which of the following is true of resistance training for the patient with known osteoporosis? A.Safe resistance training imposes only submaximal loads; no more than the patient encounters during ADLs. B.Only isometric exercises should be prescribed in order to eliminate torque on the bones. C.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. D.Resistance training is contraindicated for patients with known osteoporosis due to the risk of pathological stress fracture.

C.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.

Which of the following most accurately describes the deformities that progressively develop in rheumatoid arthritis of the foot/ankle? A.Fixed supination of the foot, hallux valgus, hallux rigidus, dorsal subluxation of the proximal phalanges on the metatarsal heads B.Fixed pronation of the foot, hallux valgus, hallux rigidus, plantar subluxation of the proximal phalanges on the metatarsal heads C.Fixed pronation of the foot, hallux valgus, hallux rigidus, dorsal subluxation of the proximal phalanges on the metatarsal heads D.Fixed supination of the foot, hallux valgus, hallux rigidus, plantar subluxation of the proximal phalanges on the metatarsal heads

C.Fixed pronation of the foot, hallux valgus, hallux rigidus, dorsal subluxation of the proximal phalanges on the metatarsal heads

A quadriceps lag may be described as: A.Patient has full active knee extension but exhibits increased time to peak torque when knee extensors are evaluated on an isokinetic dynamometer. B.Patient has full passive knee flexion but limited passive knee extension. C.Patient cannot actively extend the knee to full extension even though there is full passive knee extension. D.Another term for knee extension contracture.

C.Patient cannot actively extend the knee to full extension even though there is full passive knee extension.

Of the following activities, which is the most appropriate choice for developing stability of the scapulothoracic joint? A.While in the supine position, have the patient perform repeated concentric contractions of the scapular protractors against manual resistance applied to the anterior aspect of the shoulder. B.While standing, have the patient place the arms in a reverse-T position while holding a piece of elastic tubing between the hands. Then have the patient attempt to "pinch the shoulder blades together" repeatedly against the elastic resistance. C.Have the patient stand, face a wall, place the hands on the wall, and lean into the wall as the therapist applies alternating resistance against the shoulders. D.Have the patient hold the arms in various positions in space (perform isometric contractions) as the therapist applies resistance in various directions.

C.Have the patient stand, face a wall, place the hands on the wall, and lean into the wall as the therapist applies alternating resistance against the shoulders.

Which of the following is true about total knee arthroplasty (TKA)? A.When a cruciate-retaining prosthesis/procedure is used for a TKA, the anterior cruciate ligament (ACL) is not excised, thus providing greater anterior-posterior stability to the knee. B.A tricompartmental TKA involves replacing not only the articulating surfaces of the proximal tibia and distal femur, but also the tibiofibular articulation. C.If a semiconstrained or unconstrained prosthetic implant is used, the medial and lateral collateral ligaments (MCL and LCL) must be intact or repairable for adequate postoperative medial-lateral stability of the replaced joint. D.A mobile-bearing prosthesis typically is selected for the elderly, relatively sedentary patient because this design permits earlier weight bearing than a fixed-bearing design.

C.If a semiconstrained or unconstrained prosthetic implant is used, the medial and lateral collateral ligaments (MCL and LCL) must be intact or repairable for adequate postoperative medial-lateral stability of the replaced joint.

You are seeing a patient to initiate exercises 5 days after reconstruction of the anterior cruciate ligament (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.

If present, which of the following conditions is a contraindication to having a patient perform an exercise program in an aquatic environment? A.Tracheotomy B.Fear of water C.Influenza D.High blood pressure

C.Influenza

Activation of the VMO is crucial for strengthening the quadriceps and developing appropriate patellar tracking. Which of the following exercises is the most effective to selectively activate and train the VMO, according to the literature and current research? A.Closed-chain mini-squat to 30° B.Open-chain supine SLR to 15° with isometric ADD of the hip C.Isometric quad sets coupled with electrical stimulation or biofeedback D.Open-chain short-arc quad terminal extension from 20° flexion to full extension

C.Isometric quad sets coupled with electrical stimulation or biofeedback

While playing tennis, Mr. K sustained a grade 3 tear of the Achilles tendon and subsequently underwent a surgical repair of the tendon. His wound is now well healed, and he is permitted to immerse the incision site in water. His goal for therapy is to return to tennis competitively. To challenge his balance on the involved lower extremity, you have him stand in front of a strong, single stream of water (jet) while trying not to use his arms for balance. This activity applies which hydromechanics property of water? A.Drag B.Viscosity C.Laminar flow D.Turbulent flow

C.Laminar flow

Which of the following is true about ligament injuries of the knee and postinjury management? A.The most common mechanism of injury of the anterior cruciate ligament (ACL) is forceful internal rotation of the tibia while the foot is planed. B.Under similar, noncontact conditions, a man is far more likely to injure the ACL than a woman. C.MCL injuries are managed nonoperatively more often than are ACL, PCL, or LCL injuries. D.Forceful hyperextension of the knee is the most common mechanism of injury of the PCL.

C.MCL injuries are managed nonoperatively more often than are ACL, PCL, or LCL injuries.

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.

Your patient has regained normal strength and range of motion during rehabilitation following a traumatic injury that severely stressed several ligaments and joints of the ankle. He continues to have problems while walking, including stumbling and poor control while walking on gravel or other uneven surfaces. To remedy this problem, your exercise program should focus on: A.Strengthening exercises for the invertor and evertor muscles of the ankle using elastic resistance. B.Stretching the invertor and evertor muscles of the ankle. C.Performing balance training with closed-chain disturbed balance activities on a rocker/balance board. D.Practicing walking on uneven surfaces while wearing a custom-made ankle/foot orthosis that controls inversion and eversion.

C.Performing balance training with closed-chain disturbed balance activities on a rocker/balance board.

You test the muscle strength of the middle deltoid and determine it to be 2/5. The goal of an exercise you are 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? A.Place the patient in a side-lying position and have her actively abduct the arm without assistance as many times as possible. B.Place the patient in a sitting position with the elbow flexed and have her abduct the arm through the full ROM 8 to 10 times against light resistance. C.Place the patient in a supine position on a large mat. As you support the weight of the arm, have the patient abduct the arm through a full ROM as many times as possible against a minimal amount of manual resistance. D.Have the patient assume the supine position. Provide as much assistance as needed to enable the patient to flex the shoulder from 0° to 90° for as many repetitions as possible.

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

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.

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 has a diagnosis of rheumatoid arthritis and is developing a capsular pattern in the foot and ankle. Which joint-mobilization technique could perpetuate or worsen the impairment/deformity typically associated with RA of the foot and ankle? A.Stabilize the mortise and glide the talus in an anterior direction B.Stabilize the calcaneus and glide the cuboid in a plantar direction C.Stabilize the talus and glide the navicular in a dorsal direction D.Stabilize the talus and glide the calcaneus in a lateral direction

C.Stabilize the talus and glide the navicular in a dorsal direction

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

Research studies in the literature surrounding ACL rehabilitation have coined the terms "potential copers" and "potential noncopers" to identify and classify individuals with ACL injury who are good versus poor candidates for nonoperative rehabilitation. "True copers" applies to individuals who: A.Resolve personally to use a gait-assistive device and reduce their activity level to avoid surgery and have no incidence of knee buckling for at least 1 year. B.Complete a course of rehabilitation in preparation for surgical repair of the ACL in order to return to vigorous work or sporting activities within 1 year of injury. C.Successfully return to full pre-injury activity 1 year after injury with no episodes of knee buckling, following a rehab program without surgery. D.Do nothing and develop a quad avoidance gait pattern within 1 year of injury.

C.Successfully return to full pre-injury activity 1 year after injury with no episodes of knee buckling, following a rehab program without surgery.

The ability of the body to regulate temperature must be considered with the prescription of aquatic therapy for both the healthy and the rehabilitating patient. All of the following are true of temperature regulation except: A.The body is not as efficient at dissipating heat in the water as it is on land. B.Patients are unable to maintain adequate core warmth at water temperatures below 25°C. C.The ambient air temperature should be equal to the water temperature to avoid overheating or chilling while in the pool area. D.Water temperatures above 37°C cause increased cardiac demand both at rest and while exercising, especially with prolonged time or deep immersion.

C.The ambient air temperature should be equal to the water temperature to avoid overheating or chilling while in the pool area.

Each of the following is true about surgical repair/reconstruction of the lateral ligament complex of the ankle and postoperative management except: A.The most common procedure is a direct repair and imbrication of the torn ligaments through an open surgical approach. B.After reconstruction of the lateral ligaments that includes a tendon autograft and tendon transposition (often the peroneus brevis tendon) to reinforce the lateral aspect of the ankle, there may be some permanent loss of full ankle inversion postoperatively. C.The ankle is immobilized in plantarflexion and slight eversion for 4 to 6 weeks postoperatively; therefore the patient must remain non-weight-bearing on the operated lower extremity during the period of immobilization to prevent rupture of the repair site. D.It is usually permissible to remove the ankle immobilizer by about 4 to 6 weeks postoperatively to begin active range of motion exercises of the ankle.

C.The ankle is immobilized in plantarflexion and slight eversion for 4 to 6 weeks postoperatively; therefore the patient must remain non-weight-bearing on the operated lower extremity during the period of immobilization to prevent rupture of the repair site.

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.Free weights 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

Which of the following best describes cross-training or cross-exercise, a phenomenon that has been observed as a result of resistance training? A.When resistance exercise is carried out by a muscle, the antagonist to that muscle also shows an increase in strength. B.When exercise is carried out concentrically against resistance, an increase in eccentric muscle strength in the same leg also occurs. C.When resistance exercise is carried out by a muscle group on the right side of the body, small gains in strength occur in the same unexercised muscle on the opposite side of the body. D.When training is carried out for the purpose of developing strength, muscular endurance also develops in that same muscle.

C.When resistance exercise is carried out by a muscle group on the right side of the body, small gains in strength occur in the same unexercised muscle on the opposite side of the body.

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.

Which of the following best defines 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 forms of resistance training is most appropriate for a 9-year-old child with weakness of the elbow musculature as the result of an elbow sprain, followed by several weeks of elbow immobilization combined with daily active (nonresisted) ROM? A.High-load, low-repetition biceps curls on equipment specifically designed to adjust to a child's body proportions B.Low-load, high-repetition biceps curls on equipment usually used by the adult patient population C.Supervised exercise by unlicensed support personnel D.Underhand bilateral toss of a weighted ball

D. Underhand bilateral toss of a weighted ball

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: A.Adductors, internal rotators, and wrist and finger flexors. B.Abductors, external rotators, and wrist and finger extensors. C.Adductors, external rotators, and wrist and finger flexors. D.Abductors, internal rotators, and wrist and finger extensors.

D.Abductors, internal rotators, and wrist and finger extensors.

The difficulty of exercises can be controlled with the depth of immersion and the body's physiological response to hydrostatic pressure. According to Barbosa and colleagues, which of the following best describes a proper progression of a patient's exercise program in order to increase physiological demands? A.Land exercises to aquatic chest depth to hip depth B.Aquatic hip depth to neck depth to land exercises C.Alternate land exercises with aquatic chest depth exercises D.Aquatic chest depth to hip depth to land exercises

D.Aquatic chest depth to hip depth to land exercises

During closed-chain strengthening of the quadriceps, the range of knee motion (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 is true of pools used for aquatic therapy? A.Ventilation is not necessary for installation of a self-contained, individual pool in your clinic. B.Therapeutic pools should not have a depth that exceeds 6 feet because of safety requirements in case of a medical emergency. C.One disadvantage of a self-contained individual pool is the inability to incorporate a treadmill. D.Built-in filtration systems are available in both therapeutic pools and self-contained pools.

D.Built-in filtration systems are available in both therapeutic pools and self-contained pools.

Which of the following describes the research evidence regarding the effective treatment of delayed onset muscle soreness (DOMS) once it occurs? A.Modalities consisting of ES and cold are the only treatments that are consistently effective at reducing muscle soreness experienced with DOMS. B.Postexercise massage reduces both the signs and symptoms of DOMS in the elite athlete but not in the casual athlete. C.Use of compression sleeves on the affected muscles improves the strength deficits that occur as a result of DOMS. D.Continuation of the training program that has induced DOMS does not worsen the muscle damage or slow the process of recovery.

D.Continuation of the training program that has induced DOMS does not worsen the muscle damage or slow the process of recovery.

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

Each of the following is true about guidelines for rehabilitation after a procedure to repair an articular cartilage defect except: A.ROM exercises (within a protected range) typically are begun a few days postoperatively. B.Protective bracing is worn during early weight bearing and exercises. C.The larger the articular defect, the slower the progression of postoperative rehabilitation. D.There is a longer period of protected weight bearing after microfracture than after an osteochondral autograft transplantation or autologous chondrocyte implantation.

D.There is a longer period of protected weight bearing after microfracture than after an osteochondral autograft transplantation or autologous chondrocyte implantation.

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? A.Low-intensity PRE, mobilization with movement techniques, and manual stretching of the shoulder and scapular stabilization exercises with progressive weight bearing through the upper extremity. B.Grade III joint-mobilization techniques, self-stretching, and strengthening exercises. C.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). D.Grade 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.

D.Grade 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.

Your patient sustained a fracture of the right calcaneus as the result of a motor vehicle accident 3 months ago. After 10 weeks in a cast followed by a rocker bottom immobilization boot that prevented ankle and foot motion, the fracture shows radiological evidence of bony union. The patient has been ambulating (weight bearing as tolerated) while wearing the boot and is now supposed to discontinue wearing it slowly. Your examination reveals marked limitation of dorsi- and plantarflexion and a high, rigid arch. There is no visible swelling, and pain (2/10) occurs at the end of the day and during passive range of motion (PROM) with overpressure. Which of the following is the most appropriate intervention during the first week of therapy? A.PROM of the ankle (dorsiflexion/plantarflexion and calcaneal inversion/eversion) B.Gentle passive stretching of ankle musculature C.Grade II joint mobilization at the subtalar joint D.Grade III joint mobilization at the midtarsal joint

D.Grade III joint mobilization at the midtarsal joint

If a patient has lower extremity edema, which of the following principles associated with hydrotherapy (an aquatic environment) will assist with decreasing the edema? A.Viscosity B.Buoyancy C.Surface tension D.Hydrostatic pressure

D.Hydrostatic pressure

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.

The "minimally invasive knee arthroplasty" is a more recent surgical approach for performing TKA. When the surgeon chooses this approach, it is because: A.It is easier to perform and therefore is the choice of the less-experienced surgeon. B.The incidence of intraoperative complications is lower. C.It is an arthroscopic procedure, so the rehabilitation is shorter. D.It is less disruptive to the soft tissue, with increased rate of post-op recovery and less post-op pain.

D.It is less disruptive to the soft tissue, with increased rate of post-op recovery and less post-op pain.

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 patient has a capsular pattern, decreased joint play in the knee, and restricted mobility of the patella after a prolonged period of immobilization following a fracture. Which of the following mobilization techniques can be used to increase knee flexion? A.Posterior glide of the tibia on the femur with the tibia positioned in lateral rotation; caudal glide of the patella B.Posterior glide of the tibia on the femur with the tibia positioned in lateral rotation; superior glide of the patella C.Posterior glide of the tibia on the femur with the tibia positioned in medial rotation; superior glide of the patella D.Posterior glide of the tibia on the femur with the tibia positioned in medial rotation; caudal glide of the patella

D.Posterior glide of the tibia on the femur with the tibia positioned in medial rotation; caudal glide of the patella

Your patient had a total hip replacement several weeks ago. Now that her incision is well healed, she has clearance from her orthopedic surgeon to begin an aquatic exercise program to improve lower extremity strength. Which combination of the following patient positions and velocities of limb movement in water is the most appropriate to begin to improve the strength of the hip abductors/adductors at the initiation of the aquatic exercise program? A.Fast repetitions while standing in chest-deep water B.Slow, controlled motions while standing in chest-deep water C.Fast repetitions, buoyancy-supported in a supine position D.Slow, controlled repetitions buoyancy-supported in supine position

D.Slow, controlled repetitions buoyancy-supported in supine position

Each of the following is a true statement about total ankle arthroplasty (TAA) and postoperative rehabilitation except: A.At the close of surgery, the foot and ankle typically are immobilized in a neutral position in a well-padded compression dressing and short-leg posterior splint. B.A patient with peripheral arterial disease of the lower extremities in addition to advanced arthritis of the ankle is not an appropriate candidate for TAA. C.After a TAA that involved biological fixation, weight bearing on the operated lower extremity during ambulation with a walker initially is permissible only while wearing an ankle immobilizer and may need to be partially restricted for several weeks to allow time for some degree of bio-ingrowth to occur. D.TAA is an appropriate procedure for a patient with advanced arthritis combined with marked instability of the ankle.

D.TAA is an appropriate procedure for a patient with advanced arthritis combined with marked instability of the ankle.

Of the following, which is the best definition of an "8 RM"? A.The number of repetitions of a particular exercise a patient can perform in 8 seconds against a specific load (amount of resistance) B.The number of sets (bouts) of a specific exercise a patient can perform for 8 repetitions C.The greatest amount of resistance (load) a patient can lift or lower through the available ROM in 8 seconds D.The greatest amount of resistance (load) a patient can lift or lower through the available ROM for 8 repetitions (no more, no less)

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

Which of the following describes the most effective patient position and use of the buoyancy of water for self-stretching the hamstrings? A.In a buoyancy-supported supine position (flotation devices around the neck and hips), perform a unilateral straight-leg raise, lifting the leg to be stretched out of the water. B.With a buoyancy device secured around the distal thigh of the leg to be stretched, stand on the opposite leg and hold on to the side of the pool for balance. Keep the knee relaxed as the buoyancy device lifts the thigh and flexes the hip. C.Sit on the steps of a pool in waist-deep water, hips flexed to 90°, with a buoyancy device secured around the ankle of the leg to be stretched. D.With a buoyancy device secured around the ankle of the leg to be stretched, stand on the opposite leg and hold on to the side of the pool for balance. Allow the buoyancy device to lift the leg to the surface of the water with the knee extended.

D.With a buoyancy device secured around the ankle of the leg to be stretched, stand on the opposite leg and hold on to the side of the pool for balance. Allow the buoyancy device to lift the leg to the surface of the water with the knee extended.

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 the humerus. C.With the shoulder placed at the end of the available range of external rotation, 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.