Physical Agents Final Exam Review

13. Match each term below with a point on the accompanying illustration depicting stimulus-duration curves that corresponds best with the associated level of stimulation. Each term has only one correct point, but a point may correspond with more than one term. *Functional electrical stimulation (FES): *Interferential stimulation: *Strong, low rate TENS: *Pain gating: *EMS for denervated muscles: *Microcurrent: *Brief, intense TENS:

*Functional electrical stimulation (FES): C *Interferential stimulation: B *Strong, low rate TENS: C *Pain gating: B *EMS for denervated muscles: E *Microcurrent: A *Brief, intense TENS: D

61. According to your textbook, name another method of traction that a person can perform at home.

Answer: Inversion or gravity.

1. Match the statements below with the labeled points on the strength-duration curve that represent levels of suitable stimulation? Brief-intense TENS: Neuromuscular reeducation: Point stimulation (hyperstimulation): Microcurrent stimulation: Electrical muscle stimulation: Pain masking or pain gating:

Brief-intense TENS: B Neuromuscular reeducation: C Point stimulation (hyperstimulation): B Microcurrent stimulation: E Electrical muscle stimulation: A Pain masking or pain gating: D

1. Motorized traction is quite effective at providing a localization of force to a specific spinal segment. True False

False

10. Application of a biophysical agent can be expected to directly improve a patient's ability to perform an activity such as ascending a flight of stairs. True False

False

11. All pulsed currents are interrupted direct current. True False

False

11. Ultraviolet energy lies in the ionizing radiation portion of the EM spectrum True False

False

14. Use of the Boolean operator OR to combine two database search terms is likely to decrease the number of results obtained by the search. True False

False

16. The primary way in which an individual is able to increase the force of a muscle contraction (or the amplitude of the EMG signal) is by recruiting additional motor units. True False

False

17. If the subject's skin becomes slightly red following preparation for EMG electrode application, the tester has been overly vigorous in his/her preparation technique. True False

False

3. In order to be effective, the amount of force applied during pneumatic compression must be greater than the diastolic blood pressure. True False

False

34. An increase in connective tissue extensibility can be achieved when a thermal modality produces a moderate level of heating. True False

False

4. For most large muscles, a clinician can expect a nearly linear relationship between EMG amplitude and muscle force production. True False

False

5. Energy attenuation occurs mainly as a result of scattering and reflection. True False

False

5. The Guide to Physical Therapist Practice suggests that it is preferable to employ biophysical agents in the absence of other interventions. True False

False

7. You are conducting an infrared treatment. If you increase the distance between the light source and the surface of the skin, you will decrease the intensity of the heat by twice the amount of the distance change. True False

False

8.A tissue high in water content will more readily absorb US energy than SWD energy. True False

False

9. Needle EMG is more functional than surface EMG. True False

False

*Decision making related to the application of physical agents is very well supported by solid research evidence. True False (We still have a long way to go)

False (We still have a long way to go)

7. Match the types of evidence with their appropriate position on the EBP pyramid. Systematic review: Randomized controlled trial: Cohort study: Case series: Expert opinion:

Systematic review: #1 Randomized controlled trial: #2 Cohort study: #3 Case series: #4 Expert opinion: #5

12. The direction of energy transfer during a whirlpool treatment depends on the relative difference between the temperatures of the water and the skin. True False

True

15. Skin impedance of less than 10 KOhms is generally considered desirable during surface EMG measurement. True False

True

8. When using EMG Biofeedback for relaxation, a patient is instructed to decrease the muscle activity through mental effort. True False

True

9. The different levels of a PICO search should be combined in a search engine using the Boolean operator AND. True False

True

2.The delivery intensity of a diathermy treatment is chosen by: a. A dosage descriptor (Dose I - IV) determined by patient report b. The amount specified in a physician prescription c. A mathematical formula that incorporates the variables of distance from the patient, percent body fat, depth of target tissue, and frequency of energy applied d. None of the above

a. A dosage descriptor (Dose I - IV) determined by patient report

9. Normalization is: Select all that apply a. A method of counteracting the influence of the detection condition on the EMG signal amplitude b. A maximum contraction of an individual muscle against a static resistance c. One way of decreasing variability and thereby increasing statistical power when trying to make quantitative comparisons among individuals or muscles d. A good way of controlling for contraction differences that may occur as a result of pain e. Most commonly accomplished using an MVC

a. A method of counteracting the influence of the detection condition on the EMG signal amplitude c. One way of decreasing variability and thereby increasing statistical power when trying to make quantitative comparisons among individuals or muscles e. Most commonly accomplished using an MVC

2. Which of the following does NOT belong in the list of elements of evidence-based practice? a. Allocate b. Apply c. Appraise d. Acquire

a. Allocate

2. Which of the following statements is the reason we take all of the different factors into consideration (research evidence, patient personal factors, clinical expertise, setting, etc) during decision making about biophysical agents. a. Considering all these factors gives us the highest level of confidence in our decisions. b. If we consider all these factors, we can be certain that our treatments will have the effects we want. c. We can accurately predict the patient's response to the treatment if we consider all factors. d. Because the research in physical therapy is lacking, we need to consider additional factors.

a. Considering all these factors gives us the highest level of confidence in our decisions.

6. According to Ohms law, when using a device that has a constant voltage, what will happen to the current when the skin impedance increases? a. Current decreases. b. No change in current c. Current increases d. The patient will feel a short duration shock

a. Current decreases. Sometimes a moistened electrode will dry out, increasing impedance, decreasing current flow and decreasing treatment effectiveness. Conversely, If you decrease impedance in the circuit the current increases and may cause a surprising or even painful increase in current. This can happen if a patient moves and puts pressure or body weight on an electrode, so caution the patient to be careful with movement during treatment.

14.Which is a physiologic response to cold therapy following acute injury? a. Decreased white blood cell count b. Increased muscle tone related to a decrease in afferent muscle spindle discharge c. Decreased joint stiffness d. Decreased nerve conduction velocity greatest in small, unmyelinated nerves

a. Decreased white blood cell count

7. Which cervical position is recommended for cervical traction? a. Depends on pathology and exam findings b. Slight cervical extension c. Neutral cervical spine d. 15 degrees-35 degrees cervical flexion

a. Depends on pathology and exam findings

18. Which type(s) of current waveform is (are) most likely to cause changes in the tissues underlying the electrodes as a result of electrode polarity? a. Direct current b. Monophasic pulsed current c. Balanced, asymmetrical biphasic pulsed current d. Burst modulated alternating current

a. Direct current

*Which of the following statements are true regarding evidence-based practice (EBP)? a. EBP requires that clinicians regularly ask clinically important. (Asking questions and then seeking the best answers is one of the main principles of EBP) b. Current research findings should always take precedence over individual patient presentation c. Clinicians can assume that all peer-reviewed literature is equally valuable in answering a given clinical question d. Personal experience is of almost no value in clinical decision making

a. EBP requires that clinicians regularly ask clinically important. (Asking questions and then seeking the best answers is one of the main principles of EBP)

3. Which of the following are among what are considered to be benefits of EMG use in the clinic? Select all that apply a. EMG allows clinicians and patients to perceive muscle processes not normally available b. EMG can enable analysis that may help improve sport activities c. EMG may help patients "find" and train muscles d. EMG can assist in monitoring progress for muscle training programs e. EMG may assist in clinical decision making related to surgery

a. EMG allows clinicians and patients to perceive muscle processes not normally available b. EMG can enable analysis that may help improve sport activities c. EMG may help patients "find" and train muscles d. EMG can assist in monitoring progress for muscle training programs e. EMG may assist in clinical decision making related to surgery

1.The methods available to deliver diathermy include which of the following (choose all that apply): Select all that apply a. Inductance shortwave devices b. Low level LASER (LLLT) devices c. Capacitance shortwave devices d. Microwave devices e. Ultraviolet devices

a. Inductance shortwave devices c. Capacitance shortwave devices d. Microwave devices

53. Perception of pain intensity: a. Is affected by an individual's thoughts and emotions b. Requires presence of chemicals released as a result of cell damage c. Is a purely electrophysiologic response to a high-intensity stimulus d. Is the same for everyone given the same intensity stimulus

a. Is affected by an individual's thoughts and emotions

16. Which descriptors is consistent with A - delta fibers (nociceptors)? a. Its axons are myelinated. b. It produces dull, aching pain c. It's the slowest-conducting nociceptor d. Its pain signal is difficult to localize. e. It's responsive to chemical stimulation only

a. Its axons are myelinated.

62. Decreased range of motion may improve with modalities if the loss is caused by: Select all that apply a. Joint capsule tightness/adhesions b. Joint subluxation c. Presence of large osteophytes around joint margins d. Soft-tissue tightness/stiffness

a. Joint capsule tightness/adhesions d. Soft-tissue tightness/stiffness

7. Which of the following is FALSE for neuromuscular electrical stimulation (NMES) electrode selection and placement? a. Larger electrodes are always better for NMES treatments b. If a patient cannot tolerate the intensity required to achieve a strong muscle contraction, one potential solution is to increase the size of the electrode to decrease the current density and perceived discomfort c. For a bipolar electrode configuration, more motor units will be recruited if the electrodes are further apart over the target muscle vs. close together d. Electrode size should be appropriate to the size of the target muscle

a. Larger electrodes are always better for NMES treatments

13. The main objective(s) during the application of surface EMG electrodes is/are: Select all that apply a. Low skin impedance b. Stable electrode contact c. High skin impedance d. Positioning as near to motor points as possible e. Avoiding areas of perspiration

a. Low skin impedance b. Stable electrode contact

4. The APTAs Guide to Physical Therapist Practice terminology defines evaluation as which of the following? a. Making judgments based on information obtained in the history, systems review, and relevant tests and measures b. Making clinical judgments based on physician diagnosis and referral c. Deciding whether a patient requires referral to another health care provider to address comorbidities d. Determining how quickly the patient will recover completely from a given pathology

a. Making judgments based on information obtained in the history, systems review, and relevant tests and measures

6. Sensory level TENS: a. May manage pain that a patient would otherwise have during daily activities b. Is not as effective as subsensory TENS (microcurrent electrical stimulation) at managing pain, but it is easier to use c. Should be tried only in patients who have failed to respond to motor level TENS d. Decreases pain by stimulating the release of endorphins, which inhibit pain perception

a. May manage pain that a patient would otherwise have during daily activities

10.Which level of heating is recommended to achieve pain reduction? a. Moderate heating b. Vigorous heating c. Deep heating d. Mild heating

a. Moderate heating

6. Select the correct statements related to the Arndt-Schultz principle. Assume sufficient energy to elicit a response. Select all that apply a. Moderate stimuli will tend to favor physiologic activity b. Excessive stimuli will tend to arrest or block physiologic activity c. Weak stimuli will tend to excite physiologic activity d. Strong stimuli are needed to produce any physiologic activity

a. Moderate stimuli will tend to favor physiologic activity b. Excessive stimuli will tend to arrest or block physiologic activity c. Weak stimuli will tend to excite physiologic activity

12. Which of the following is a normal response to neuromuscular electrical stimulation for muscle strengthening? a. Muscle soreness related to muscle overload b. Patchy red and white skin related to high-intensity current c. Small raised rash under electrodes related to decreased tissue pH d. Mild skin burn related to high frequency

a. Muscle soreness related to muscle overload

10. Use of which Boolean operator(s) will likely result in expanding the number of 'hits' when conducting a search with an on-line search engine? a. OR b. NOT c. AND d. BUT

a. OR

2. Which of the following pulse characteristics is associated with amplitude? a. Peak intensity b. Peak frequency c. Pulse duration d. Rise time

a. Peak intensity

2. The unprocessed (except for some minor filtering) sEMG signal that detects the voltages from numerous motor unit action potentials (MUAPs) during a muscle contraction is referred to as: a. Raw EMG b. Rectified EMG c. Integrated EMG d. Summated EMG

a. Raw EMG

11.For a patient with which of the following medical conditions would cryotherapy be contraindicated? a. Raynauds phenomenon b. Impaired sensation c. Osteoarthritis d. Acute inflammation e. None of the above

a. Raynauds phenomenon

5. Select the true statement regarding enhancement of peripheral blood flow with electrotherapy. a. Rhythmic muscle contractions using neuromuscular electrical stimulation can enhance arterial, venous, and lymphatic flow b. Direct current is the only current that is effective at improving peripheral blood flow c. No type of stimulation can effectively enhance poor microvascular perfusion that occurs with vasospastic disorders d. Strong sensory level stimulation is more effective than motor level stimulation at improving arterial blood flow

a. Rhythmic muscle contractions using neuromuscular electrical stimulation can enhance arterial, venous, and lymphatic flow

56. Cardinal sign of acute inflammation include rubor (redness), calor (heat), tumor (firmness), and which of the following? a. Swelling b. Numbness c. Hyper-sensitivity d. none of the above

a. Swelling

3. Which type of evidence sits at the apex of the Evidence Hierarchy? a. Systematic review b. Cohort study c. Randomized, controlled trial d. Expert opinion

a. Systematic review

*Which of the following statements is most correct? a. The effects of cold last longer than the effects of heat because cold-induced vasoconstriction restricts the flow of warm blood into the treatment area b. The effects of heat last longer than the effects of cold because the resultant increased nerve conduction velocity from heating generates a greater sensation of temperature change c. The effects of heat last longer than the effects of cold because heat treatments generally last longer than cold treatments d. The effects of cold last longer than the effects of heat because decreased cell metabolism results in lower oxygen demand e. The effects of heat and cold will last roughly the same amount of time regardless of how they are applied

a. The effects of cold last longer than the effects of heat because cold-induced vasoconstriction restricts the flow of warm blood into the treatment area

18.The delivered dosage of superficial heating agent can be directly determined by which of the following? Select all that apply a. The position of the patient relative to the heating source b. The difference in temperature between the heating source and the tissues it contacts c. The length of time the heating source is applied d. The amount of skin in contact with the heating source e. The thickness of the subcutaneous tissue

a. The position of the patient relative to the heating source b. The difference in temperature between the heating source and the tissues it contacts c. The length of time the heating source is applied d. The amount of skin in contact with the heating source

15. Which statement is FALSE regarding neuromuscular electrical stimulation (NMES) for muscle strengthening? a. The strength benefits of NMES are superior to voluntary exercise in healthy muscle b. NMES is no better than exercise for strengthening healthy muscle c. The strength benefits of NMES are superior to voluntary exercise in weakened muscle d. NMES must generate a maximally tolerated contraction to adequately overload the muscle

a. The strength benefits of NMES are superior to voluntary exercise in healthy muscle

5. Strategies that may effectively increase reception selectivity (avoid cross-talk from non-target muscles) during EMG measurement might include: Select all that apply a. The use of small electrodes b. Applying electrodes as close to the motor point as possible c. A close spacing between electrode pairs d. Closely clipping any hair from the area electrode application e. Omitting a reference electrode

a. The use of small electrodes c. A close spacing between electrode pairs

4. The element that relates power and energy is: a. Time b. Frequency c. Duty cycle d. None of the above

a. Time

37. You are working with a patient who has decreased range of motion, tightness, and pain along the anterior medial ankle. You note in the chart they had a fractured ankle and has a plate with 6 screws along the distal medial tibia 1 year ago. They recently began a job that requires 6 hours of standing and/or walking which they believe is the reason they now have discomfort. Considering all the factors and any contraindication, which of the following modalities would be BEST? a. Vigorous heating with Ultrasound (pain decreased ROM & tightness, metal not contraindicated) b. Cold pack with compression c. Dosage IV Diathermy d. Ice massage for 5 min

a. Vigorous heating with Ultrasound (pain decreased ROM & tightness, metal not contraindicated)

6. Which of the following factors influence the detection of the EMG signal? Select all that apply a. Voltages produced by external sources such as room lighting b. Movement of the muscles under the electrodes c. Movement of the lead wires d. Temperature of the tissues directly under the receiving electrodes e. Cross talk

a. Voltages produced by external sources such as room lighting b. Movement of the muscles under the electrodes c. Movement of the lead wires d. Temperature of the tissues directly under the receiving electrodes e. Cross talk

8. Which of the following contribute to the motor unit action potential (MUAP) acquired from a gastrocnemius muscle? Select all that apply a. Voltages produced by the dendrite of the motor unit's alpha motor neuron b. Voltages from all of the branches of the alpha motor neuron that supply the motor unit c. Voltages picked up from heart muscle contractions d. Impedance signals from the skin and subcutaneous tissue e. Voltages produced by the membranes of all the muscle fibers in the motor unit

a. Voltages produced by the dendrite of the motor unit's alpha motor neuron b. Voltages from all of the branches of the alpha motor neuron that supply the motor unit e. Voltages produced by the membranes of all the muscle fibers in the motor unit

15. Which of the following statements is the reason we take all of the different factors into consideration (research evidence, patient personal factors, clinical expertise, setting, etc) during decision making about biophysical agents. a. We wish to have the highest level of confidence in our decisions. b. We wish to be certain that our treatments will have the effects we want. c. It enables us to accurately predict what the patient's response to the treatment will be. d. All of the above.

a. We wish to have the highest level of confidence in our decisions.

10. Which of the following instructions would be most helpful for a patient who has just completed the first intermittent pneumatic compression (IPC) treatment for lower extremity edema? a. Wear compression garments to maintain changes in limb volume b. Avoid moving the treated limb for as long as possible c. Alert the patient that compensatory swelling in other areas of the body is an expected response to IPC d. Put the leg in a dependent position as soon as possible to prevent ischemia

a. Wear compression garments to maintain changes in limb volume

21. You are treating a patient's forearm with a cold pack to help reduce pain after exercise. After 5 min you remove the cold application to check the skin and you observe this skin presentation. This skin presentation is most likely which of the following? a. Wheals from an allergic reaction. b. A normal response to cold. c. The beginning stages of frostbite. d. Signs of Raynaud's phenomenon.

a. Wheals from an allergic reaction.

10. Which of the following conditions has the most evidence that LLLT may be beneficial in relieving pain? a. trigger/tender point in the cervical spine region b. degenerative joint disease c. temporomandibular joint dysfunction (TMJ) d. shoulder pain

a. trigger/tender point in the cervical spine region

11. Which of the following risks are present with the use of LLLT (low level laser therapy)? a. without proper eye protection, damage can occur to the retinas b. people with circulatory issues are at risk of blood clots c. with higher doses, one is at risk of a burn d. repeated exposure overtime can cause cellular damage

a. without proper eye protection, damage can occur to the retinas

46. Per your textbook and under most conditions, what is the maximum recommended inflation pressure for treatment with an intermittent pneumatic compression device? a. 10 mmHg more than systolic pressure b. 10 mmHg less than diastolic pressure c. 10 mmHg less than systolic pressure d. 10 mmHg more than diastolic pressure

b. 10 mmHg less than diastolic pressure

*On presentation to the clinic today, which of the following patients is the most likely candidate for heat modalities? a. 78-year-old female with arthritic hand pain who applied a heat liniment just prior to todays visit b. 13-year-old female with muscular neck pain from a motor vehicle accident last week c. 19-year-old male who is developing a hematoma following a thigh contusion sustained in basketball practice today d. 64-year-old male with referred back pain related to prostate cancer

b. 13-year-old female with muscular neck pain from a motor vehicle accident last week

29. You are delivering a diathermy treatment and select the dosage of Dose II (delta 2). What temperature change are you expecting? a. 4 degrees Celsius b. 2 degrees Celsius c. 4 degrees Fahrenheit d. 2 degrees Fahrenheit

b. 2 degrees Celsius

4. When performing NMES in a healthy patient, a muscle contraction occurs from electrical stimulation that effects which of the following structures? a. Type A delta nerve fibers b. Alpha motor neurons c. Type A beta nerve fibers d. The muscle fibers directly

b. Alpha motor neurons

17. Hypertension is a precaution for the application of cold. Which of the following statements is the BEST rationale for this precaution? a. Cold therapy can cause an allergic reaction in persons with hypertension. b. Cold therapy over a significant area may worsen hypertension as a result of localized vasoconstriction. c. Cold therapy will stiffen tissues which cause an increase in blood pressure that can be detrimental in persons with hypertension. d. Cold therapy may alter the effectiveness of hypertension medication due to diminished blood flow.

b. Cold therapy over a significant area may worsen hypertension as a result of localized vasoconstriction.

63. Comparing the physiologic effects of heat or cold, which last the longest and why? Select the best response. a. Heat, because the increased metabolic rate results in self-sustaining internal heating b. Cold, because the vascular response to cold limits how quickly relatively warm blood can enter the treatment area c. Cold, because the decreased nerve conduction velocity slows voluntary movements that would encourage re-warming d. Heat, because the vascular response to heat results in relatively cool blood entering the treatment area

b. Cold, because the vascular response to cold limits how quickly relatively warm blood can enter the treatment area

11. Select an appropriate electrode placement for ambulation assist in a person with decreased active dorsiflexion during the swing phase of gait. a. Gastrocnemius and anterior tibialis muscle bellies b. Common peroneal nerve and anterior tibialis muscle belly c. Posterior tibialis muscle belly d. Peroneus longus and brevis muscle bellies

b. Common peroneal nerve and anterior tibialis muscle belly

2. A problem that can occur during EMG monitoring if the electrodes are too large or positioned too far apart, or if there are many non-target muscles packed closely near the target muscle in the receptive field of the sensors is: a. Standing waves b. Cross talk c. Normalization d. Feedback

b. Cross talk

3. A problem that can occur during EMG monitoring if the electrodes are too large or positioned too far apart, or if there are many non-target muscles packed closely near the target muscle in the receptive field of the sensors is: a. Standing waves b. Cross talk c. Feedback d. Normalization

b. Cross talk

64. What is one of the main purposes of the inflammatory phase of wound healing? a. Production of granulation tissue to fill in wound bed b. Deliver white blood cells for phagocytosis of bacteria and debris c. Revascularization of injury site to improve oxygenation d. Wound contraction to minimize the size of the wound

b. Deliver white blood cells for phagocytosis of bacteria and debris

17. Which treatment parameters below would be best for treating inflammation with iontophoresis? a. Lidocaine, delivery electrode is positive b. Dexamethasone, delivery electrode is negative c. Lidocaine, delivery electrode is negative d. Dexamethasone, delivery electrode is positive

b. Dexamethasone, delivery electrode is negative

1. Which of the following statements are true regarding evidence-based practice (EBP)? a. Current research findings should always take precedence over individual patient presentation b. EBP requires that clinicians regularly ask clinically important questions c. Clinicians can assume that all peer-reviewed literature is equally valuable in answering a given clinical question d. Personal experience is of almost no value in clinical decision making

b. EBP requires that clinicians regularly ask clinically important questions

52. Which of the following chemical substances is NOT associated with producing or increasing pain? a. Histamine b. Enkephalin c. Potassium d. Bradykinin

b. Enkephalin

43. The recommended placement of the thoracic belt when applying mechanical is best described at which of the following locations? a. Just below the breast on at the mid thorax b. Just below the widest aspect of the rib cage c. Just below the axillas (arm pits) d. At the level of the umbilical (belly button)

b. Just below the widest aspect of the rib cage

5. Which is true regarding the physical properties of laser light? a. Because laser light depends on population inversion to stimulate light emission, the light from a laser scatters like an overhead lamp b. Laser is monochromatic and coherent c. The color of laser light depends on the characteristics of the air it travels through before it reaches its target d. Laser light is generated by spontaneous emission

b. Laser is monochromatic and coherent

13. In the APTAs Guide to Physical Therapist Practice patient care management model, which of the following is part of an examination? a. Referring the patient to another provider b. Learning about the patient's past and current status c. Establishing prognosis for recovery d. Reviewing the patient's treatment options and obtaining informed consent for treatment

b. Learning about the patient's past and current status

*When comparing dry vs. moist heat, which statement is FALSE? a. Moist heat increases the temperature of deeper tissues more than dry heat b. Moist heat increases surface temperatures more than dry heat c. Dry heat can be as effective as moist heat at elevating surface temperatures d. Most people can tolerate higher temperatures when the modality is dry rather than moist

b. Moist heat increases surface temperatures more than dry heat

6. Which form of exercise results in greater muscle fatigue? a. Voluntary exercise, because it is more comfortable b. NMES, because it preferentially recruits fatigable type II fibers c. Neuromuscular electrical stimulation (NMES), because a person will tolerate more repetitions of contraction with NMES than with voluntary exercise d. Voluntary exercise, because it preferentially recruits fatigable type I fibers

b. NMES, because it preferentially recruits fatigable type II fibers

10. Which of the following conditions does NOT merit special caution when using electrotherapy? a. Patient with a demand cardiac pacemaker b. Over metal implants used for joint arthroplasty c. Strong muscle contraction in the patient with osteoporosis d. Obese patient

b. Over metal implants used for joint arthroplasty

*Which of the following statements about paraffin baths is true? a. When used to increase joint range of motion, a patient should do active exercises while immersed in the paraffin b. Paraffin conducts heat to tissues slower than water of the same temperature c. Paraffin should never be used over healed burn areas because this tissue is very fragile d. Paraffin has a higher specific heat than water

b. Paraffin conducts heat to tissues slower than water of the same temperature

14. Which of the following rationales is best for choosing paraffin instead of ultrasound for treating the hand? a. Ultrasound requires a conduction medium which is more difficult to apply. b. Paraffin is better and safer for heating bony or irregular surfaces c. The thermal properties of the paraffin wax and mineral oil combination allow it to penetrate to deeper tissues than ultrasound d. The patient can move or exercise with the paraffin in place, which greatly facilitates the treatment

b. Paraffin is better and safer for heating bony or irregular surfaces

1. Which of the following are examples of measurements or calculations based on EMG amplitude that a researcher or clinician might obtain and report? Select all that apply a. Median frequency b. Peak c. Average d. Area e. Time to peak f. Contraction duration g. Onset slope

b. Peak c. Average d. Area e. Time to peak g. Onset slope

12. The preferred method of smoothing the EMG amplitude signal is: a. Rectification b. Root mean square (RMS) c. Sampling d. Moving average (Movag) e. None of the above

b. Root mean square (RMS)

20.Which of the following statements about heat-generated reflex vasodilation is FALSE? a. Is mediated in the spinal cord b. Should be avoided in people with peripheral vascular disease c. Does not result in significant increases in skeletal muscle blood flow d. May result in vasodilation of an area remote from the treatment site

b. Should be avoided in people with peripheral vascular disease

20. For two waveforms with the same peak amplitude and the same phase duration, which will have the greatest phase charge? a. Twin spike waveform b. Square wave c. Sine wave d. Triangle waveform

b. Square wave

3. Energy is defined as: a. The time it takes a wave to arrive at a target tissue b. The ability to do work c. The ability to elicit a response in a target tissue d. None of the above

b. The ability to do work

7. Which electrochemical effects match the given electrode polarity? a. The chemical reactions that occur under the cathode are related to an increase in acidity b. The alkaline reaction under the cathode results in softening of the underlying tissues c. Sodium hydroxide that builds up under the anode results in sclerosis of tissues d. Hydrochloric acid produced under the anode results in softening of hard scar tissue

b. The alkaline reaction under the cathode results in softening of the underlying tissues

*Which of the following statements is true regarding heating and temperature changes? a. Tissue temperatures 40 degrees-45 degrees F will result in increased blood flow b. The degree and rate of tissue heating both affect the magnitude of physiologic responses c. Mild heating occurs at tissue temperatures near 45 degrees C d. All of the above are true

b. The degree and rate of tissue heating both affect the magnitude of physiologic responses

2. Which of the following can be indications for external compression therapy? Select all that apply a. Arterial insufficiency b. Venous insufficiency c. Limb shaping after amputation d. Lymphedema e. Minimizing edema formation after a treatment

b. Venous insufficiency c. Limb shaping after amputation d. Lymphedema e. Minimizing edema formation after a treatment

14. According to the textbook, which of the following is a beneficial effect of traction? a. intradiscal pressures can be increased assisting in the balance of the disc material b. fluid exchange and nutrient transport within the disc may be enhanced c. There are no true benefits from traction. d. muscle activity is depressed through the activation of gamma efferent fibers.

b. fluid exchange and nutrient transport within the disc may be enhanced

3. Iontophoresis is most likely to reduce pain in which of the following cases? a. 7-year-old male with undisplaced fracture of the radius b. 60-year-old male with cervical pain from whiplash injury c. 20-year-old female recreational volleyball player with biceps tendonitis This is the condition in this list that would probably respond best to iontophoresis using an anti inflammatory drug. d. 40-year-old female homemaker with chronic low back pain

c. 20-year-old female recreational volleyball player with biceps tendonitis This is the condition in this list that would probably respond best to iontophoresis using an anti inflammatory drug.

9.The range of temperatures generally considered to be the "therapeutic range" for producing the desired effects associated with tissue heating is: a. 35 - 37 deg C b. 100 - 104 deg F c. 40 - 45 deg C d. None of the above

c. 40 - 45 deg C

45. When working with a patient with Stage 2 lymphedema in the upper extremity, a moderate compression force for 60 min once or twice a day is recommended. Which of the following settings for the intermittent compression pump would be best? a. 20 - 40 mm Hg (millimeters of mercury) b. 20 - 40 cm H2O (centimeters of water) c. 40 - 60 mm Hg d. 40 - 60 cm H2O (centimeters of water)

c. 40 - 60 mm Hg

Which statement best describes neurapraxia? a. A transient decrease in nerve conduction velocity expected with most cold therapy treatments b. Impaired nerve function that affects only deep peripheral nerves when core temperature decreases 0.5 degrees C or more c. A risk of long duration cold therapy over a superficial peripheral nerve d. Equivalent to the term frostbite

c. A risk of long duration cold therapy over a superficial peripheral nerve

*Which variable is least likely to affect the magnitude of temperature change in tissues under a cold pack? a. Body surface area covered by the cold pack b. Water content of the tissues covered by the cold pack c. Ambient air temperature d. Temperature of the cold pack

c. Ambient air temperature

19. Pain relief or analgesia achieved as a result of tissue cooling can occur through which of the following mechanisms? a. Decrease in the pain threshold b. Increased activation of thermal receptors in the skin that helps to mask pain c. An alteration in muscle spindle firing rate d. all of the above

c. An alteration in muscle spindle firing rate

2. Select the true statement regarding LLLT: a. To date, no human studies exist to support the use of LLLT in a clinical setting b. LLLT uses the same laser devices as are used in surgery, so extreme caution is warranted c. Animal and cellular studies have shown that LLLT increases ATP production d. It is indicated for treatment of epileptic seizures

c. Animal and cellular studies have shown that LLLT increases ATP production

14. Which of the following responses is (are) typical for an electrical stimulation treatment? a. Muscle contractions usually occur with stimulation set at subsensory levels b. C-fibers are the first afferent nerves to depolarize with electrical stimulation c. As stimulation intensity increases, a person will usually feel a muscle twitch or contraction before experiencing pain from the stimulation d. All of the above are true

c. As stimulation intensity increases, a person will usually feel a muscle twitch or contraction before experiencing pain from the stimulation

12. Which of the following statements is the most correct according to the Guide to Physical Therapy Practice? a. Diagnosis of a given pathology is the most important consideration in creating a plan of care b. Prognosis is the process of classifying patients into diagnostic categories so that clinicians can make sense of varying patient presentations c. Classification of patients based on impairments and functional limitations leads to better intervention planning than classification based on pathology alone d. Assigning a patient to a given classification inappropriately encourages a clinician to ignore individual patient differences

c. Classification of patients based on impairments and functional limitations leads to better intervention planning than classification based on pathology alone

5. Which of the following statements is the most correct according to the Guide to Physical Therapy Practice? a. Assigning a patient to a given classification inappropriately encourages a clinician to ignore individual patient differences b. Prognosis is the process of classifying patients into diagnostic categories so that clinicians can make sense of varying patient presentations c. Classification of patients based on impairments and functional limitations leads to better intervention planning than classification based on pathology alone d. Diagnosis of a given pathology is the most important consideration in creating a plan of care

c. Classification of patients based on impairments and functional limitations leads to better intervention planning than classification based on pathology alone

15.Which of the following cold therapy applications is most appropriate for the given scenario? a. Controlled cold therapy unit for acute left ankle sprain in patient with medical history of diabetic neuropathy b. Cold whirlpool for left upper extremity pain in patient with hypertension c. Cold pack to cervical spine following whiplash injury in patient with leukemia d. Ice massage for right lateral epicondylitis in patient with history of cryoglobulinemia

c. Cold pack to cervical spine following whiplash injury in patient with leukemia

20. The total amount of cooling (i.e. the greatest amount of thermal energy exchange) is likely to be greatest with which of the following cryotherapy applications? a. A 6" by 3" gel pack applied over a dry towel to the anterior knee for 15 minutes b. A 6" by 3" gel pack applied through a pillow case to the anterior knee for 15 minutes c. Crushed ice in a gallon-sized zip-lock bag applied to the anterior knee over a wet towel for 15 minutes d. Ice massage to the superior and inferior patella tendon for 5 minutes

c. Crushed ice in a gallon-sized zip-lock bag applied to the anterior knee over a wet towel for 15 minutes

3. Which of the following statements is true regarding evidence-based practice (EBP)? a. Clinicians can assume that all peer-reviewed literature is equally valuable in answering a given clinical question b. Personal experience is of almost no value in clinical decision making c. EBP requires that clinicians regularly ask clinically important questions d. Current research findings should always take precedence over individual patient presentation

c. EBP requires that clinicians regularly ask clinically important questions

11. Which of the following chemical substances is NOT associated with producing or increasing pain? a. Histamine b. Potassium c. Enkephalin. Is an endogenous opiate that operates primarily in the spinal cord. It reduces pain. d. Bradykinin

c. Enkephalin. Is an endogenous opiate that operates primarily in the spinal cord. It reduces pain.

*Regarding skeletal muscle blood flow, which of the following statements is true? a. Increases in blood flow are equivalent with application of either heat pack or exercise b. Neither exercise nor superficial heat can increase skeletal muscle blood flow as it is primarily under metabolic regulation c. Exercise results in greater increases in blood flow than application of heat pack d. Using a heat pack can result in greater increases in blood flow than exercise if the duration of heat application is greater than 30 minutes

c. Exercise results in greater increases in blood flow than application of heat pack

3. Which is FALSE regarding ultraviolet (UV) radiation? a. Has a bactericidal effect b. UV is effective in treating psoriasis c. Exposure to therapeutic UV does not present the same risk of skin cancer as exposure to UV from the sun d. Pharmacologic agents have replaced UV for the treatment of most skin conditions

c. Exposure to therapeutic UV does not present the same risk of skin cancer as exposure to UV from the sun

31. Which is true when comparing shortwave diathermy (SWD) with ultrasound (US)? a. If an SWD unit is available, it is always a better choice than US for tissue heating b. US is more effective than SWD because it can heat tissues much more deeply than SWD c. For a given treatment duration, SWD can heat a much larger area than US d. US is more popular than SWD because it can increase tissue temperatures to vigorous levels of heating, and SWD only achieves mild heating

c. For a given treatment duration, SWD can heat a much larger area than US

11. Which statement is FALSE regarding the evidence in support of intermittent pneumatic compression (IPC)? a. There is scientific evidence to show that IPC can reduce edema and improve lymph return b. The available literature is not sufficient to advocate using one particular IPC protocol over another c. IPC can enhance the resolution of deep venous thrombosis. d. Studies have shown that IPC can enhance healing of venous stasis ulcers

c. IPC can enhance the resolution of deep venous thrombosis.

13.The total amount of cooling (i.e. the greatest amount of thermal energy exchange) is likely to be greatest with which of the following cryotherapy applications? a. A 6" by 3" gel pack applied over a dry towel to the anteromedial knee for 15 minutes b. Crushed ice in a gallon-sized zip-lock bag applied to the anteromedial knee over a wet towel for 15 minutes c. Ice massage to the thenar eminence for 5 minutes d. A 6" by 3" gel pack applied through a pillow case to the anteromedial knee for 15 minutes

c. Ice massage to the thenar eminence for 5 minutes

3. Electrically generated action potentials conduct along a nerve: a. Only orthodromically, or in the direction of normal physiologic conduction b. Only antidromically, or conduction opposite the normal physiologic direction c. In both directions d. Orthodromically for sensory nerves and antidromically for motor nerves

c. In both directions

*The effects of cold on spasticity: a. Include an increase in gamma-motorneuron activity related to improved purposeful movement b. Last up to 4 hours c. Include a temporary decrease in frequency of clonus d. Include an increased resistance to passive stretch as voluntary muscle function improves

c. Include a temporary decrease in frequency of clonus

12. Perception of pain intensity: a. Requires presence of chemicals released as a result of cell damage b. Is a purely electrophysiologic response to a high-intensity stimulus c. Is affected by an individual's thoughts and emotions. This makes it much more difficult for clinicians to address pain, especially chronic pain. d. Is the same for everyone given the same intensity stimulus

c. Is affected by an individual's thoughts and emotions. This makes it much more difficult for clinicians to address pain, especially chronic pain.

*Select the most correct statement regarding ultrasound (US) frequency. a. It takes about 2 times longer to heat deep muscle tissue with 3 MHz than with 1 MHz US b. The rate of temperature increase in muscle tissue is not dependent on US frequency c. It takes longer to achieve vigorous heating in muscle tissue with 1 MHz than with 3 MHz US d. It takes longer to achieve vigorous heating in muscle tissue with 3 MHz than with 1 MHz US

c. It takes longer to achieve vigorous heating in muscle tissue with 1 MHz than with 3 MHz US

55. Which descriptors is consistent with A - delta fibers (nociceptors)? a. Its pain signal is difficult to localize. b. It's responsive to chemical stimulation only c. Its axons are myelinated. d. It's the slowest-conducting nociceptor e. It produces dull, aching pain

c. Its axons are myelinated.

15. You would like to maximize the traction force being achieved to the L4/5 segement. Which hip position would be best? a. Flex the hips to near 90 degrees with the patient's legs supported on a stool. b. Flex the hips to 60 degrees by having the patient bend their knees keeping their feet on the table (hooklying position). c. Keep the hips in neutral (legs flat on the table) d. Flex the hips to 25 degrees supported the legs on a small bolster

c. Keep the hips in neutral (legs flat on the table)

6. Which of the following is NOT a contraindication for IPC? a. Dermatitis b. Lower extremity edema due to acute congestive heart failure c. Lymphatic edema following a mastectomy d. Anterior compartment syndrome of the leg

c. Lymphatic edema following a mastectomy

15. Sensory level (also called high frequency or Conventional) TENS: a. Decreases pain by stimulating the release of endorphins, which inhibits pain perception b. Should be tried only in patients who have failed to respond to motor level TENS c. May manage pain that a patient would otherwise have during daily activities. There are no muscle contractions with sensory level stimulation, which occur during Motor Level stim and may interfere with function. d. Is not as effective as subsensory TENS (microcurrent electrical stimulation) at managing pain, but it is easier to use

c. May manage pain that a patient would otherwise have during daily activities. There are no muscle contractions with sensory level stimulation, which occur during Motor Level stim and may interfere with function.

7. Which of the following EMG variables is commonly used to identify muscle fatigue? a. Offset time b. Area c. Median frequency d. Onset slope

c. Median frequency

13. Which of the following is true when comparing neuromuscular electrical stimulation (NMES) with voluntary exercise in subjects with substantial muscle weakness? a. NMES can increase muscle endurance only and cannot increase muscle strength b. Because NMES selectively targets slow twitch muscle fibers, it can improve endurance better than voluntary exercise alone c. NMES is beneficial only when superimposed onto a voluntary contraction d. NMES is better than voluntary exercise because it preferentially targets type I fibers e. NMES is superior to voluntary exercise

c. NMES is beneficial only when superimposed onto a voluntary contraction

58. Which of the following best describes central pain (central sensitization)? a. Pain related to injury of a nerve root, as in radiculopathy b. Responds well to most modalities c. Pain related to abnormal sensitivity or discharge of CNS neurons or synapses d. Often referred to as reflex sympathetic dystrophy

c. Pain related to abnormal sensitivity or discharge of CNS neurons or synapses

5. Which of the following is an example of allodynia? a. Intermittent knee pain related to osteoarthritis b. Headache caused by suboccipital muscle spasm c. Patient reports pain with light touch to forearm. The amount of stimulus associated with light touch is normally not sufficient to activate nociceptors. d. Back pain in the presence of kidney pathology

c. Patient reports pain with light touch to forearm. The amount of stimulus associated with light touch is normally not sufficient to activate nociceptors.

6.Which of the following tissues is most likely to be adversely affected by the summation of incoming and reflected ultrasound energy? Select one: a. Bone marrow b. Nociceptive afferent axons c. Periosteum d. Capillaries e. All of these tissues are equally likely to be affected adversely

c. Periosteum

11. A signal processing method by which negative EMG amplitude values are converted to positive values (so that all EMG activity is portrayed on the same side of the isoelectric line) is: a. Low-pass filtering b. Smoothing c. Rectification d. MVC e. None of the above

c. Rectification

17. Which of the following electrotherapy modalities is most appropriate for alleviating acute global knee pain? a. Iontophoresis b. NMES c. Sensory level (High Freq or Conventional) TENS. Given only this information, Sensory Level will probably be your best first choice for treating this type of painful condition. If it doesn't work, don't hesitate to try another form of pain management. d. Motor level (Low Freq) TENS

c. Sensory level (High Freq or Conventional) TENS. Given only this information, Sensory Level will probably be your best first choice for treating this type of painful condition. If it doesn't work, don't hesitate to try another form of pain management.

47. Which of the following is a possible complication following an intermittent pneumatic compression treatment and may warrant contacting the patient's physician? a. Slight dizziness b. Swelling in other areas of the body c. Shortness of breath d. Joint stiffness

c. Shortness of breath

*Which of the following statements about fluidotherapy is true? a. Heat transfer with fluidotherapy occurs via thermal conduction from the cellex material to the superficial tissues b. The recommended temperature range of fluidotherapy is much lower than for a hot whirlpool treatment c. Some people may be able to tolerate higher temperatures using fluidotherapy vs. other heating modalities because it is dry heat d. One disadvantage of fluidotherapy is that a patient must hold a limb still during the treatment in order to maximize the therapeutic benefits

c. Some people may be able to tolerate higher temperatures using fluidotherapy vs. other heating modalities because it is dry heat

9. The purpose of splitting a table used for lumbar traction is: a. Splitting the table helps to effectively increase the pulling force by a small percentage b. Splitting increases the comfort of lumbar traction for most patients c. Splitting reduces the amount of friction that would oppose the pulling force d. Splitting ensures that the paraspinal muscles are not in contact with the table, allowing them to relax more readily e. None of the above

c. Splitting reduces the amount of friction that would oppose the pulling force

9. Which is true regarding electrical stimulation for inhibition and/or reduction of edema? a. Sustained contraction of a muscle near the edematous joint is most effective for edema reduction b. For best results, place the positively charged electrode over the treatment area for sensory level stimulation c. There is evidence that rhythmic muscle contractions generated by motor level stimulation can decrease chronic edema in the hand d. Studies show that sensory level stimulation is effective at limiting edema formation in humans

c. There is evidence that rhythmic muscle contractions generated by motor level stimulation can decrease chronic edema in the hand

4. Select the true statement regarding electrical stimulation for tissue healing. a. There is no evidence that electrical stimulation increases rate of tissue healing in humans b. The wound should be cleaned and dried thoroughly before applying electrical stimulation c. To enhance wound granulation, place the negative electrode over the wound d. Motor-level stimulation is most effective for promoting tissue healing

c. To enhance wound granulation, place the negative electrode over the wound

12. Which type of ultraviolet light (UV) is used for its anti-bacterial effect? a. UVA b. UVB c. UVC d. UVR

c. UVC

13. Which ultraviolet light (UV) is not received through direct sunlight exposure? a. UVA b. UVB c. UVC d. UVR

c. UVC

1. Which descriptor is accurate with respect to type C afferent fibers? a. Often generate a reflexive withdrawal response b. Patient reports bright, sharp, stabbing, prickling pain c. Unmyelinated; small diameter d. Sensitive only to mechanical stimulation

c. Unmyelinated; small diameter

41. You are planning to administer lumbar traction to a fairly healthy 47 year old man who weighs 200 pounds to help relief some nerve root compression through vertebral distraction. He reports no adverse effects with the first two treatments and believes his symptoms are improving. Which of the following settings would be best on the third visit using an intermittent cycle of 30 seconds at maximum tension and 10 seconds at lower tension? a. minimum force of 20# and Maximum force of 40# for total treatment time of 10 min. b. minimum force of 50# and Maximum force of 70# for total treatment time of 10 min. c. minimum force of 50# and Maximum force of 100# for total treatment time of 15 min. d. minimum force of 75# and Maximum force of 125# for total treatment time of 15 min.

c. minimum force of 50# and Maximum force of 100# for total treatment time of 15 min.

11. Upon removing the paraffin from a treatment to a 15 year old's R hand, you check her skin and compare it with the other hand. The picture below is what you see. You document this response as a/an.... a. allergic response to heat exposure. b. mild heat rash that should resolve in about 2 hours. c. normal response to paraffin application. d. mild first degree burn that should heal in 2 days.

c. normal response to paraffin application.

15. Which of the following is the proposed mechanism of pain relief with the application of MIRE? a. sequelae of thermal effects b. mechanism is completely unknown c. stimulation and production of nitric oxide d. stimulation and production of red blood cells

c. stimulation and production of nitric oxide

4. What is the typical beat frequency range for interferential current (IFC)? a. 4000 - 4500 Hz b. 80 - 150 beats /min c. 4000 - 4100 Hz d. 80 - 150 beats / sec

d. 80 - 150 beats / sec

*Which of the following would NOT be considered an outcome for a given patient case? a. Increase wrist extension range of motion by 5 degrees b. Decrease self-rated disability score by 25% c. Improve grip strength to 80% of opposite hand d. Add wrist extension strengthening exercises. (This is an example of a modification of the intervention strategy and treatment planning)

d. Add wrist extension strengthening exercises. (This is an example of a modification of the intervention strategy and treatment planning)

*Which of the following methods of heat transfer occur(s) with therapeutic cold application? (consider all of the types of applications) Select one: a. Conduction b. Convection c. Evaporation d. All of the above

d. All of the above

38. Which of the following would be suitable measures for determining status change in a patient undergoing cervical traction for neck pain and upper extremity radiculopathy due to an impinged cervical nerve root? a. Cervical range of motion (goniometry or inclinometry) b. Pain or symptom level c. Grip strength d. All of the above

d. All of the above

4.Employing a moving sound head during the application of therapeutic US helps to do which of the following? Select one: a. Lessen the chances of standing wave formation b. Overcome non-uniformities in the energy beam c. Avoid the development of "hot spots" d. All of the above

d. All of the above

6. Routine monitoring of patient status and re-examination can help the clinician to: a. determine if referral to another professional is warranted. b. determine the need to discharge the patient or terminate PT services. c. decide whether to modify specific treatment parameters or to continue the current course of action. d. All of the above

d. All of the above

9. The "P" in a PICO search represents which of the following? a. Population b. Problem c. Patient d. All of the above

d. All of the above

18. Which of the following locations are considered optimal stimulation sites? a. Acupuncture points b. Motor points c. Trigger points d. All of the above Correct.

d. All of the above Correct.

12. Which of the following is (are) contraindicated? a. Sensory level TENS over the anterior neck for pain in 67-year-old male 2 weeks postoperative cervical fusion b. NMES for quadriceps muscle strengthening in a 16-year-old male with quadriceps tendon lesion sustained in basketball practice yesterday c. Motor level TENS for low back pain in a 34-year-old female who is 20 weeks pregnant d. All of the above are contraindicated

d. All of the above are contraindicated

*When documenting a therapeutic heat treatment, which information is necessary? a. The method of heat application b. The treatment duration c. The location of heat application d. All of the above are necessary

d. All of the above are necessary

13. Which of the following is (are) true regarding the strength-duration curve for electrical stimulation? a. The strength-duration curve predicts the type of response that occurs with a given pulse amplitude and duration b. Motor threshold stimulation implies stimulation of motor nerves rather than direct stimulation or depolarization of muscle cell membranes c. The relationships among the S-D curves of various excitable fibers predicts that direct stimulation of denervated muscle requires a high amplitude and long pulse duration d. All of the above are true

d. All of the above are true

16. Which statement(s) is (are) true regarding electrode placement? a. Current will travel through deeper tissues when electrodes are farther apart b. Electrodes should not touch one another c. The best electrode placement for a given treatment may require some trial and error d. All of the above are true

d. All of the above are true

*When educating an otherwise healthy patient about using cold therapy at home following acute injury, you should instruct him to: a. Use a cold pack for 2 hours minimum, as longer duration treatments are associated with better physiologic responses to cold b. Monitor his blood pressure as it can reach dangerously high levels with cold therapy c. Use a specialized frozen gel pack, as a bag of ice will not adequately cool the injured tissue d. Avoid vigorous activity immediately after cold therapy

d. Avoid vigorous activity immediately after cold therapy

16. Which of the following cold therapy applications best fits the given patient problem? a. Cold whirlpool for patient with acute anterior thigh contusion b. Vapocoolant spray for limited knee flexion in patient who is 3 days post total knee surgery c. Ice massage for acute exacerbation of metacarpophalangeal joint pain in patient with rheumatoid arthritis d. Cold pack for patient with shoulder pain 2 days following traumatic subluxation

d. Cold pack for patient with shoulder pain 2 days following traumatic subluxation

7. According to the International Classification of Function (IFC) system, which of the following is an example of a participation restriction that would be addressed in physical therapy? a. Decreased knee flexion range of motion to 20% of normal b. Unable to walk without knee pain c. Abnormal gait pattern d. Decreased ability to care for infant because of knee pain and decreased knee range of motion

d. Decreased ability to care for infant because of knee pain and decreased knee range of motion

*Would you expect increased or decreased agility in your patient immediately following cold therapy? a. Increased agility, as muscle strength is greater following cold therapy b. Increased agility, as inflammatory cell count decreases following cold therapy c. Decreased agility, as local blood viscosity decreases d. Decreased agility, as nerve conduction velocity decreases following cold therapy

d. Decreased agility, as nerve conduction velocity decreases following cold therapy

5. Which of the following EMG measures is the best indicator of muscular force given a pre-set duration? a. Smoothed EMG b. EMG Peak Frequency c. EMG Peak amplitude d. EMG Area amplitude

d. EMG Area amplitude

6. Chronic venous ulcers are associated with which of the following? a. Responds best to upright standing postures b. More likely to occur in a person who is physically active than someone who is sedentary c. Prolonged edema increases oxygen density in interstitial tissues, resulting in tissue breakdown from oxygen overload d. Effect of gravity promotes venous insufficiency

d. Effect of gravity promotes venous insufficiency

35. Which of the statements are correct regarding the benefit of heat versus cold for treatment pain? a. Heat is better than cold for treating pain as it is usually more comfortable than cold b. Cold is always better for treating pain than heat, unless the patient cannot tolerate cold c. The most important factor to consider when choosing heat or cold is patient preference d. Either heat or cold may be the best choice, depending on several factors e. all are accurate

d. Either heat or cold may be the best choice, depending on several factors

*Once the physical therapist has identified an appropriate intervention to address a particular clinical problem, the therapist should: a. Establish this intervention as a standard of care b. Use the same intervention for every patient with the same diagnosis c. Ensure that the patient receives the intervention, whether or not the patient has concerns about it d. Evaluate whether the selected intervention is best for an individual patient (And this is a continual process)

d. Evaluate whether the selected intervention is best for an individual patient (And this is a continual process)

*Which is true when comparing shortwave diathermy (SWD) with ultrasound (US)? a. If an SWD unit is available, it is always a better choice than US for tissue heating b. US is more effective than SWD because it can heat tissues much more deeply than SWD c. US is more popular than SWD because it can increase tissue temperatures to vigorous levels of heating, and SWD only achieves mild heating d. For a given treatment duration, SWD can heat a much larger area than US

d. For a given treatment duration, SWD can heat a much larger area than US

*One advantage of heat over cold therapy is: a. Heat increases the resistance of collagen to a deforming force, resulting in improved scar strength b. Heat decreases soft tissue swelling more than cold c. Heat decreases cellular metabolism, reducing the risk of hypoxic injury d. Heat decreases joint stiffness, while cold increases stiffness

d. Heat decreases joint stiffness, while cold increases stiffness

19.Which of the following represents a risk one should consider when applying external heating modalities? a. Anti-inflammatory effect of heat results in increased joint effusion b. Systemic response of decreased heart rate results in cardiovascular complications c. Heating a large volume of tissue results in compensatory cutaneous vasodilation, which increases risk for surface burns d. Increased tissue oxygen demand exceeds delivery of oxygen-rich blood

d. Increased tissue oxygen demand exceeds delivery of oxygen-rich blood

1. Which of the following EMG variables is commonly used to identify muscle fatigue? a. Onset slope b. Offset time c. Area d. Median frequency

d. Median frequency

14. Which of the following terms is used to describe the electrode configuration when a monophasic waveform is delivered via a hand-held probe and dispersive electrode? a. Quadripolar b. Bipolar c. Tetrapolar d. Monopolar

d. Monopolar

59. Which of the following types of pain is characterized by being caused by actual damage to nerve tissues resulting in radicular pain? a. Acute b. Neuropathic c. Referred d. Neurogenic

d. Neurogenic

57. Which cells are the first to appear at the site of a new injury? a. Natural killer cells b. Monocytes c. Lymphocytes d. Neutrophils

d. Neutrophils

22. Higher frequency ultrasound energy penetrates to deeper tissues than low frequency energy because: a. Higher frequency waves can carry more energy than low frequency waves b. Low frequency energy is more readily absorbed by superficial tissues c. Higher frequency waves are subjected to less scattering than low frequency waves d. None of the above - higher frequency US energy does not penetrate deeper

d. None of the above - higher frequency US energy does not penetrate deeper

8. Which of the following terms describe the area noted as "A" on the diagram below? a. Maximal Hz or frequency b. Pulse of phase charge c. Pulse duration or width d. Peak Amplitude or current

d. Peak Amplitude or current

7. Which of the following conditions would be an indication for the use of biofeedback to Up-Regulate the system through neuromuscular re-education? a. Muscular trigger points b. Spasticity c. Increased muscle tension d. Peripheral nerve injury

d. Peripheral nerve injury

*Which statement is true regarding phonophoresis? a. 10 percent hydrocortisone cream is a good conductor of US energy b. Phonophoresis using hydrocortisone creams results in significantly increased tissue concentrations of cortisol c. Conclusive evidence supports the use of phonophoresis as effective for inflammation d. Phonophoresis refers to enhanced drug delivery through the skin using ultrasound (US) pressure waves

d. Phonophoresis refers to enhanced drug delivery through the skin using ultrasound (US) pressure waves

10. Which neuromuscular electrical stimulation (NMES) parameter is most directly related to muscle fatigue during a given treatment session? a. Pulse duration b. Polarity c. Electrode placement d. Pulse frequency

d. Pulse frequency

13. When applying intermittent compression for a person with swelling who also has peripheral arterial disease, which of the following parameters would be best? a. Quick and long inflate time (1 min) at ~20 mmHg with a long deflate time b. Quick and short inflate time (< 5sec) at ~20 mmHg with a short deflate time c. Quick and long inflate time (1 min) at ~120 mmHg with a short deflate time d. Quick and short inflate time (< 5sec) at ~120 mmHg with a long deflate time e. none of the above, it is contraindicated

d. Quick and short inflate time (< 5sec) at ~120 mmHg with a long deflate time

4. Which is true regarding application of UV? a. Newer models of UV do not require that the patient or therapist use goggles b. According to the inverse square law, the intensity of UV radiation is inversely related to the mathematical square of the treatment area c. Because UV light can travel unimpeded through air, it does not matter how far away the UV source is from the treatment site d. The MED is the smallest UV dose that produces short duration erythema that fades within 24 hours

d. The MED is the smallest UV dose that produces short duration erythema that fades within 24 hours

1. According to the inverse square law, if the distance between a light source and the target tissue is decreased by half: a. The illumination intensity is increased by 100 percent b. The illumination intensity is decreased by half c. The illumination intensity is increased by 2 times d. The illumination intensity is increased by 4 times

d. The illumination intensity is increased by 4 times

*The presence of circulatory disorders is a precaution when using superficial thermal modalities because: a. They change the permeability of veins and could cause more edema b. It may indicate the presence of a more serious pathology c. They decrease pain and the patient will not be able to feel it if the tissues are not receiving enough blood supply after application of the modality d. The normal local response of blood vessels helps to prevent excessive tissue heating or cooling

d. The normal local response of blood vessels helps to prevent excessive tissue heating or cooling

3. The carrier frequency of an AC device represents which of the following parameters? a. The average amplitude of the waves over time b. The average width of each wave c. The total average charge d. The number of waves over a period of time

d. The number of waves over a period of time

10. Looking at the picture below, which of the following statements best describe the two different wave forms? a. The waveforms in line 1 are all monophasic direct current and the waveforms in line 2 are all biphasic alternating current b. The waveforms in line 1 are all monophasic symmetrical and the waveforms in line 2 are all biphasic symmetrical c. The waveforms in line 1 are all monophasic with some symmetrical and some asymmetrical and the waveforms in line 2 are all biphasic with some symmetrical and some asymmetrical d. The waveforms in line 1 are all monophasic and the waveforms in line 2 are all biphasic with some symmetrical and some asymmetrical

d. The waveforms in line 1 are all monophasic and the waveforms in line 2 are all biphasic with some symmetrical and some asymmetrical

2. All of the following are examples of clinical applications or effects which can be accomplished by using motor level electrical stimulation except: a. Functional electrical stimulation b. Acupuncture-like TENS c. Muscle re-education d. Tissue repair

d. Tissue repair

7. Electromagnetic energy, such as diathermy, has which of the following mechanisms of action or application requirements? a. Requires contact with the body or another conducting pathway b. Can cause increase heat through muscle contraction c. Transfers heat via conduction d. Travels through air without a transport medium

d. Travels through air without a transport medium

*Which statement is true regarding ultrasound (US) for fracture healing? a. Results of research suggests that US for bone healing commences no sooner than 4 weeks following a fracture b. It is not possible for a standard US unit to generate the correct US parameters for bone healing c. In animal models, US is effective only at improving bone healing in chronic, nonunion fractures, not in fresh fractures d. US units designed specifically for bone healing have a set intensity that is lower than that of most other therapeutic uses of US

d. US units designed specifically for bone healing have a set intensity that is lower than that of most other therapeutic uses of US

28. When reviewing the operation of an ultrasound machine, the beam non-uniformity ratio is important to know because. a. a lower ratio enables standing wave production. b. a lower ratio (1:2) can produce less consistent acoustic streaming. c. a higher ratio is an indication of a higher quality crystal. d. a higher ratio (1:6) can more readily produce a hot spot.

d. a higher ratio (1:6) can more readily produce a hot spot.

33. All other factors being equal, which of the following might influence your decision to use a particular modality in a clinical setting for a given patient problem? a. Modality availability b. Patient preference c. Ease of application d. all of the above

d. all of the above

10. Which of the following parameters would be BEST to target the descending endorphin release mechanism of pain control when using an electrical stimulation treatment? a. short pulse duration (<200 micro sec); high frequency (>50 pps) b. short pulse duration (<200 micro sec); slow frequency (<10 pps) c. long pulse duration (>200 micro sec); high frequency (>50 pps) d. long pulse duration (>200 micro sec); slow frequency (<10 pps)

d. long pulse duration (>200 micro sec); slow frequency (<10 pps) These are parameters for low frequency or motor level TENS. Another option might be point stimulation, which delivers noxious level current.

14. Which of the following choices regarding electrodes would result in the current reaching deeper tissue? a. Use a larger electrode b. Use a smaller electrode c. space the electrodes closer together d. space the electrode farther apart

d. space the electrode farther apart

14. For which of the following EMG testing is a thorough skin preparation most important? a. When very small muscles are being tested b. The testing conditions makes no difference in the need to thoroughly prepare the skin c. A stable testing condition, such as one involving only isometric contractions d. A situation in which the test subject's body weight is pressing on the electrodes (eg when sitting on the electrodes) e. A very dynamic test, such as running, during which there is high risk of movement artifact

e. A very dynamic test, such as running, during which there is high risk of movement artifact

27. Which of the following parameters have an effect on the intensity of the ultrasound dosage received by the tissues? a. Intensity setting b. Frequency setting c. Depth of the target tissue d. Duration of treatment e. All of the above

e. All of the above

5. On the picture below match the best description for the labels on this pulsed current. interpulse interval: phase duration: pulse duration:

interpulse interval: A phase duration: C pulse duration: B

25. Which biologic tissue listed below has the highest impedance to ultrasound? a. Bone b. Tendon c. Blood d. Muscle

a. Bone

*Which would be the most appropriate ultrasound (US) parameters to treat a joint contracture of the posterior hip (used prior to stretching the joint capsule)? a. 1 MHz 20 percent, pulsed US b. 1 MHz continuous US c. 1 MHz 50 percent, pulsed US d. 3 MHz continuous US

b. 1 MHz continuous US

23. Which of the following parameters of ultrasound would be BEST for obtaining a vigorous heating effect to a muscular trigger point in the levator scapula muscle near its insertion on a 34 year old rock climber? a. 3 mHz for 12 min at 1.0 w/cm2, 50% duty cycle b. 1 mHz for 8 minutes at 1.5 w/cm2, continuous c. 1 mHz for 10 minutes at 1.5 w/cm2, 50% duty cycle d. 3 mhz for 8 min at 1.2 W/cm2, continuous

b. 1 mHz for 8 minutes at 1.5 w/cm2, continuous

*Which of the following is NOT a systemic response to increased core body temperature? a. Increased respiratory rate b. Decreased cutaneous blood flow c. Increased blood pressure d. Increased heart rate

c. Increased blood pressure

*Which of the following interventions is most likely to produce a generalized heating effect (i.e. increased core temperature) in a patient? a. SWD to the shoulder b. Hot pack to the anterior thigh c. Lower body and torso immersion in a 102 deg F whirlpool bath d. Paraffin to the hand/wrist

c. Lower body and torso immersion in a 102 deg F whirlpool bath

15. The process by which a monopolar electrotherapy treatment with a high pulse frequency has an effect on tissue swelling is called: a. muscle pumping b. iontophoresis c. cataphoresis d. capacitance

c. cataphoresis

8. Which of the following is NOT one of the legs of the EBP stool? a. Best available evidence b. Patient values c. Clinical expertise d. Patient current status

d. Patient current status

*Complete the 3 legs of Evidence Based Practice. (You have to be specific in your placement and try all 3 places with the same choice)

1. Best Research Evidence 2. Clinical Expertise 3. Patient Values and Preferences

2. Match the current with the descriptor. 1 Premodulated Current: 2 Microcurrent: 3 High Volt Pulsed Current: 4 Interferential Current: 5 Russian or Aussie Current: 6 Biphasic Pulsed current: A can be symmetrical or asymmetrical B has bursts of alternating current and used for muscle contractions C can accumulate a net charge D delivers an amplitude modulated current E produces amplitude modulated current within the tissue F has a very low amplitude

1D, 2F, 3C , 4E, 5B, 6A,

10. Higher frequencies of the EM spectrum are capable of delivering more energy than lower frequencies. True False

True

19. You wish to use iontophoresis to deliver 40 Ma min of an anti-inflammatory medication. If your patient can tolerate 2 mA of current, how long is the treatment? a. 20 minutes b. 40 minutes c. 80 minutes d. Duration does not matter as long as you maintain a steady 2 mA current

a. 20 minutes

9. You wish to use iontophoresis to deliver 40 Ma min of an anti-inflammatory medication. If your patient can tolerate 2 mA of current, how long is the treatment? a. 20 minutes b. 40 minutes c. 80 minutes d. Duration does not matter as long as you maintain a steady 2 mA current

a. 20 minutes

15. Which of the following patients and conditions would be BEST served with the application of superficial heat? a. A 17 year old with attention deficit disorder who presents with pain along the lateral knee from repetitive jumping. b. An 80 year old with rheumatoid arthritis who presents with an acute exacerbation of pain in both hands. c. A 45 year old with multiple sclerosis, fibromyalgia, and chronic low back who presents with pain along the entire paraspinal muscles of the back. d. A 64 year old with hypertension who presents with low back pain and stiffness that was aggravated at work 2 weeks ago

a. A 17 year old with attention deficit disorder who presents with pain along the lateral knee from repetitive jumping.

*Which of the following is true regarding application of a cold pack? a. A person with more adipose tissue will need a longer duration treatment to achieve the same effects in a target muscle than a person with less adipose tissue b. By the end of the treatment, expect the skin under the ice pack to appear white as a result of decreased superficial blood flow c. Recommended treatment times range from 30 minutes to 2 hours d. All of the above statements are true

a. A person with more adipose tissue will need a longer duration treatment to achieve the same effects in a target muscle than a person with less adipose tissue

12.Which of the following is true regarding application of a cold pack? a. A person with more adipose tissue will need a longer duration treatment to achieve the same effects in a target muscle than a person with less adipose tissue b. By the end of the treatment, expect the skin under the ice pack to appear white as a result of decreased superficial blood flow c. Recommended treatment times range from 30 minutes to 2 hours d. All of the above statements are true

a. A person with more adipose tissue will need a longer duration treatment to achieve the same effects in a target muscle than a person with less adipose tissue

5.The non-thermal (athermal) effects that occur as a result of the application of ultrasound are thought to be caused at least in part by which one of the following mechanisms? a. Acoustical streaming b. Collimation c. Beam non-uniformity d. Condensation

a. Acoustical streaming

12. In general when apply intermittent compression, which of the following pressures represent a moderate compression force? a. Between 40 - 60 mmHg b. Between 10 - 30 mmHg c. none of the above d. Less than 10 mmHg

a. Between 40 - 60 mmHg

*Correctly complete the following sentence. Proposed mechanical responses to ultrasound (US) at therapeutic intensities include: a. Cavitation, which refers to expansion and compression of gas bubbles exposed to US b. Unstable cavitation, which can be avoided by increasing US frequency c. Vessel rarefaction, which results in increased capillary permeability d. Microstreaming, which is responsible for decreased muscle tone

a. Cavitation, which refers to expansion and compression of gas bubbles exposed to US

9. An ice pack over a wet towel produces its thermal effects primarily through which type of energy transfer? Select one: a. Conduction b. Conversion c. Convection d. Rarefaction e. Evaporation Try again.

a. Conduction

1. Physical agent application generally involves the delivery of energy into the tissues. The main exception(s) to this delivery is/are: Select all that apply a. Cryotherapy b. Ultrasound c. EMG biofeedback d. Mechanical cervical traction e. TENS

a. Cryotherapy c. EMG biofeedback

50. The amount of energy or dose required to elicit a specific response in the target tissues is controlled by the: a. Dosage parameter b. Received dosage c. Dose-response relationship d. Delivered dosage

a. Dosage parameter

17.Regarding skeletal muscle blood flow, which of the following statements is true? a. Exercise results in greater increases in blood flow than application of heat pack b. Neither exercise nor superficial heat can increase skeletal muscle blood flow as it is primarily under metabolic regulation c. Increases in blood flow are equivalent with application of either heat pack or exercise d. Using a heat pack can result in greater increases in blood flow than exercise if the duration of heat application is greater than 30 minutes

a. Exercise results in greater increases in blood flow than application of heat pack

4. The recommended minimum amount of force to apply during mechanical traction (to achieve vertebral separation) is: a. For lumbar traction, 50% body weight b. For cervical traction, 10 pounds of force c. For cervical traction, 25% of the patient's body weight d. For lumbar traction, 35 pounds of force e. For lumbar traction, 25% body weight

a. For lumbar traction, 50% body weight

39. A patient with cervical radiculopathy and lower cervical pain has a history of chronic pain, smoking, TMJ, and hypertension. They deny any acute trauma and believes the pain is a result of working on writing a mid-term examination. The patient reports finding relief of symptoms with traction. Which of the following treatment set ups would be best at this time? a. In the clinic mechanical cervical traction in supine starting at 10# intermittent for 15 min. b. Home traction in the seated position using the over the door unit with a 25# load for 10 min twice a day. c. Do not perform traction since it is contraindicated. d. Home traction in the supine position using the pneumatic cervical unit set at 25# for 10 min twice a day.

a. In the clinic mechanical cervical traction in supine starting at 10# intermittent for 15 min.

4. Which of the following would NOT be a good way of decreasing the number of 'hits' obtained during a database search of the research literature? a. Including the Boolean operator OR to combine search terms b. Including the Boolean operator AND to combine search terms c. Specifying the type of article (eg. systematic review) to search d. Using pre-defined 'limits' to eliminate unwanted age groups or languages

a. Including the Boolean operator OR to combine search terms

*Select the FALSE statement regarding meta-analysis. a. Meta-analysis is a synonym for a randomized clinical trial b. Meta-analysis is a type of systematic review c. A meta-analysis may be able to detect statistical significance in cases where an individual study could not detect a significant difference d. A meta-analysis combines data from similar studies to improve statistical power Feedback

a. Meta-analysis is a synonym for a randomized clinical trial

*Which of the following statements is the reason we take all of the different factors into consideration (research evidence, patient personal factors, clinical expertise, setting, etc) during decision making about biophysical agents. a. We wish to have the highest level of confidence in our decisions. b. We wish to be certain that our treatments will have the effects we want. c. It enables us to accurately predict what the patient's response to the treatment will be. d. All of the above.

a. We wish to have the highest level of confidence in our decisions.

*For which of the following patients would contrast bath likely be most beneficial? Select all that apply a. A child with an acute burn on her (R) hand b. A patient with chronic low back pain c. An elderly woman with chronic knee osteoarthritis d. A varsity basketball player who twisted her (L) ankle during the first round of the NCAA tournament 2 nights ago

b. A patient with chronic low back pain c. An elderly woman with chronic knee osteoarthritis d. A varsity basketball player who twisted her (L) ankle during the first round of the NCAA tournament 2 nights ago

40. Which of the following patients have a condition that would contraindicate or serve as a precaution to the use of cervical traction? a. A 57 year old with cervical radiculopathy after sustaining a whiplash injury from a car accident when she was 50. b. A woman who is 7 months pregnant complaining of left sided neck pain secondary to frequent carrying of her 10 month old child. c. A 67 year old man with cervical pain secondary to spinal stenosis. d. All would equally benefit from cervical traction.

b. A woman who is 7 months pregnant complaining of left sided neck pain secondary to frequent carrying of her 10 month old child.

1. Which of the following does NOT belong in the list of elements of evidence-based practice? a. Acquire b. Allocate c. Appraise d. Apply

b. Allocate

8. In the electromagnetic (EM) spectrum, a radio wave: a. Is equivalent to ultraviolet radiation b. Can carry the EM energy of diathermy c. Has the highest frequency of the EM radiations d. Has a wavelength shorter than infrared radiation

b. Can carry the EM energy of diathermy

7.Per the textbook and Physiotherapy Canada article, which of the following conditions is a contraindication to the use of continuous or pulsed ultrasound therapy in the target area (i.e. local)? Select one: a. Presence of a tattoo b. Cardiac pacemaker c. Significant adipose tissue d. Chronic inflammation e. Superficial bony prominence

b. Cardiac pacemaker

8. Which of the following is correct with regard to cervical traction? a. Approximately 30-45 pounds of traction force is required to achieve vertebral separation in the cervical spine b. Cervical traction applied with the patient sitting requires more force to achieve the desired effect than when applied with the patient supine c. Patients always have better outcomes when the traction force is as high as they can tolerate d. A person with a history of temporomandibular joint problems should not have any form of cervical traction

b. Cervical traction applied with the patient sitting requires more force to achieve the desired effect than when applied with the patient supine

49. Which of the following indications or contraindication of intermittent pneumatic compression (IPC) is correct? a. IPC is indicated for decreasing high extremity blood pressure related to pulmonary edema b. IPC can prevent deep venous thrombosis formation in a person who is immobilized c. IPC is contraindicated for open wounds, as it decreases oxygen delivery to the wound d. ICP is indicated for post-traumatic edema resulting from an acute fracture

b. IPC can prevent deep venous thrombosis formation in a person who is immobilized

44. Mechanical traction is unlikely to be effective in achieving which of the following? a. Distraction of vertebral facet joints b. Permanent reduction of herniated nucleus pulposis (disc) c. Separation of vertebral bodies d. Stretching of soft tissues of the spine

b. Permanent reduction of herniated nucleus pulposis (disc)

10. The unprocessed (except for some minor filtering) sEMG signal that detects the voltages from numerous motor unit action potentials (MUAPs) during a muscle contraction is referred to as: a. Integrated EMG b. Raw EMG c. Rectified EMG d. Summated EMG

b. Raw EMG

*Which of the following conditions is NOT cause for extra caution when using cold therapy? a. Open wound b. Rheumatoid arthritis c. Arterial insufficiency d. Hypertension

b. Rheumatoid arthritis

7. Which of the following electrical stimulation parameters would be best for tissue healing in a chronic wound? a. Motor level DC, negative polarity b. Submotor level HVPC, 100 pps, with negative electrode over infected wound c. Motor level NMES, 50 pps, for muscle pump of muscles adjacent and distal to wound d. Sensory level TENS, low frequency (2-4 pps), positive electrode over necrotic wound bed

b. Submotor level HVPC, 100 pps, with negative electrode over infected wound

9. The main reason a probe can be useful for locating motor points prior to applying electrodes for an NMES treatment is: a. The probe is roughly the same size as the neurovascular bundle entering the muscle at the motor point b. The probe can help distinguish the area of lower skin impedance that exists over a motor point from that of adjacent areas of skin c. The surface area of the probe is smaller than that of the electrodes you will use for the actual NMES treatment d. The probe can be set to either positive or negative polarity

b. The probe can help distinguish the area of lower skin impedance that exists over a motor point from that of adjacent areas of skin

20. Which of the following statements about Type C fibers is INCORRECT. a. They may respond to a variety of stimulus types b. Their distribution in the skin is less than that of A delta fibers c. They are associated with 'slow pain'? d. All of the above statements are correct.

b. Their distribution in the skin is less than that of A delta fibers

8. Which of the following is true regarding motor units and recruitment? a. The smaller diameter type I motor fibers are more easily recruited with NMES than the larger diameter type II fibers b. Type II fibers are more fatigable than type I c. With a voluntary contraction, all motor units are recruited simultaneously, which generates a stronger contraction than with neuromuscular electrical stimulation (NMES) d. Type II motor fibers are recruited first with voluntary contractions

b. Type II fibers are more fatigable than type I

14. The quadripolar electrode configuration is used for which of the following effects? a. all of the above b. pain modulation. c. muscle stimulation d. tissue healing

b. pain modulation. Quadripolar is the electrode arrangement used in IFC, which is most commonly used for pain.

14. According to recent literature, for which of the following condition might monochromatic infrared energy (MIRE) be effective? a. dermatitis b. peripheral neuropathy c. osteoarthritis d. fibromyalgia

b. peripheral neuropathy

19. During electrotherapy applications, most of the resistance or impedance in the patient circuit occurs in: a. the special low conductance regions of the skin which coincide with acupuncture points or trigger points. b. the skin. c. the motor end plates. d. the myelinated axon membranes

b. the skin.

16.On presentation to the clinic today, which of the following patients is the most likely candidate for heat modalities? a. 19-year-old male who is developing a hematoma following a thigh contusion sustained in basketball practice today b. 78-year-old female with arthritic hand pain who applied a heat liniment just prior to todays visit c. 13-year-old female with muscular neck pain from a motor vehicle accident last week d. 64-year-old male with referred back pain related to prostate cancer

c. 13-year-old female with muscular neck pain from a motor vehicle accident last week

3.A pulsed or interrupted modality that is on for 1 msec and off for 3 msec has a duty cycle of: a. 20% b. 66.7% c. 25% d. 33.3%

c. 25%

*Which of the following parameters would be BEST to obtain a mild heating effect in the patella tendon using continuous ultrasound? a. 3 Mhz frequency; 1.5 w/cm2 b. 1 Mhz frequency; 0.5 w/cm2 c. 3 MHz frequency; 0.5 w/cm2 d. 1 Mhz frequency; 1.5 w/cm2

c. 3 MHz frequency; 0.5 w/cm2

8. Which electrode choice below is most appropriate when the goal of electrical stimulation is to produce a strong muscle contraction in a large muscle group, such as the quadriceps? a. The size of the electrode does not matter as long as it has a metal interface b. A small electrode is best because motor threshold stimulation requires a high current density c. A large electrode, because the intensity required for stimulation is most comfortable when using an electrode with lower current density d. A probe electrode, as muscle contractions are more likely when stimulating a very specific site

c. A large electrode, because the intensity required for stimulation is most comfortable when using an electrode with lower current density

51. Attenuation of acoustic energy is defined as: a. Increases in kinetic energy as sound is refracted at a tissue interface b. The net acoustic energy passing into the subcutaneous tissue c. A measure of the decrease in sound energy as the sound wave progresses through the tissue d. Creation of a standing wave when an ultrasound transducer is held stationary for too long

c. A measure of the decrease in sound energy as the sound wave progresses through the tissue

8. Which of the following responses is (are) typical for an electrical stimulation treatment? a. Muscle contractions usually occur with stimulation set at subsensory levels b. C-fibers are the first afferent nerves to depolarize with electrical stimulation c. As stimulation intensity increases, a person will usually feel a muscle twitch or contraction before experiencing pain from the stimulation d. All of the above are true

c. As stimulation intensity increases, a person will usually feel a muscle twitch or contraction before experiencing pain from the stimulation

26. Which of the following conditions would continuous ultrasound be MOST indicated for its therapeutic effectiveness? a. Chronic ankle edema b. Non-specific shoulder pain c. Carpal tunnel syndrome (scar tissue) d. Bursitis pain

c. Carpal tunnel syndrome (scar tissue)

2. Energy refraction occurs as a result of: a. Summation of the energy waves coming in and bouncing back b. An increase in the frequency of the wave as it enters a new medium with a different density c. Changes in the wave velocity due to density differences in the new medium d. None of the above

c. Changes in the wave velocity due to density differences in the new medium

7. The type of pain that is most influenced by psychological factors is: a. Neuropathic pain b. Neurogenic pain c. Chronic pain d. Referred pain

c. Chronic pain

13. Chronic venous insufficiency is a precaution when using what type(s) of modalities? a. Intermittent pneumatic compression b. Cryotherapy c. Heating agents d. Traction

c. Heating agents

4. The general type of EMG practiced by therapists during rehabilitation is referred to as: a. Biomechanical EMG b. Integrated EMG c. Kinesiological EMG d. Neurological EMG e. Functional EMG

c. Kinesiological EMG

6. Which of the following EMG measures would indicate a muscle is slow to return to a full baseline relaxation state? a. Inconsistent MIVC percentage b. Fast or steep offset slope c. Slow or shallow offset slope d. Slow or shallow onset slope

c. Slow or shallow offset slope

13. All for the wave forms below represent which of the following? a. They are all monopolar b. They are all types of pulsed current. c. They are all types of alternating current (AC) d. They are all types of unbalanced asymmetrical current.

c. They are all types of alternating current (AC)

3. Placing electrodes farther apart will result in which of the following effects? a. shallower current penetration b. higher current intensity under the electrodes. c. deeper current penetration d. lower current intensity under the electrodes.

c. deeper current penetration

5. Unequal electrode sizes within one application will result in which of the following effects? a. higher current intensity under the larger electrode. b. greater depth of penetration under the larger electrode. c. higher current intensity under the smaller electrode. d. greater depth of penetration under the smaller electrode

c. higher current intensity under the smaller electrode.

32. What is the maximum tissue depth that diathermy can have a heating effect in the tissues? a. 1 cm b. 2 cm c. 3 cm d. 4 cm

d. 4 cm

*What is the maximum tissue depth that diathermy can have a heating effect in the tissues? a. 1 cm b. 2 cm c. 3 cm d. 4cm

d. 4cm

15. Which parameters would most likely be effective when the goal of neuromuscular electrical stimulation is to enhance strength? a. 30 pps, 4 seconds on : 4 seconds off, 10 minutes b. 30 pps, 10 seconds on : 30 seconds off, 10 contractions c. 75 pps, 4 seconds on : 4 seconds off, 10 contractions d. 50 pps, 10 seconds on : 50 seconds off, 10 minutes

d. 50 pps, 10 seconds on : 50 seconds off, 10 minutes

*Physiologic changes attributed to therapeutic levels of tissue heating include which of the following? a. Increased cell metabolism b. Increased tissue oxygen demand c. Vasodilation d. All of the above

d. All of the above

11. From the following, which factors might influence the clinical decision making (CDM) process related to PT interventions? a. Chronicity or severity of the current condition b. Comorbidities, complications, or secondary impairments c. Concurrent medical, surgical, and therapeutic interventions d. All of the above

d. All of the above

4. Because the physiologic effects of conventional (high frequency) transcutaneous electrical nerve stimulation (TENS) for electroanalgesia can be generally short-lived, which of the following support(s) the use of TENS in a clinical setting? a. TENS may decrease pain enough that a patient could participate in an exercise regimen that may result in long-term improvements b. TENS may improve patient comfort after a painful treatment session c. TENS may decrease pain during an otherwise painful, but necessary, treatment procedure d. All of the above

d. All of the above

5. Which traction parameters are likely to affect treatment efficacy for a given indication? a. Angle of pull b. Force of traction c. Position of patient d. All of the above

d. All of the above

9. How do electrical currents affect tissue repair? a. Facilitate migration of inflammatory cells to site of injury b. Stimulate release of chemicals, such as histamine c. Increase production of fibroblasts, ATP, and epithelial cells d. All of the above

d. All of the above

8. The method of thermal energy transfer that relies upon the movement of fluids is: a. Evaporation b. Conversion c. Radiation d. Convection e. Conduction

d. Convection

1. According to Ohms law, when using a device that has a constant voltage, what will happen to the current when the skin impedance increases? a. No change in current b. The patient will feel a short duration shock c. Current increases d. Current decreases

d. Current decreases

2. Which type of current is represented in the diagram below? a. Direct monopolar current b. Monophasic pulsed current c. Interferential Alternating Current (IFC) d. High Volt pulsed current (HVPC)

d. High Volt pulsed current (HVPC)

8. Which of the following would NOT be a good way of decreasing the number of 'hits' obtained during a database search of the research literature? a. Specifying the type of article (eg. systematic review) to search b. Including the Boolean operator AND to combine search terms c. Using pre-defined 'limits' to eliminate unwanted age groups or languages d. Including the Boolean operator OR to combine search terms

d. Including the Boolean operator OR to combine search terms

11. Which of the following electrotherapy modalities is most appropriate for alleviating acute global knee pain? a. Iontophoresis b. Motor level TENS c. NMES d. Sensory level TENS

d. Sensory level TENS

6. With repeated exposure to UV radiation: a. There is only risk of skin burn with repeated exposure to UVC b. The duration of time to cause erythema decreases by 35 percent per day c. The risk of skin cancer from overexposure decreases d. The amount of exposure required to achieve a MED increases

d. The amount of exposure required to achieve a MED increases

12. Which of the following statements best describes the wave forms shown below? a. Waveform A is symmetrical and balanced; Waveform B is Asymmetrical and balanced b. Waveform A is symmetrical and unbalanced; Waveform B is Asymmetrical and balanced c. Waveform A is asymmetrical and balanced; Waveform B is Asymmetrical and unbalanced d. Waveform A is symmetrical and balanced; Waveform B is Asymmetrical and unbalanced

d. Waveform A is symmetrical and balanced; Waveform B is Asymmetrical and unbalanced

1. Which of the following are potential conditions that should be disclosed to the patient as part of receiving informed consent when applying an electrotherapeutic agent? a. If using direct current, it may cause a burn b. A rash can develop under the electrode c. The muscle contraction may be uncomfortable d. The sensation may be unpleasant e. all of the above

e. all of the above