Evidence Based Practice - Quiz questions
A therapist poses the question "Is aquatic exercise alone as effective as aquatic exercise plus land based exercise in a 78-year-old male with osteoarthritis in both hips?" Which italicized phrase will make this question more consistent with an evidence-based practice format? 1) "...in a 78-year-old male with osteoarthritis in both hips for five years?" 2) "...plus land based exercise to improve ambulation tolerance..." 3) "...in a 78-year-old retired male postal worker..." 4) "...aquatic exercise in a group format as effective as..."
"...plus land based exercise to improve ambulation tolerance..."
In a randomized control trial, the best way for a researcher to protect against the biases associated with the patient's and investigator's knowledge of the treatment the patient is receiving is to: a. randomly assign patients to the intervention group b. perform an intent-to-treat analysis of the data 3. use a double-blind research design 4. use a single-blind research design
3. use a double-blind research design
All of the following statements about the qualitative research paradigm are true EXCEPT: 1) It espouses an objective reality that can be measured by the investigators 2) It draws conclusions from patterns of data that are the subjects' own words 3) It includes designs in which researchers interview subjects in their natural environments 4) It rejects use of strategies to control subjects' natural environments or behavior
4) It rejects use of strategies to control subjects' natural environments or behavior
All of the following are desirable design characteristics when searching for evidence to answer a clinical question except: 1) The information includes the type of interventions about which the therapist has a question 2) The information includes subjects similar to the individual about whom the question is posed 3) The information is consistent with the contemporary physical therapist practice for patients like this one 4) The information comes from an equipment manufacturer sales piece that is not peer reviewed
4) The information comes from an equipment manufacturer sales piece that is not peer reviewed
Which of the following is an essential element in the informed consent process? 1) A clinical practice guideline in plain language that details physical therapist management 2) A form composed by an attorney describing legal obligations of the physical therapist 3) A description of available evidence in plain language the patient can understand 4) A casual conversation about treatment options during the initial examination
A description of available evidence in plain language the patient can understand
A physical therapist is considering a continuing education course about dry needling but wants to know if it is safe and effective for use with high school athletes with neck pain. What type of clinical question is this therapist asking? 1) A background question about neck pain 2) A background question about dry needling 3) A foreground question about neck pain 4) A foreground question about dry needling
A foreground question about dry needling
The informed consent process is characterized by all of the following options EXCEPT: 1) An explicit invitation to the patient to share preferences and values about treatment 2) A form composed by an attorney describing legal obligations of the physical therapist 3) A description of available evidence in plain language the patient can understand 4) A formal conversation about treatment options during the initial examination
A form composed by an attorney describing legal obligations of the physical therapist
Clinicians at a local rehabilitation hospital conduct an historical chart review to compare outcomes in patients who received botulinum toxin (botox) injections versus patients who were placed in serial casts to control spasticity at the ankle. How were these groups created? 1) A probabilistic sampling method 2) A non-probabilistic sampling method 3) A probabilistic assignment method 4) A non-probabilistic assignment method
A non-probabilistic assignment method
All of the following factors have contributed to the focus on patient-centered care EXCEPT: 1) Access to health and medical information through the Internet 2) Proliferation of chronic diseases that require self-management 3) Enhanced satisfaction when patients participate in decision-making 4) A preference to rely on the expertise of the physical therapist
A preference to rely on the expertise of the physical therapist
Which of the following factors has contributed to the focus on patient-centered care? 1) Access to health and medical information through the Internet 2) Proliferation of chronic diseases that require self-management 3) Enhanced satisfaction when patients participate in decision-making 4) All of these are correct
All of these are correct
Which of the following formats is an example of a pre-appraised collection of evidence? 1) Systematic review 2) Clinical practice guideline 3) Synopsis of selected studies 4) All of these are correct
All of these are correct
Which of the following is a focus area for evidence-based physical therapist practice? 1) Accuracy of prognostic indicators 2) Effectiveness of interventions 3) Responsiveness of outcomes measures 4) All of these are correct
All of these are correct
Which of the following is an appropriate strategy to deal with an insufficient number of citations returned during an evidence database query? 1) Use the related citations feature in the search engine 2) Make the research question more general 3) Reduce the number of search field limits 4) All of these are correct
All of these are correct
Which of the following research products is an example of a primary source of evidence? 1) A systematic review about the accuracy of a clinical test for knee pain 2) An individual study about the accuracy of a clinical test for knee pain 3) A PubMed abstract from a study about the accuracy of a clinical test for knee pain 4) A citation list of studies about the accuracy of a clinical test for knee pain
An individual study about the accuracy of a clinical test for knee pain
Which of the following study designs has the fewest strategies for controlling unwanted influence on the outcomes of interest? 1) Anecdotal reports about individual patients 2) Randomized trials in clinical settings 3) Observational studies based on large data sets 4) Quasi-experimental studies of one group of subjects
Anecdotal reports about individual patients
Which of the following statements describes how evidence can inform the impact of interventions a physical therapist may use? 1) Articles are located that evaluate the accuracy of the Lachman's test in the detection of anterior cruciate ligament laxity. 2) Articles are located that evaluate the effectiveness of aquatic therapy for spasticity due to cerebral palsy 3) Articles are located that indicate obesity is associated with delayed back pain recovery. 4) Articles are located that indicate the Oswestry Disability Index is sensitive to change in patients with low back pain.
Articles are located that evaluate the effectiveness of aquatic therapy for spasticity due to cerebral palsy
Which of the following statements describes how evidence can inform the prediction of patient outcomes? 1) Articles are located that evaluate the accuracy of the Homan's sign in the detection of deep vein thrombosis 2) Articles are located that evaluate the effectiveness of aquatic therapy for spasticity due to cerebral palsy 3) Articles are located that indicate smoking is associated with delayed back pain recovery 4) Articles are located that indicate the Neck Disability Index is sensitive to change in patients with whiplash injuries
Articles are located that indicate smoking is associated with delayed back pain recovery
A physical therapist reads a systematic review that includes statistically significant evidence of harmful effects of a long-established intervention for chronic neck pain. He shares this information with his patient but she insists on receiving the intervention because it worked for a friend with a similar complaint. Which ethical principles are in conflict in this situation? 1) Beneficence - Nonmaleficence 2) Beneficence - Autonomy 3) Autonomy - Nonmaleficence 4) Autonomy - Self-determination
Autonomy - Nonmaleficence
Which of the following is an example of a concept? 1) Self-awareness 2) Balance 3) Motivation 4) Readiness
Balance
A physical therapist uncovers evidence that a new intervention publicized to treat chronic low back pain is not effective compared to standard exercise and manual techniques. She informs her patient of this information but he demands she apply the new technique because he has seen favorable testimonials on the television. Which ethical principles are in conflict in this situation? 1) Beneficence - Nonmaleficence 2) Beneficence - Autonomy 3) Autonomy - Nonmaleficence 4) Autonomy - Self-determination
Beneficence - Autonomy
Researchers study two groups of elderly people, one of which is characterized by healthy aging, the other of which is not. The investigators want to know whether the volume of physical activity in each group was related to their current health status. Which of the following is the correct research design for this study? 1) Case-control 2) Cohort 3) Experimental 4) Qualitative
Case-control
Which of the following electronic evidence databases indexes citations that are systematic reviews produced by an international collaborative network? 1) CINAHL Plus 2) PTNow 3) PEDro 4) Cochrane Library
Cochrane Library
Clinical prediction rules and self-report outcomes measures have which of the following research design elements in common? 1) Implementation of a randomization process to place subjects into groups 2) Numerous controls in place to minimize the effect of unwanted influences 3) Development and validation processes that may occur in separate studies 4) Use of interviews and video tapes to triangulate information obtained from subjects
Development and validation processes that may occur in separate studies
According to the Institutes of Medicine, which of the following is a characteristic of patient-centered care? 1) Development of patient knowledge and skills for self-management 2) Directing the patient and family throughout the episode of care 3) Deferring out-of-pocket expenses if the patient is financially limited 4) Consulting with the patient's medical team about the plan of care
Development of patient knowledge and skills for self-management
A physical therapist is using a second-grade classroom to study the usefulness of a new seating device in children with cerebral palsy. This approach is an example of an: 1) Effectiveness study 2) Efficacy study 3) Physiologic study 4) Experimental study
Effectiveness study
A physical therapist is using the cardiovascular lab to study the impact of a new treadmill exercise program in healthy graduate students. This approach is an example of an: 1) Effectiveness study 2) Efficacy study 3) Physiologic study 4) Experimental study
Efficacy study
All of the following are focus areas for evidence-based physical therapist practice EXCEPT: 1) Accuracy of clinical prediction rules about intervention 2) Patient and caregiver perspectives about physical therapy 3) Responsiveness of patient reported outcomes measures 4) Epidemiologic studies about the origins of a disorder
Epidemiologic studies about the origins of a disorder
A keynote lecture emphasized the speaker's experience managing individuals with weakness due to post-polio syndrome. This scenario is an example of: 1) Participation restrictions 2) Expert practice 3) Biologic plausibility 4) Patient preferences and values
Expert practice
Which of the following is an example of a background question? 1) How long will it take for muscle spasticity to decrease following a botulinum toxin injection in the calves of a 19-year-old male with a spinal cord injury? 2) What is the most accurate measure of wound dimension in a 68-year-old woman with a diabetic pressure ulcer? 3) Does a previous fall predispose an 89-year-old man to a future fall with injury? 4) What is the most effective way to manage pain in a 25-year-old woman with fibromyalgia?
How long will it take for muscle spasticity to decrease following a botulinum toxin injection in the calves of a 19-year-old male with a spinal cord injury?
Which of the following statements reflects a move away from authority and tradition in practice? 1) Regular attendance at continuing education courses by the same clinical teacher. 2) Requests for consultation from expert therapist to answer clinical questions. 3) Reliance on DPT program text books to guide clinical decision making. 4) Internet search for scientific articles in response to a gap in knowledge
Internet search for scientific articles in response to a gap in knowledge
Which of the following is a correct statement about the qualitative research paradigm? 1) It espouses multiple realities that are constructed through subjects' perceptions 2) It relies on use of research design controls to isolate treatment effects 3) It only supports collection of study data in the form of numerical quantities 4) It includes designs in which researchers actively intervene with subjects
It espouses multiple realities that are constructed through subjects' perceptions
Investigators predict that elderly men with spinal stenosis will increase their pain free walking distance with aquatic exercise more than with land-based exercise. Which of the following correctly characterizes this statement? 1) It is a statistical hypothesis 2) It is a directional hypothesis 3) It is a null hypothesis 4) It is a conceptual hypothesis
It is a directional hypothesis
Physical therapists in a skilled nursing facility want to know if group exercise supervised by a PT or PTA will produce the same outcomes as the same exercise applied in a one-on-one session with a therapist. They randomly assign individuals to the group and one-on-one sessions and measure outcomes after six weeks. Which of the following accurately characterizes this research design? 1) It is a retrospective experimental design 2) It is a retrospective quasi-experimental design 3) It is a prospective experimental design 4) It is a prospective quasi-experimental design
It is a prospective experimental design
Which of the following is the least accurate statement about evidence-based physical therapist practice? 1) It provides the proof needed to convince regulators that physical therapy always works 2) It requires the therapist to consider an individual's preferences regarding clinical options 3) It de-emphasizes traditions established by authoritative physical therapists 4) It prioritizes results from research designs that minimize bias over biologic plausibility
It provides the proof needed to convince regulators that physical therapy always works
Which of the following is the most accurate statement about evidence-based physical therapist practice? 1) It provides the proof needed to convince payers that physical therapy is effective 2) It requires the therapist to articulate clearly a rationale for his/her clinical decisions 3) It emphasizes the authority and tradition established by well-known physical therapists 4) It prioritizes biologic plausibility over results from research designs that minimize bias
It requires the therapist to articulate clearly a rationale for his/her clinical decisions
Authors of a study propose that disparities in access to physical therapist services are explained by a multitude of factors depicted in this figure.Which of the following terms most accurately characterizes this figure? 1) It's a biologically plausible construct 2) It's a conceptual framework 3) It's a theoretical model 4) It's a null hypothesis
It's a conceptual framework
Investigators predict that young women with patellofemoral knee pain will benefit equally from a silicone sleeve and from kinesiotape. Which of the following correctly characterizes this statement? 1) It's a research hypothesis 2) It's a directional hypothesis 3) It's a null hypothesis 4) It's a conceptual hypothesis
It's a null hypothesis
Clinicians at a local home health agency compare home exercise program adherence among a randomly selected group of current patients who underwent total knee arthroplasty. Which term correctly characterizes this approach? 1) It's a probabilistic sampling method 2) It's a non-probabilistic sampling method 3) It's a probabilistic assignment method 4) It's a non-probabilistic assignment method
It's a probabilistic sampling method
A therapist enters the phrase "(reliability OR validity) AND measure AND wound" into PubMed. The term "validity" is an example of a: 1) Keyword 2) Boolean operator 3) Search string 4) Field limit
Keyword
Which of the following terms refers to the pooling of data as part of a systematic review? 1) Meta-analysis 2) Randomized trial 3) Prospective cohort 4) Case series
Meta-analysis
Which of the following is a true statement about theoretical models? 1) Researchers can prove a theory is true with one investigation 2) Theories are unable to predict future outcomes 3) Theories are simplistic characterizations of a phenomenon 4) Multiple constructs may be linked together to create a theory
Multiple constructs may be linked together to create a theory
An article in which the authors provide a summary of individual studies without using a standardized analysis of their quality is referred to as a/an: 1) Peer review 2) Narrative review 3) Systematic review 4) Guideline review
Narrative review
Which of the following is a true statement about hypotheses? 1) Researchers are required to include them in all studies submitted for publication 2) Rejection of a hypothesis means that an alternative explanation has been proven 3) Null hypotheses form the basis for statistical tests used in research reports 4) Formal hypotheses are not useful for testing theories or conceptual frameworks
Null hypotheses form the basis for statistical tests used in research reports
All of the subjects in a study investigating a new modality for diabetic neuropathic pain indicate a positive belief in the likelihood of relief due to the intervention. Which of the following terms characterizes the situation if subjects in the sham modality group experience an improvement in pain? 1) Ceiling effect 2) Floor effect 3) Treatment effect 4) Placebo effect
Placebo effect
A study about the risk of falling in an elderly person with frailty is referred to as a/an: 1) Experimental study 2) Prognosis study 3) Single-system study 4) Physiologic study
Prognosis study
Which of the following design elements is mostly likely to help researchers isolate the effect of an experimental intervention if one exists? 1) Systematic sampling of subjects 2) Use of a sampling frame 3) Protocols for subject management 4) Application of inclusion criteria
Protocols for subject management
Investigators use focus groups to study perceptions of the quality of care at local free health clinics in one city. What form of subject selection does this approach represent? 1) Random sampling 2) Purposive sampling 3) Convenience sampling 4) Cluster sampling
Purposive sampling
Which of the following study designs has the most strategies for controlling unwanted influence on the outcomes of interest? 1) Anecdotal reports about individual patients 2) Randomized trials in clinical settings 3) Observational studies based on large data sets 4) Quasi-experimental studies of one group of subjects
Randomized trials in clinical settings
Which of the following is an example of a concept? 1) Safety awareness 2) Empowerment 3) Range of motion 4) Satisfaction
Range of motion
Authors of a hypothetical research report indicate that prior studies did not have enough power to detect a relationship between age and deterioration in bone density. What type of justification does this represent for their study? 1) Epidemiologic data about the prevalence of the problem 2) Research design limitations in previously published articles 3) A need to test scientifically a phenomenon based in clinical theory 4) An interest in investigating a newly discovered phenomenon
Research design limitations in previously published articles
All of the following are accurate statements about theoretical models EXCEPT: 1) Researchers can prove a theory is true with one investigation 2) Theories are designed to predict future outcomes 3) Theories are complex characterizations of a phenomenon 4) Multiple constructs may be linked together to create a theory
Researchers can prove a theory is true with one investigation
All of the following factors are potential reasons to implement evidence-based practice EXCEPT: 1) Variability in PT practice that cannot be explained by differences in co-morbidities. 2) Increased patient injury due to inappropriate direction and supervision of support staff. 3) Stabilization of costs for physical therapist services over the last twelve months. 4) Identification of harmful effects from previously established PT interventions.
Stabilization of costs for physical therapist services over the last twelve months.
A null hypothesis also is referred to as a: 1) Statistical hypothesis 2) Research hypothesis 3) Alternate hypothesis 4) Conceptual hypothesis
Statistical hypothesis
Which of the following is a facilitator of evidence-based physical therapist practice? 1) Statistical results that are understandable and clinically relevant. 2) Management expectations that therapist learning occurs during "off hours". 3) Technology access and use restrictions during patient care. 4) Evidence that has design flaws that are difficult to detect.
Statistical results that are understandable and clinically relevant.
Meta-analyses are a subset of: 1) Randomized controlled trials 2) Systematic reviews 3) Experimental designs 4) Clinical prediction rules
Systematic reviews
Which of the following is a desirable design characteristic when searching for evidence to answer a clinical question? 1) The article focuses on the type of diagnostic test about which the therapist has a question 2) The article reports on historical interventions previously in use for patients like this one 3) The article is published in a non-peer reviewed trade publication for physical therapists 4) The article includes individuals unlike the patient about whom there is a question
The article is published in a non-peer reviewed trade publication for physical therapists
All of the following statements support an argument for causality in prognosis studies EXCEPT: 1) The results indicate a dose-response relationship exists between the predictive factor and the outcome 2) The results indicate a statistically significant relationship between the predictive factor and the outcome 3) The design clearly establishes a temporal sequence in which the predictive factor preceded the outcome 4) The design included extraneous influences that were likely to influence the predictive factor or the outcome
The design included extraneous influences that were likely to influence the predictive factor or the outcome
Which of the following behaviors characterizes shared decision-making? 1) The patient shares responsibility for treatment decisions with his family 2) The patient shares responsibility for treatment decisions with the physical therapist 3) The physical therapist shares responsibility for treatment decisions with the physician 4) The physical therapist shares responsibility for treatment decisions with the payer
The patient shares responsibility for treatment decisions with the physical therapist
Shared decision-making differs from informed consent in which of the following ways? 1) The patient and physical therapist take mutual responsibility for treatment decisions 2) The patient and his family assume primary responsibility for treatment decisions 3) The physical therapist defers responsibility for treatment decisions to the physician 4) The physical therapist assumes primary responsibility for treatment decisions
The physical therapist assumes primary responsibility for treatment decisions
Authors indicate that the lighting and room temperature were set at the same levels for all exercise testing sessions during their study. Which of the following unwanted influences does this method of control attempt to address? 1) The possibility that the outcome will be influenced by extraneous variables related to the subjects 2) The possibility that the outcome will be influenced by subjects in different groups interacting with each other 3) The possibility that the outcome will be influenced by environmental conditions during the testing period 4) The possibility that the outcome will be influenced by the clinical personnel's behavior during the testing period
The possibility that the outcome will be influenced by environmental conditions during the testing period
Authors indicate that subjects were recruited and studied at three different employment locations in the state of New Hampshire. Which of the following unwanted influences does this method of control attempt to address? 1) The possibility that the outcome will be influenced by extraneous variables related to environmental conditions 2) The possibility that the outcome will be influenced by the testing and measurement methods used 3) The possibility that the outcome will be influenced by subjects in different groups interacting with each other 4) The possibility that the outcome will be influenced by the clinical personnel's behavior during the testing period
The possibility that the outcome will be influenced by subjects in different groups interacting with each other
Authors of a study about utilization and quality of physical therapist services for toddlers with cystic fibrosis recruited subjects from one local children's hospital. Which of the following statements accurately characterizes this approach? 1) The sample is referred to as the accessible population of interest 2) The sample is divided into subgroups based on relevant characteristics 3) The sample is representative the target population of interest 4) The sample is biased due to the probabilistic method of selection
The sample is referred to as the accessible population of interest
Which of the following statements explains why randomized clinical trials are highly valued in evidence-based practice? 1) They are an efficient way for therapists to access results from multiple studies 2) They are experimental designs with a high degree of bias control in their methods 3) They focus on bench research to determine the effectiveness of interventions 4) They are case report designs that depict patient management in a realistic way
They are experimental designs with a high degree of bias control in their methods
Which of the following is an advantage of general Internet search engines such as Yahoo Education or Google Scholar? 1) Evidence search limit options are not specific to health care related terms or concepts 2) They have intuitive control features that facilitate the efficiency of evidence searches 3) They require an annual paid subscription fee to perform regular advanced searches 4) Studies identified in a search are ranked according to the number of times they are cited
They have intuitive control features that facilitate the efficiency of evidence searches
Which of the following most accurately characterizes traditional evidence hierarchies? 1) They minimize the need for a quality assessment of individual studies 2) They have the same operational definitions and number of levels 3) They may improve the efficiency of a search process for physical therapists 4) They rank physiologic studies highly because of the degree of bias control they achieve
They may improve the efficiency of a search process for physical therapists
How can qualitative studies about patient perceptions and experiences inform physical therapist practice? 1) They may provide insight into culturally acceptable treatment options 2) They may describe specific steps for applying an intervention 3) They may facilitate conclusions based on large secondary data sets 4) They may provide background on the natural evolution of a condition
They may provide insight into culturally acceptable treatment options
Which of the following is a correct description about randomizing individual subjects to groups in an experimental study about physical therapy interventions? 1) This method is most likely to distribute subject characteristics equally 2) This method is most likely to result in a representative sample to study 3) This method is guaranteed to create study groups of equal size 4) This method is guaranteed to eliminate sampling error
This method is most likely to distribute subject characteristics equally
The inability of a statistical test to find a significant difference in hospital readmission rates between elders with family support and elders without when a difference actually exists is correctly characterized by which term? 1) Regression to the mean 2) Sampling error 3) Type I error 4) Type II error
Type II error
A therapist is performing clinical research in which a specific myofascial technique is applied to a patient with chronic back pain. She is using a single case experimental design with an A-B-A-B format. Her research hypothesis states that pain rating scores will decrease with the treatment intervention. Acceptance of this hypothesis would be indicated if: a. B is less than A b. B is equal to A c. B is greater than A, at the 1.0 level d. B is greater than A, at the .05 level
a. B is less than A
In a clinical trial, patient height is measured in centimeters and weight is measured in kilograms. What inference can the physical therapist make about the scale of measurement for height and weight? a. Height and weight are measurements on the ratio scale. b. Height and weight are measurements on the ordinal scale. c. Height and weight are measurements on the nominal scale. d. Height and weight are measurements on the interval scale.
a. Height and weight are measurements on the ratio scale.
A physical therapist wants to assess the effects of PNF using the technique of contract-relax on shoulder ROM. A group of 10 patients with adhesive capsulitis were recruited. A matched group of patients were given straight plan active-assisted exercise for the same length of time (3 time/week for 6 weeks). In this study the independent variable is: a. PNF contract-relax technique b. active-assisted exercise c. ROM d. adhesive capsulitis
a. PNF contract-relax technique
A comparison of the effects of exercise in water, on land, or combined on the rehabilitation outcome of patients with intra-articular anterior cruciate ligament reconstructions revealed that less joint effusion was noted after 8 weeks in the water group. An appropriate statistical test to compare the girth measurements of the three groups is: a. analysis of variance b. Spearman rho c. analysis of covariance d. chi square
a. analysis of variance
A study of patients in cancer trials looked at several outcome measures to evaluate pain treatment. Three measurements were used: a visual analog scale using "no pain" to "pain" as anchors, a pain relief scale assessing complete relief to worsening of pain, and a patient satisfaction scale rating how satisfied patients were with their treatment. The investigators found that the adequacy of treatment for pain varied from 16% to 91% depending on the type of outcome measure used. The difference approaches to measuring pain represent: a. construct validity b. content validity c. face validity d. internal validity
a. construct validity
A therapist wants to know whether NDT handling technique produces an improvement in independent rolling that lasts longer than 30 minutes. In this study rolling is the: a. dependent variable b. independent variable c. intervening variable d. control variable
a. dependent variable
According to proponents of evidence-based medicine, the least reliable source of information upon which to make clinical decisions about therapy for an individual patient is a: a. expert opinion b. randomized controlled trial c. systematic review d. case report
a. expert opinion
A physical therapist participates in a research study to determine the effect of noise on the ability to perform a memory task. In the study, noise is the: a. independent variable b. dependent variable c. criterion variable d. extraneous variable
a. independent variable
Two therapists are asked to perform a test on the same group of patients using the Functional Independence Measure (FIM). The results of both sets of measurements reveal differences in therapists' scores but not in the repeat measurements. This is indicative of a problem in: a. interrater reliability b. concurrent validity c. intrarater reliability d. construct validity
a. interrater reliability
You are treating a patient with multiple sclerosis who is part of a national study testing the effectiveness of a new medication. Your subject reports that the pill she is taking makes her feel better and allows her to move easier. At the conclusion of the study it is revealed that she was part of the control group. Her responses are MOST likely due to: a. placebo effect b. sampling bias c. Hawthorne effect d. pretest-treatment interference
a. placebo effect
A therapist wishes to determine the effectiveness of TENS on the relief of pain in a group of 20 patients with phantom limb pain. She recruits patients over a 2 year period. All receive a 6 week intervention. She finds that 12 patients with phantom pain got pain relief while 8 had no relief. The BEST conclusion that can be reached is: a. since a no treatment group was not used for comparison, no conclusions can be reached b. TENS has a 60% rate of effectiveness c. 40% of patients with phantom pain do not benefit from TENS d. since a quasi-experimental design was used, the treatment effectiveness of TENS is established
a. since a no treatment group was not used for comparison, no conclusions can be reached
A therapist wants to determine whether a treatment was effective in reducing lower extremity edema in a group of patients with peripheral vascular edema. Volumetric measurements are used using a water displacement method. The data was compared to a control group receiving no treatment. Analysis of this data is BEST done by employing: a. t test b. chi square c. ANOVA d. Pearson's product moment
a. t test
A group of 10 patients is recruited into a study investigating the effects of relaxation training on blood pressure. One group of patients is scheduled to participate in a cardiac rehabilitation program which includes relaxation training 3 times a week for 12 weeks. The other group of patients is instructed to perform activities as usual. At the conclusion of the study there was no significant difference between the groups; BP decreased significantly in both groups. The investigator can reasonable conclude: a. the activities of the non-rehab group were not properly monitored and may account for these results b. cardiac rehabilitation is not effective in reducing blood pressure c. both groups had blood pressures initially so high that reductions should have been expected d. the rehab group was not properly monitored
a. the activities of the non-rehab group were not properly monitored and may account for these results
The grip strength of a group of 50 to 60 year-olds was investigated. A mean score of 40, SD of 5, and range of 26-57 were reported. The grip strength score for a given patient was determined to be 34. You can safely conclude that in a normal distribution this patient's score fell within: a. 68% b. 95% c. 75% d. 32%
b. 95%
The MOST important contribution case reports make to evidence-based practice in physical therapy is: a. A case report demonstrates a causal relationship between treatment and outcome in a single patient. b. A case report provides information that can be used to generate inductive hypotheses for future studies. c. A case report provides data on the natural history of disease states. d. A case report uses triangulation to test a hypothesis with more than one source of data.
b. A case report provides information that can be used to generate inductive hypotheses for future studies.
A researcher compares a health status measure called the Sickness Impact Profile (SIP) to several other measures of function. The researchers report a high correlation between the physical dimensions of the SIP and the SF-36 health survey questionnaire but a low correlation with the Carroll Rating Scale for Depression. These findings inform: a. positive and negative face validity b. convergent and discriminant validity c. criterion-related validity and gold standard d. gold standard and reference standard
b. convergent and discriminant validity
A patient has been screened using a new test for the presence of a mutation in a gene (ALG-2) linked to Alzheimer's disease. His physician reports he lacks the gene and should not be at increased risk to develop the disease. Some years later he develops Alzheimer's and a repeat test reveals the presence of the mutation. The results of the initial test can be interpreted as: a. false positive b. false negative c. high specificity d. high sensitivity
b. false negative
A researcher states that he expects that there will be no significant difference between 20 and 30 year-olds after a 12 week exercise training program using exercise heart rates and myocardial oxygen consumptions as measures of performance. The kind of hypothesis that is being used in this study is a (an): a. experimental hypothesis b. null hypothesis c. research hypothesis d. directional hypothesis
b. null hypothesis
A researcher uses a group of volunteers ( healthy, college students) to study the effects of Swiss ball exercises on ankle ROM and balance scores. Twenty volunteers participated in the 20 minute ball exercise class 3 times a week for 6 weeks. Measurements were taken at the beginning and end of the sessions. Significant differences were found in both sets of scores and reported at the local PT meeting. Based on this research design, you conclude: a. Swiss ball exercises are an effective intervention to improve ankle stability following chronic ankle sprain b. the validity of the study was threatened with the introduction of sampling bias c. the reliability of the study was threatened with the introduction of systematic error of measurement d. the Hawthorne effect may have influenced the outcomes of the study
b. the validity of the study was threatened with the introduction of sampling bias
A multicenter study was done on the reliability of passive wrist flexion and extension goniometric measurements using volar/dorsal alignment, ulnar alignment and radial alignment. Significant differences were revealed between the three techniques. An appropriate level for determining significant difference is a P value of: a. P=0.015 b. P=0.5 c. P=0.05 d. P=0.1
c. P=0.05
A therapist investigated the accuracy of pulse oximeter estimates during exercise. Correlational analysis measured the strength of the relationship between two types of ear-probe-equipped pulse oximeters during heavy cycle exercise under hypoxic conditions. The investigator found measured arterial oxyhemoglobin saturation (%HbO2) levels to have a correlation of .89 at high saturation but only .68 at low saturation levels. The results of the study suggest: a. both machines are highly accurate at all saturation levels b. during heavy exercise, oxygen saturation levels should be interpreted cautiously c. accuracy of the measurements increases at higher saturation levels d. both machines are only moderately accurate
c. accuracy of the measurements increases at higher saturation levels
A physical therapist critically analyzes the methodology used in a published research study. Which type of sampling procedure would result in the GREATEST degree of sampling error? a. simple random sample b. systematic sample c. cluster sample d. stratified random sample
c. cluster sample
A therapist is investigating the relationship between ratings of perceived exertion (RPE) and type of testing modality: arm ergometry versus leg ergometry. She finds a correlation 0.59 with the arm testing while the correlation is 0.79 with the leg testing. She determines: a. both arm and leg ergometry are only moderately correlated with RPE b. both arm and leg ergometry are highly correlated with RPE c. leg ergometry is highly correlated with RPE while arm ergometry is only moderately correlated d. the common variance of both types of testing is only 22%
c. leg ergometry is highly correlated with RPE while arm ergometry is only moderately correlated
A study of patients with acute back pain shows no statistically significant difference between patients who received physical therapy and patients who did not receive physical therapy. Both groups of patients improved over time at equal rates. This is MOST likely due to: a. random errors b. systematic errors c. regression toward the mean d. test-retest reliability
c. regression toward the mean
A physical therapist participating in a research project uses stratification to draw a sample from the population. By using this type of sampling technique, the therapist ensures: a. the data collected from the sample will be normally distributed b. the sample size will be large c. the sample will have proportional representation from all parts of the population d. that every member of the population has an equal opportunity of being chosen
c. the sample will have proportional representation from all parts of the population
A therapists conducts a study of the effectiveness of hot and cold in treating patients with pain. He recruits 200 patients for each treatment group. The pain instrument he uses has a possible score of 50, with 50 being the worst pain. His data analysis reveals that Group A (heat modalities) has a mean score of 33 with a standard deviation of 1.0 while Group B (cold modalities) had a mean of 35 with a standard deviation of 6.0. Based on this data the conclusion one should reach is: a. heat has a greater effect on pain relief than cold b. cold has a greater effect on pain relief than heat c. the spread of scores with cold treatment demonstrates variability is greater d. the spread of scores with heat treatment demonstrates variability is greater
c. the spread of scores with cold treatment demonstrates variability is greater
A therapist is conducting a longitudinal study assessing the use of aquatic therapy in children with CP. The study is expected to last five years. Which study design is BEST to address the effect of maturation on the validity of the study? a. One-group pretest-posttest design b. One-way repeated measures design over time c. Time series design d. Pretest-posttest control group design
d. Pretest-posttest control group design
A valid informed consent for research purposes should include all of the following elements EXCEPT: a. an understandable explanation of the purpose and procedures to be used b. all reasonable and foreseeable risks and discomforts c. all potential benefits of participation d. a statement ensuring the subject's commitment to participate for the duration of the study
d. a statement ensuring the subject's commitment to participate for the duration of the study
A therapist wants to compare the frequencies of carpal tunnel syndrome occurring in different groups of individuals: assembly line workers and computer programmers. The MOST appropriate statistical tool to use for analysis of the data is: a. simple one-way ANOVA b. t test c. normal distribution curve d. chi square test
d. chi square test
A therapists wants to investigate the effectiveness of use of the therapeutic pool for decreasing pain in a group of patients with fibromyalgia. Two groups of patients were recruited. One group was assigned to exercises and walking in the pool 3 times/week for 6 months. The other group was assigned to a gym walking program for the same amount of time. At the end of the study, outcomes were assessed using the McGill Pain Questionnaire and the Health Status Questionnaire. In order to improve reliability, the lead investigator should: a. have another therapist reassess after 6 months and compare to normalized scores b. utilize a core of 4 experienced therapists to randomly complete all the assessments c. perform all the final assessments himself and compare to the initial assessments performed by a core group of therapists d. have the same therapist reassess the patients after 6 months
d. have the same therapist reassess the patients after 6 months
A researcher uses the Standord-Binet to measure intelligence in a group of first grade students. This scale used in this test is: a. ordinal b. nominal c. ratio d. interval
d. interval
In a research study in which there is a skewed distribution with extreme scores on a balance measure that deviates from the performance of the total groups, the MOST accurate representation of central tendency is: a. mean b. mode c. standard deviation d. median
d. median