Modalities Final

All of the following are correct regarding eye safety and LLLT EXCEPT a. never look into the aperture of the laser b. retina damage can occur if necessary precautions are not observed c. wear eye protection at all times d. the eye's protective reflex will prevent damage

d. the eye's protective reflex will prevent damage

A therapeutic modality is A. a device or apparatus having curative powers B. a treatment that causes changes to the body C. a central component to the rehabilitation plan of care D. a relatively new concept within the evolution of patient care

A. a device or apparatus having curative powers

Chemotaxic factors A. attract leukocytes B. assist with the formation of bradykinin C. help to promote lymphatic drainage D. promote vasodilation

A. attract leukocytes

Neutrophil chemotactic factor A. attracts neutrophils to areas of damaged tissue B. increases blood flow C. increases capillary membrane permeability D. initiates the inflammatory response

A. attracts neutrophils to areas of damaged tissue

Self-report instruments can help the health care professional understand the patient's perception of injury and wellness from a _________________ perspective. A. biopsychosocial B. risk-reward C. medical D. clinical treatment

A. biopsychosocial

This model suggests that personal and situational factors affect a person's response to injury. A. cognitive appraisal model B. WHO International Classification of Functioning Model C. Nagi's disablement model D. Kubler-Ross grief and stage model

A. cognitive appraisal model

The effort made to manage circumstances that are appraised as stressful is called A. coping B. secondary gain C. cognitive appraisal D. placebo

A. coping

Which of the following statements regarding macrophages is true? A. macrophages release growth factors, which in turn stimulate fibroblast activity B. macrophages mature from undifferentiated satellite cells C. macrophages attract neutrophils into an area of tissue damage D. macrophages are smaller and more numerous than neutrophils

A. macrophages release growth factors, which in turn stimulate fibroblast activity

The following statements about mast cells are true, EXCEPT A. mast cells help initiate the inflammatory response B. mast cells release serotonin C. mast cells synthesize prostaglandin E2 D. mast cells produce reactive oxygen species

A. mast cells help initiate the inflammatory response

Which of the following is likely to be poorly tolerated by the patient suffering from CRPS? A. moist heat and cold B. biofeedback C. TENS D. gentle massage and joint mobilization

A. moist heat and cold

The combination of visual, cognitive, and emotional influences on pain experiences relates to the A. neuromatrix theory of pain B. specificity theory C. gate control theory D. pattern theory

A. neuromatrix theory of pain

A healthcare professional is pondering whether a study can be generalized to an individual case. This scenario is the rationale for A. specifying eligibility criteria B. randomly allocating subjects into groups C. blinding all subjects D. blinding all clinicians who administered therapy

A. specifying eligibility criteria

All of the following anatomical levels of pain transmission can be affected by therapeutic modalities EXCEPT A. systemic B. descending pathways C. peripheral D. ascending pathways

A. systemic

Of the following, which most accurately reflects the rehabilitation process of the injured physically active person? A. The rehabilitation plan of care is developed to speed healing of injured tissues B. The rehabilitation plan of care is developed to address the symptoms, impairments, functional limitations, and disabilities resulting from musculoskeletal injury. C. The rehabilitation plan of care is developed to alleviate the symptoms of a musculoskeletal injury. D. The rehabilitation plan of care is based on the clinician's time and treatment cost.

B. The rehabilitation plan of care is developed to address the symptoms, impairments, funcitonal limitations, and disabilities resulting from musculoskeletal injury.

Nerve fibers in the spinothalamic tract are A. principally efferent fibers B. second-order afferent nerves C. considered interneurons D. first-order efferent nerves

B. second-order afferent nerves

Deep receptors transmit all of the following sensations EXCEPT A. muscle and tendon pain B. warm and cold temperatures C. position D. deep pressure and kinesthesia

B. warm and cold temperatures

Which of the following regarding a subjective report of the medical history is NOT true? A. Determine the patient's rating of pain and dysfunction B. Identify the location of pain C. Avoid forming a working diagnosis to prevent bias D. Ask about the previous experience with treatments for injuries

C. Avoid forming a working diagnosis to prevent bias

Which guideline is used to assess the methodological quality of clinical trials? A. NIH B. Scopus C. PEDro D. PRISMA

C. PEDro

Which guideline is used to assess the methodological quality of systematic review? A. Scopus B. NIH C. PEDro D. PRISMA

C. PEDro

Of the following, which is NOT a component of informed consent? A. an explanation of the diagnosis or findings of a physical examination B. an explanation of the risks and benefits of recommended treatment C. an assurance that the recommended treatment will be effective D. an agreement between the clinician and patient before moving forward with a treatment

C. an assurance that the recommended treatment will be effective

If an ultrasound wave strikes a surface at a 30° angle, less energy is transferred than if it had been perpendicular to the surface. This is based on the A. Arndt-Schultz principle B. law of Grotthus-Draper C. cosine law D. inverse-square law

C. cosine law

All of the following are examples of a patient-derived assessment to gauge whether a specific treatment has the desired outcome EXCEPT A. a global rating of change B. the Oswestery Back Pain Index C. goniometric measurement of elbow ROM D. a survey of patient satisfaction

C. goniometric measurement of elbow ROM

The prominent phagocyte at the end of acute inflammation is the A. neutrophil B. T lymphocyte B. macrophage D. basophil

C. macrophage

All of the following are factors that may affect data validity of a study EXCEPT A. natural history B. placebo C. modality selection D. investigator bias E. subject bias

C. modality selection

A person who perceives that the shoulder rehabilitation program will be effective, will decrease his/her susceptibility to further physical harm, and will be possible to complete is operating according to the A. cognitive appraisal model B. athlete masculine identity C. protection motivation theory D. personal investment theory

C. protection motivation theory

_________________ modulates pain by inhibiting somatosensory transmission and blocking C fiber terminals for substance P and glutamate. A. the substantia gelatinosa B. the raphe nucleus C. serotonin D. the hypothalamus

C. serotonin

All of the following pertain to C fibers EXCEPT A. slowest sensory nerve fibers B. unmyelinated C. smallest efferent pain fibers D. require stimulation to elicit a response

C. smallest efferent pain fibers

Faulty movement patterns resulting in repetitive microtrauma injuries can lead to A. Type II complex regional pain syndrome B. Type I complex regional pain syndrome C. Type II myofacial pain syndrome D. Type I myofacial pain syndrome

C. type II myofacial pain syndrome

Which of the following regarding ligament repair is FALSE? A. Ligaments can become stronger and thicker after repetitive loading B. It is not possible to isolate loading through therapeutic exercise. C. Ligaments respond to mechanical stresses D. The repair capacity of ligaments is the same regardless of mechanism of injury

D. The repair capacity of ligaments is the same regardless of mechanism of injury

Palpation of tender trigger points on the upper trapezius causes symptoms to radiate to the arm and hand of an athlete with myofacial pain in the cervical and shoulder region. The radiating symptoms do not correspond to the sensory nerve distribution of the nerves comprimising the brachial plexus. Of the following, which statement most likely describes the source of these symptoms? A. They symptoms are most likely due to a herniated disc in the cervical spine B. The symptoms are strongly suggestive of somatization C. The symptoms are strongly suggestive of complex regional pain syndrome D. The symptoms are likely referred pain due to trigger point sensitivity

D. The symptoms are likely referred pain due to trigger point sensitivity

The temporary pain relief that results from counterstimulation techniques (menthol rubs) is based on A. rhythmical pain modulation B. specificity theory C. the neuromatrix theory of pain D. gate control theory

D. gate control theory

Applying psychological skills while completing a rehabilitation program is beneficial. These skills include all of the following EXCEPT A. positive self-talk B. the use of imagery C. goal setting D. having the support of team members, family and friends

D. having the support of team members, family, and friends

Failure of an athlete to improve following treatments with therapeutic modalities and exercises A. is always due to diagnostic error B. is strongly suggestive that secondary gain is a barrier to recovery C. occurs only when modalities are applied improperly D. is important information in the reevaluation of the injured athlete

D. is important information in the reevaluation of the injured athlete

The model that is based on a person's belief in the efficacy of the treatment, self-belief, and incentives is A. protection motivation theory B. the cognitive appraisal model C. athlete masculine identity D. personal investment theory

D. personal investment theory

Pain during movement, but not at rest, is most commonly associated with A. an increase in the central zone of injury B. acute inflammation C. the tissue maturation phase of the inflammatory response D. the tissue repair phase of the inflammatory response

D. the tissue repair phase of the inflammatory response

What is the purpose or objective(s) of immediate vasoconstriction following soft tissue damage? a. to minimize the loss of red blood cells b. to increase hemophilia c. to increase the permeability of involved capillary membrane d. to promote the invasion of neutrophils into the damaged tissue

a. to minimize the loss of red blood cells

All of the following are strategies to minimize electrode resistance EXCEPT a. use small electrodes b. remove excess hair and oil from skin c. use clean electrodes and sponges d. maintain even, firm contact with the skin

a. use small electrodes

All of the following are common contraindications for using cryotherapy except a. Raynaud's phenomenon b. Inflammation c. caculitis d. Cold urticaria e. A & D

b. Inflammation

The principal protein comprising gap junctions within the interconnected cellular network is a. focal adhesion complex b. connexin c. syndecan d. globular actin

b. connexin

Electromagnetic energy from diathermy is an example of which form of thermal energy transfer? a. conduction b. conversion c. convection d. radiation

b. conversion

All of the following are examples of TENS units EXCEPT a. biphasic low-voltage stimulators b. diathermy c. interferential units d. portable TENS units

b. diathermy

A civil legal action brought by a person injured while being treated by a certified athletic trainer would be a a. negligent act b. tort c. misdemeanor d. case of malpractice

b. tort

Continual stimulation that bombards the nerve and can result in anesthesia between electrodes is called a. ramping b. Russian stimulation c. Wedenski's inhibition d. chronaxie

c. Wedenski's inhibition

Light that is produced by photons traveling in a similar phase relationship with one another describes which property of lasers? a. biomodulation b. monochromatic c. coherence d. collimation

c. coherence

________________ nerves are most responsible for fast pain sensation and are myelinated and larger in diameter. A. C fiber afferent B. A-delta afferent C. A-alpha afferent D. A-beta afferent

D. A-beta afferent

As part of the critical appraisal of literature, which of the following should be completed before integrating results into clinical practice? A. Read most of the articles from your literature search B. Scan the references for additional reading C. Scan article titles and headings D. Consider patient characteristics of the study

D. Consider patient characteristics of the study

A warm whirlpool is an example of which form of thermal energy transfer? a. conduction b. radiation c. convection d. conversion

c. convection

Exercise programs after tendon injury should be completed for ______________________ before determining if more aggressive intervention is needed. a. 3-7 weeks b. 1-4 weeks c. 10-14 weeks d. 6-12 weeks

d. 6-12 weeks

Under normal circumstances, which of the following nerves would be the first to be stimulated by an electrical current? a. A superficial small-diameter nerve b. A deep small-diameter nerve c. A deep large-diameter nerve d. A superficial large-diameter nerve

d. A superficial large-diameter nerve

Ultrasound waves are reflected by _________ and absorbed by _________. a. Bone, skin b. Skin, connective tissue c. Skin, muscle d. Bone, muscle

d. Bone, muscle

The recommendation for RICE after injury is similar to the recommendation for POLICE. POLICE stands for

Protection Optimal loading Ice Compression Elevation

What are 4 sensations a patient will experience with the application of cryotherapy a. Cold, burning, cramping, numbness b. Pain, aching, stinging, cold c. Aching, burning, pain numbness d. Cold, burning, aching, numbness e. Cold, burning, stinging, aching

d. Cold, burning, aching, numbness

When the phase duration is infinite, the minimum amplitude needed to depolarize a nerve fiber is called a. chronaxie b. Wedenski's inhibition c. ampere d. rheobase

d. rheobase

Which of the following is considered a first-order neuron? a. decussate b. T cell c. sensory cortex d. sensory

d. sensory

What is the frequency range currently available for therapeutic ultrasound in the United States? a. .8 to 3.3 MHz b. 1 to 2 MHz c. 3 to 4 MHz d. 3.3 to 6 Hz

a. .8 to 3.3 MHz

Which of the following parameters would be most appropriate to heat the posterior capsule of the hip? a. 1 MHz, 10 min at 2 W/cm2 b. 3 MHz, 3-4 min at 2 W/cm2 c. 1 MHz, 5 min at 2 W/cm2 d. 3 MHz, 5 min at 1.5 W/cm2

a. 1 MHz, 10 min at 2 W/cm2

The therapeutic range for heat modalities is: a. 104-113°F b. 115-130°F c. 25-50°F d. 53-100°F

a. 104-113°F

The greatest change tissue temperature 2 cm below the skin surface occurs with which of the following treatments? a. 20 min application of ice bag b. 20 min application of superficial heat c. 20 min application of contrast irritant d. 20 min treatment of contrast bath

a. 20 min application of ice bag

What depth of penetration occurs with superficial heating modalities? a. < 2 cm b. 3 to 5 cm c. 6 to 8 cm d. 2 to 4 cm

a. < 2 cm

Of the following nerve fibers, which are thermoreceptors? a. A-delta b. A-alpha c. A-beta

a. A-delta

All of the following are true about acoustical streaming from the application of ultrasound EXCEPT a. Acoustical streaming is the result of gas bubble expansion and contraction b. Mechanical pressure is generated at the leading edge of sound waves c. Acoustical streaming facilitates fluid movement and increased cell permeability d. Acoustical streaming is associated with non thermal effects of ultrasound

a. Acoustical streaming is the result of gas bubble expansion and contraction

A patient has been progressing through a rehabilitation program after a grade II ankle sprain. He reports to the clinic with increased swelling after trying a set of exercises. Which of the following is the most appropriate response? a. Avoid the activities that aggravate the healing tissues b. Temporarily immobilize the patient to limit accessory motion. c. Apply ice in between exercises to limit swelling. d. Encourage the patient to work through the pain.

a. Avoid the activities that aggravate the healing tissues

Which of the following statements regarding cryokinetics is FALSE? a. Cryokinetics is effective in the early management of acute inflammation. b. Cryokinetics is a treatment where cold application is applied before controlled exercise. c. Cryokinetics can speed functional recovery. d. Cryokinetics cannot be applied until active range of motion can be performed safely.

a. Cryokinetics is effective in the early management of acute inflammation.

All of the following are correct about the helium-neon gas laser EXCEPT a. it does not use fiber optics b. it usually emits a red light c. it was one of the first developed in the 1970s d. it is commonly used in superficial wound care

a. it does not use fiber optics

Of the following, which is a correct statement regarding the response to superficial heat? a. Heat decreases muscle spasm via a spinal reflex mechanism. b. The analgesic response to a 20 min superficial heat application is most likely due to a decrease in nerve conduction velocity. c. Profound heat-induced vasodilation occurs in muscle tissue following 20 min of application. d. Superficial heat stimulates lymphatic drainage, which results in decreases in interstitial edema

a. Heat decreases muscle spasm via a spinal reflex mechanism.

All of the following regarding extracellular matrix I true EXCEPT a. It is a cellular component of connective tissue b. A majority of tissue cells must remain attached to the ECM for survival c. It is compromised of fibrous proteins and polysaccharides d. It adds strength and resilience to tissue

a. It is a cellular component of connective tissue

Which of the following terms describe a cold-induced vasodilation? a. Lewis reaction b. Knight response c. Law of Grotthus-Draper d. paraffin reaction

a. Lewis reaction

Which statements relate to the capacitance technique? a. Mechanical friction from rapid rotation of dipoles results in heat production b. A patient is placed in an electric field. c. The greatest heating occurs in subcutaneous fat. d. Coiled wires create an electric current to heat tissue.

a. Mechanical friction from rapid rotation of dipoles results in heat production b. A patient is placed in an electric field. c. The greatest heating occurs in subcutaneous fat.

Which of the following would be appropriate to enhance bone repair after a fracture? a. PEMF b. TENS c. massage d. diathermy

a. PEMF

____________________ involves tangible and intangible rewards that injured people receive because of the injury, such as financial settlements from litigation associated with the injury or time away from work in a job that is disliked. a. Secondary gain b. Adherence c. Compliance d. Placebo

a. Secondary gain

A moist heat pack offers what type of therm-therapy a. Superficial b. deep c. Cutaneous d. Surface e. None of the above

a. Superficial

All of the following are correct about Class 1 lasers except: a. They are capable of producing damaging radiation in the eye b. They are exempt from most control measures c. Laser printers and CD players are examples of this type of laser d. They are within an enclosure that limits access to laser radiation

a. They are capable of producing damaging radiation in the eye

All of the following are contraindications for lumbar traction EXCEPT a. a herniated disc b. advanced osteoporosis c. pregnancy d. bone cancer

a. a herniated disc

Reported effects of LLLT on muscle function include a. an increase in the number of repetitions completed before fatigue b. a decrease in ATP production c. an increase in production of C-reactive proteins d. slower removal of blood lactate and metabolic by-products

a. an increase in the number of repetitions completed before fatigue

Tissue remodeling, repair, and adaptation in tendon rely mostly on a. autocrine/paracrine responses b. concentric exercises to strengthen tendon and muscle c. activation of alternate phenotypes d. vascular supply and access to nutrients

a. autocrine/paracrine responses

All of the following laser attributes affect LLLT parameter selection EXCEPT a. classification of the laser b. power density (intensity) c. wavelength d. energy density (dosage)

a. classification of the laser

The first step in reevaluating an athlete with persistent pain is to a. consider whether the original diagnosis is correct b. examine the athlete for symptoms of complex regional pain syndrome c. determine whether the athlete is suffering from clinical depression d. palpate for sensitive trigger points

a. consider whether the original diagnosis is correct

The 'sweep" setting to reduce accommodation to the stimulus results from a. continuous change to the frequency of a carrier current b. increasing beat frequency c. placing the dispersal pad farther away from the treatment site d. submerging the appendage in water to allow for active movement

a. continuous change to the frequency of a carrier current

All of the following are fibrillary components EXCEPT a. decorin b. elastin c. collagen d. fibronectin

a. decorin

Select all of the following that are fibrillary components a. fibronectin b. collagen c. elastin d. Decorin

a. fibronectin b. collagen c. elastin

Integrin is anchored intracellularly to the cytoskeleton by the a. focal adhesion complex b. glycosaminoglycan c. chemoattractants d. fibronectin

a. focal adhesion complex

Select all of the following parameters that are clinician-controlled for ultrasound a. frequency b. BNR c. amplitude d. duty cycle

a. frequency c. amplitude d. duty cycle

All of the following are physiological responses to superficial heat in superficial tissues EXCEPT a. increased viscosity b. increased tissue elasticity c. increased inflammation and metabolic activity d. increased circulation and sweating

a. increased viscosity

Mechanical stimuli and tissue damage in muscle result in the release of _______________________ to regulate protein synthesis and anabolism. a. insulin-like growth factor I b. glycosaminoglycan c. proteoglycans d. collagen

a. insulin-like growth factor I

In AC currents, there is a(n) _______________ relationship between the frequency and _______________. a. inverse, pulse duration b. direct, charge c. direct, amplitude d. indirect, intensity

a. inverse, pulse duration

Raynaud's phenomenon a. is considered vasospastic disorder b. occurs in patients who are allergic to cold c. most commonly affects men d. primarily affects the ears and nose

a. is considered vasospastic disorder

Intermittent compression a. is probably less effective than active exercise for reducing swelling b. promotes lymphatic drainage through muscle contraction c. effectively and permanently reduces posttraumatic swelling d. is very difficult to set up and administer

a. is probably less effective than active exercise for reducing swelling

Which of the following are correct about the indium-gallium-aluminum-phosphide laser? Select all that apply a. it is commonly used in superficial wound care b. it requires fiber optics c. it is classified as a semiconductor laser d. it is gradually replacing HeNe lasers

a. it is commonly used in superficial wound care c. it is classified as a semiconductor laser d. it is gradually replacing HeNe lasers

Of the following statements, which are true regarding phonophoresis? a. it is similar to iontophoresis in that it drives medications through the skin b. significant research proves its effectiveness c. one must mix the active medication with a good conducting gel d. it is noninvasive and spares the patient the fear of injections

a. it is similar to iontophoresis in that it drives medications through the skin c. one must mix the active medication with a good conducting gel d. it is noninvasive and spares the patient the fear of injections

LLLT is proposed to reduce pain due to a. its effect on nerve conduction velocity b. alteration of blood flow away from the treatment site c. the inhibition of nitric oxide d. the stimulation of C and A-delta fibers

a. its effect on nerve conduction velocity

Select all true statements about acoustical streaming from the application of ultrasound. a. mechanical pressure is generated at the leading edge of sound waves b. acoustical streaming is associated with nonthermal effects of ultrasound c. acoustical streaming is the result of gas bubble expansion and contraction d. acoustical streaming facilitates fluid movement and increased cell permeability

a. mechanical pressure is generated at the leading edge of sound waves b. acoustical streaming is associated with nonthermal effects of ultrasound d. acoustical streaming facilitates fluid movement and increased cell permeability

High-voltage sensory stimulation uses which type of current? a. monophasic b. polyphasic c. biphasic d. alternating

a. monophasic

All of the following are sensory receptor classifications EXCEPT a. motor b. deep c. visceral d. superficial

a. motor

All of the following are correct about the treatment frequency of lasers EXCEPT a. physiological responses to treatment are consistent between individuals b. acute conditions are treated more often than chronic ones c. laser has a cumulative effect, so small doses spaced farther apart have better outcomes d. the least amount of energy brings about the best results

a. physiological responses to treatment are consistent between individuals

Laser radiation's analgesic effect is proposed to be due to the production of all of the following EXCEPT a. prostaglandin E2 b. serotonin c. acetycholine d. nitric oxide

a. prostaglandin E2

Ohm's law states that more voltage is needed to pass the same current through material with more a. resistance b. amperes c. impedance d. charge

a. resistance

Acupuncture and joint mobilization produce endogenous endorphins to decrease pain via a. rhythmical pain modulation b. spinal-level pain modulation c. nerve block pain modulation d. noxious pain modulation

a. rhythmical pain modulation

Which of the following is NOT a contraindication for the use of ultrasound? a. scarring b.Acute hemorrhage c. anesthesia d. Open wounds

a. scarring

Which of the following are true about the cooling of tissues following the application of ultrasound? Select all that apply a. superficial tissues cool more rapidly than deeper tissues b. tissue temperature falls fairly rapidly following ultrasound treatment c. adipose tissue will remain warmer longer than muscle following treatment with ultrasound d. stretching and manual therapies should occur immediately after ultrasound treatment

a. superficial tissues cool more rapidly than deeper tissues b. tissue temperature falls fairly rapidly following ultrasound treatment d. stretching and manual therapies should occur immediately after ultrasound treatment

A TENS unit generating an interferential current has a 2,500 Hz carrier frequency and an 80 pulse per second treatment frequency. When the clinician adjusts the treatment frequency from 80 to 100 pulses per second, a. the frequency of the interfering wave is changed b. the amplitude of the stimulating current is changed c. the carrier frequency is changed d. the phase duration of the stimulating current is changed

a. the frequency of the interfering wave is changed

Which of the following are correct about the treatment frequency of lasers? (select all that apply) a. the lowest effective dosage of energy brings about the best results b. laser has a cumulative effect, so small doses spaced farther apart have better outcomes c. acute conditions are treated more frequently than chronic ones d. physiological responses to treatment are consistent between individuals

a. the lowest effective dosage of energy brings about the best results b. laser has a cumulative effect, so small doses spaced farther apart have better outcomes c. acute conditions are treated more frequently than chronic ones

Which of the following are correct about Class 4 lasers? Select all that apply a. they are a fire hazard b. they are also used for LLLT devices c. viewing them can be dangerous to both eyes and skin d. they are the highest-powered lasers we have

a. they are a fire hazard c. viewing them can be dangerous to both eyes and skin d. they are the highest-powered lasers we have

Which of these are classified as Class 1 lasers? Select all that apply a. they are within an enclosure that limits access to laser radiation b. laser printers and CD players are examples of this type of laser c. they are capable of producing damaging radiation in the eye d. they are exempt from most control measures

a. they are within an enclosure that limits access to laser radiation b. laser printers and CD players are examples of this type of laser d. they are exempt from most control measures

In which of the following circumstances would treatment with therapeutic modalities be most appropriate? a. when pain results in muscle guarding and a loss of range of motion b. when pain results from a rest-reinjury cycle c. when pain is caused by underlying structural lesions that remain unidentified d. when biomechanical flaws are overstressing tissues

a. when pain results in muscle guarding and a loss of range of motion

Which of the following stimulation frequencies is most likely to result in enkephalinergic and gating effects? a. 20-30 Hz b. 60-120 Hz c. 35-50 Hz d. 2-10 Hz

b. 60-120 Hz

Of the following, which is true regarding the application of therapeutic ultrasound? a. Sound energy is delivered most effectively when held at a 30o angle from the tissue surface. b. A longer treatment time should be used with lower frequencies of ultrasound. c. The ideal application area is approximately four times the ERA. d. The sound head should be continuously and rapidly moved to avoid burning the patient.

b. A longer treatment time should be used with lower frequencies of ultrasound.

The belief that there is a minimal "window" threshold of light energy needed to elicit a response, yet too much energy can be harmful to tissue, is an example of the a. cosine law b. Arndt-Shultz principle c. inverse-square law d. law of Grotthus-Draper

b. Arndt-Shultz principle

Of the following, which is correct regarding joint mobilization? a. The glide of one joint surface on another is a component of osteokinematic motion. b. During mobilization, joint mechanoreceptors are stimulated. c. Joint mobilization is indicated in the management of joint instability. d. When a convex surface moves on a concave surface, roll and glide occur in same direction.

b. During mobilization, joint mechanoreceptors are stimulated

Which of the following regarding eccentric loading and tendinopathy is correct? a. Exercises should be performed once a day to observe positive outcomes. b. Heel drops should utilize the contralateral limb to return to start. c. Exercises should be progressed from fast to slow. d. Progression of exercises should move from single leg to double leg heel drops.

b. Heel drops should utilize the contralateral limb to return to start.

Which of the following about cryotherapy is FALSE? a. Superficial vasoconstriction affects blood flow to the skin b. Hypoxia-related cell death may occur after injury due to cells' increased oxygen demand. c. Conflicting findings have been reported on its effects on cutaneous sensation d. The cooling response may not drastically limit oxygen delivery to tissue

b. Hypoxia-related cell death may occur after injury due to cells' increased oxygen demand.

Which of the following is NOT a correct description of evidence-based practice? a. It is the integration of best research evidence with clinical expertise. b. It encompasses "menu-driven" protocols based on previous methods of clinical practice. c. It acknowledges ongoing changes in clinical practices. d. It highlights the importance of being well educated and remaining current.

b. It encompasses "menu-driven" protocols based on previous methods of clinical practice.

Which of the following regarding chronic pain is correct? a. The condition is well understood and effectively treated with thermal modalities. b. It is a result of altered neural function. c. Palliative treatment should be integrated to improve outcomes.

b. It is a result of altered neural function.

Which of the following is a cardinal sign of inflammation? a. Cyanosis b. Loss of function c. Cold skin d. numbness e. None of the above

b. Loss of function

Following a lateral ankle sprain, an athlete experiences impairment in single-leg balance. Of the following, which is FALSE regarding this situation? a. Damage to mechanoreceptors in the injured ligaments has altered proprioceptive input to the central nervous system. b. Loss of single-leg balance is primarily due to peroneal muscle strength deficit c. Loss of single-leg balance control suggests impaired reflex response to perturbation. d. Loss of single-leg balance could result from pain, swelling, or joint instability.

b. Loss of single-leg balance is primarily due to peroneal muscle strength deficit

Which of the following statements about premod is correct? a. Medium frequency delivered continuously between two electrodes b. Medium frequency delivered with bursts between two electrodes c. Low frequency delivered continuously among four electrodes d. High frequency delivered in bursts between two electrodes

b. Medium frequency delivered with bursts between two electrodes

Which of the following is NOT a contraindication of the use of diathermy? a. Acute joint effusion b. Muscle spasm c. Pregnancy d. Open wounds

b. Muscle spasm

Which database is supported by the U.S. National Library of Medicine? a. National line Clearinghouse Comprehensive b. PubMed c. SportDiscus d. CINAHL Plus with Full Text e. PEDro

b. PubMed

To restore neuromuscular control and force generation, which of the following is correct? a. Resistance should be increased quickly to strengthen the muscle. b. Recovery periods should be increased to 48 hours or more. c. Concentric contraction should be performed prior to isometric contraction. d. Resistance can be added once the person is within 20 degrees of normal limits.

b. Recovery periods should be increased to 48 hours or more.

Which of the following regarding temperature increase with superficial heating is true? a. Temperature increase in tissue is long-lasting after the application of superficial heat. b. Superficial heat may be effective in increasing tissue temperature in superficial and small joints. c. A 25 min application of superficial heat increases deep tissue temperature. d. The physical sensation of a heat pack may activate A-delta and C fibers to decrease pain.

b. Superficial heat may be effective in increasing tissue temperature in superficial and small joints.

Which of the following most likely explains the impact of swelling on quadriceps function? a. The pressure of swelling stimulates pain pathways, and the stimulation intensifies with movement. b. Swelling may stimulate stretch receptors and trigger reflex inhibition of muscles. c. Swelling damages quadriceps muscle tissue, which affects force production. d. Swelling does not allow space for muscles to contract through the full range of motion.

b. Swelling may stimulate stretch receptors and trigger reflex inhibition of muscles.

Which of the following is considered a second-order neuron? a. sensory cortex b. T cell c. sensory d. decussate

b. T cell

Which of the following regarding contrast therapy is FALSE? a. Cycles of cold and heat are theorized to produce a pumping action to reduce swelling. b. The cycle should always end with a warm bath to facilitate tissue recovery. c. There is little vascular response with contrast therapy. d. May be effective in decreasing pain and swelling via active range of motion during treatments.

b. The cycle should always end with a warm bath to facilitate tissue recovery.

Which of the following regarding electrical stimulation to elicit a muscle contraction is FALSE? a. If a nerve is not present, stimulation may occur at the motor endplate. b. The muscle contraction will occur prior to the perception of sensation. c. Only galvanic stimulators are configured to have such long phase durations. d. The electrical stimulation required is an example of the law of Dubois Reymond.

b. The muscle contraction will occur prior to the perception of sensation.

Which of the following is true regarding temperature decrease during cryotherapy? a. Deeper tissues cool quickly after superficial cooling has occurred. b. The quantity of adipose tissue affects the rate of cooling due to its insulation properties. c. Tissue cools slowly at first, then rapidly decreases in temperature over time. d. Decreased temperature increases the rate of metabolism in local tissue.

b. The quantity of adipose tissue affects the rate of cooling due to its insulation properties.

Phonophoresis is a. best administered using pulsed ultrasound b. a treatment technique in which ultrasound is used to drive medication into subcutaneous tissue c. supported in the literature for its effectiveness in treating musculoskeletal conditions d. clearly the treatment of choice in the management of tendinitis

b. a treatment technique in which ultrasound is used to drive medication into subcutaneous tissue

In the WHO International Classification of Functioning, Disability, and Health (ICF), the inability of an injured basketball player to run after hamstring strain relates to a. bodily function b. activity c. participation d. the disorder

b. activity

Which of the following proteoglycans is found in cartilage? a. decorin b. aggrecan c. perlecan d. syndecan-1

b. aggrecan

Social support, belief in the efficacy of the treatment, and convenience of completing treatments are the main components of the a. personal investment theory b. cognitive appraisal model c. protection motivation theory d. athlete masculine identity

b. cognitive appraisal model

An ice pack is an example of which form of thermal energy transfer? a. conversion b. conduction c. radiation d. convection

b. conduction

According to the law of Dubois Reymond, a physiological response within tissue results if there is adequate intensity to reach threshold, onset fast enough to reduce accommodation, and a. diameter small enough to absorb energy quickly b. duration long enough to exceed the capacitance of the tissue c. duty cycle short enough to elicit a motor response

b. duration long enough to exceed the capacitance of the tissue

Beam nonuniformity ratio a. is approximately equal to the surface area of the ultrasound head b. equals spatial peak intensity divided by spatial average intensity c. should be at 1 before a machine is used for patient care d. should be high to minimize the risk of "hot spots"

b. equals spatial peak intensity divided by spatial average intensity

A _______________ current causes a greater _______________, which results in more fibers recruited. a. high peak, root mean square b. high peak, depth of penetration c. low peak, depth of penetration d. low peak, root mean square

b. high peak, depth of penetration

Healing and remodeling of musculoskeletal tissue are governed in part by the a. paleocortical tract b. hypothalamic-pituitary gonadal axis c. neocortical system d. spinothalamic tract

b. hypothalamic-pituitary gonadal axis

Mobilization of the humerus _____________ on the glenoid is appropriate for treating limitations in horizontal abduction of the glenohumeral joint. a. posteriorly b. inferiorly c. anteriorly d. superiorly

b. inferiorly

Examples of modalities that exchange electrical energy include A. TENS, high-voltage, interferential currents B. intermittent compression devices, traction C. cold or warm water immersion, ice bag D. ultrasound and extreacorporeal shockwave therapy

b. intermittent compression devices, traction

The heating effect quadruples if a heat lamp is lowered half the distance between the device and body part. This is based on the a. Arndt-Schultz principle b. inverse-square law c. law of Grotthus-Draper d. cosine law

b. inverse-square law

All of the following are correct about the gallium-aluminum-arsenide laser EXCEPT (select all that apply) a. it is classified as a semiconductor laser b. it is delivered in the continuous wave mode c. its higher output allows for longer treatment times d. it is commonly used in deeper tissues than other lasers

b. it is delivered in the continuous wave mode c. its higher output allows for longer treatment times d. it is commonly used in deeper tissues than other lasers

Which of the following are correct about the gallium-arsenide laser? Select all that apply a. it is visible to humans b. it is used on deeper tissues like tendon and ligament c. its depth of penetration is 30-50 mm d. it is classified as a semiconductor laser

b. it is used on deeper tissues like tendon and ligament c. its depth of penetration is 30-50 mm d. it is classified as a semiconductor laser

All of the following are contraindications for joint mobilization EXCEPT a. infection b. joint hypomobility c. advanced osteoporosis d. bone-to-bone end-feel during joint play assessment

b. joint hypomobility

When designing a therapeutic exercise program, consideration of treatment goals for strength versus endurance would be an example of which program variable? a. use of resistance bands versus free weights b. load c. rest between sets d. order of exercises

b. load

A patient who cannot generate a muscle contraction despite her best effort may benefit from a. a biofeedback device b. neuromuscular stimulation

b. neuromuscular stimulation

Fluidotherapy units a. are commonly used for the shoulder and hip b. permit therapeutic exercise during heat application c. heat tissues via conduction d. heat deep joint capsules and muscles

b. permit therapeutic exercise during heat application `

Which of the following plays a critical role during acute repair by acting as a reservoir for chemoattractants? a. hyaluronan b. proteoglycan c. fibrillary tissue d. glycosaminoglycan

b. proteoglycan

A patient is set up on an electrical stimulation device with the following settings: phase duration of 200-300 us, pulse frequency of <10 pps, and target of A-delta nerve fibers. The primary goal of this setting is to a. reeducate the muscle b. reduce edema through muscle pumping c. stimulate wound healing d. inhibit sensory fibers only

b. reduce edema through muscle pumping

All of the following effects of LLLT support the reduction of inflammation ... select all that apply a. degranulation of mast cells b. reduction of prostaglandin E2 c. decreased production of chemicals that attract leukocytes d. inhibition of cyclooxygenase 2 within cells

b. reduction of prostaglandin E2 c. decreased production of chemicals that attract leukocytes d. inhibition of cyclooxygenase 2 within cells

Which of the following is NOT part of the assessment of methodological quality of randomized controlled trials? a. blinding of all assessors b. reporting of patient satisfaction regarding at least one key outcome c. blinding of all subjects d. reporting of at least one key outcome for more than 85% of the subjects e. reporting of between-group statistical comparison for at least one key outcome

b. reporting of patient satisfaction regarding at least one key outcome

The involvement of descending signals to and from a neural mechanism within the dorsal horn describes a. rhythmical pain modulation b. spinal-level pain modulation c. noxious pain modulation d. nerve block pain modulation

b. spinal-level pain modulation

All of the following are components of Nagi's model of injury and response EXCEPT a. impairment b. surgical intervention c. disease d. disability

b. surgical intervention

Which of the following are correct about the conducting media for ultrasound? Select all that apply a. water is equal to gel as a conducting medium b. the amount of sound energy conducted varies greatly between different media c. ultrasound gel and gel pads are superior to other conducting media d. a medium is needed because sound waves travel rather poorly through the air

b. the amount of sound energy conducted varies greatly between different media c. ultrasound gel and gel pads are superior to other conducting media d. a medium is needed because sound waves travel rather poorly through the air

All of the following are true about cavitation from the application of ultrasound EXCEPT a. cavitation is associated with nonthermal effects of ultrasound b. unstable cavitation is associated with superficial tissue burns c. stable cavitation facilitates fluid movement and membrane transport d. cavitation involves the expansion and contraction of gas bubbles e. unstable cavitation refers to the collapse of these bubbles and can cause tissue damage

b. unstable cavitation is associated with superficial tissue burns

Of the quadriceps muscles, which is most affected by swelling within the joint capsule of the knee? a. vastus intermedius b. vastus medialis c. vastus lateralis d. rectus femoris

b. vastus medialis

Which term relates to the measure of electromotive force? a. impedance b. voltage c. ampere d. resistance

b. voltage

Which of the following best describes the therapeutic temperature range for cold modalities? a. 37°C b. 104-100°F c. 55-65°F d. 50-60°F

c. 55-65°F

Which of the following would contraindicate the use of diathermy in treating low back pain? a. The patient is pregnant. b. The patient has a cardiac pacemaker. c. Both a and b are correct. d. Neither a nor b are contraindications.

c. Both a and b are correct.

_____________ nerves are most responsible for slower pain sensation and are smallest in diameter. a. A-beta afferent b. A-delta afferent c. C fiber afferent d. A-alpha afferent

c. C fiber afferent

__________________ is a hormone synthesized locally by resident cells in musculoskeletal tissue. a. Extracellular matrix b. Collagen type I c. Cytokine d. Integrin

c. Cytokine

Which collagen type is the strongest and is found in healthy tendon? a. IV b. II c. I d. III

c. I

All of the following are indications for the use of a warm whirlpool except: a. Cleaning large, open wounds b. Relieving pain c. Initial edema reduction d. Increasing range of motion e. reflexation

c. Initial edema reduction

Which statement about pulsed diathermy is correct? a. A high frequency (>600 pps) setting is typically used. b. A long phase duration is typically used. c. It has been used for the treatment of nonunion fractures. d. It has a thermal effect.

c. It has been used for the treatment of nonunion fractures.

Which of the following statements about a commercial cold pack is FALSE? a. It should be used with an insulating layer to protect the skin. b. It does not conform well to the skin. c. It is acceptable to use near superficial large nerves. d. It can result in frostbite due to colder temperatures.

c. It is acceptable to use near superficial large nerves.

Which of the following is true about mechanical cervical traction? a. It is indicated for the treatment of vertebral artery compromise. b. It should be tried before manual traction. c. It is indicated for cervical facet dysfunction, or disc pathology. d. It allows for the combination of other manual techniques during treatment.

c. It is indicated for cervical facet dysfunction, or disc pathology.

Which of the following is true regarding articular cartilage? a. It benefits from static loading. b. It is unresponsive to mechanical stimulation. c. It responds well to pulsatile doses of loading. d. It is mostly aneural and vascular.

c. It responds well to pulsatile doses of loading.

Which situation is most likely to result in depolarization of a nerve and an action potential? a. A nerve with the ability to store an electric charge b. Sensory nerves with a long phase duration c. Nerves with low capacitance and a high degree of myelination d. Nerves with high capacitance and small diameter

c. Nerves with low capacitance and a high degree of myelination

What is a vascular reaction to cold that results in a white, red, or blue discoloration of the extremities? a. Neurapraxia b. Angalgesia c. Raynaud's phenomenon d. Hypothermia e. Cyanosis

c. Raynaud's phenomenon

A moist heat pack causes all of the following effects except a. Higher superficial tissue temps b. Increases in muscle tissue temps c. Sedation d. Reduction in muscles spasms e. Vasodilation

c. Sedation

An athlete who undergoes an arthroscopic partial meniscectomy experiences a dramatic decrease in ability to perform a quadriceps set and straight leg raise the day following surgery. What has occurred? a. This athlete has likely suffered injury to the gamma efferent nerves in the quadriceps muscles. b. This athlete has experienced significant quadriceps atrophy. c. This athlete is demonstrating impaired control over volitional, isolated, quadriceps muscle contraction.

c. This athlete is demonstrating impaired control over volitional, isolated, quadriceps muscle contraction.

All of the following are recommended approaches for clinician-patient interactions EXCEPT a. listen to and observe for patient's needs b. monitor the patient throughout the rehabilitation process c. convince your patient of your knowledge through the use of medical terms d. avoid being overly simplistic

c. convince your patient of your knowledge through the use of medical terms

Which of the following would be the best treatment choice for the following patient problem? The athlete is a 20-year-old volleyball player who suffered a first-degree lateral ankle sprain two days ago. The team is participating in the NCAA regional tournament in two days. The team physician will allow the athlete to play, but the athlete limps while walking and has not jogged or jumped since the injury. There is some swelling but it does not limit motion. a. hot hydrocollator b. paraffin c. cryokinetics d. contrast bath

c. cryokinetics

What are heat producing currents in the body that are found by a magnetic field that is externally applied in short-wave diathermy called? a. Induction currents b. magnetic currents c. eddy currents d. alternating currents

c. eddy currents

During eccentric loading of injured tendons, pain is a. not expected and does not signal excessive stress b. not expected and signals excessive stress c. expected and does not signal excessive stress d. expected and signals excessive stress

c. expected and does not signal excessive stress

The primary determinant of the depth of heating with therapeutic ultrasound is a. intensity b. duty cycle c. frequency d. effective radiating area

c. frequency

Which term is defined as the sum of resistance, inductance, and capacitance? a. ampere b. resistance c. impedance d. charge

c. impedance

Rate of bone remodeling is influenced by a. frequency and volume of loading b. frequency and magnitude of loading c. magnitude, frequency, and duration of loading d. only magnitude of loading

c. magnitude, frequency, and duration of loading

"First pain" is associated with localized and discriminative pain. This is associated with a. affective-motivational pain b. the neuromatrix theory of pain c. neocortical tract pain d. paleocortical tract pain

c. neocortical tract pain

A patient with patellar tendinopathy may benefit from a. performing leg presses while lying supine to remove gravity b. increasing the amount of resistance while decreasing the number of repetitions c. performing squats on an incline board to load the quadriceps d. performing high volumes of squat jumps daily

c. performing squats on an incline board to load the quadriceps

All of the following are correct parameters pertaining to sensory TENS (high-rate TENS) EXCEPT a. there is no duty cycle b. patient should feel strong sensory perception c. phase duration above 100 µs d. phase duration in the range of 250-300 s

c. phase duration above 100 µs

All of the following are reasons to use high-voltage stimulation EXCEPT a. edema reduction b. pain control c. physiochemical responses and ion migration d. tissue healing

c. physiochemical responses and ion migration

A patient reports with specific regions of pain and discomfort. Which LLLT technique would be most appropriate? a. grid technique b. scanning c. point application

c. point application

All of the following ions are recommended to decrease pain and inflammation via iontophoresis EXCEPT a. hydrocortisone b. dexamethasone c. salicylate d. lidocaine

c. salicylate

Which of the following is an example of reflex response training after an ankle injury? a. use of resistive bands to strengthen the musculature b. walking without altered gait patterns c. standing on wobble boards or disks d. joint mobilizations to improve range of motion

c. standing on wobble boards or disks

In which of the following situations should you NOT use thermotherapy for a patient? a. to facilitate tissue healing b. to reduce muscle spasm c. to reduce acute inflammatory response d. to reduce swelling in a subacute injury

c. to reduce acute inflammatory response

The therapeutic conversion of electrical energy into high frequency sound energy above the audible range to create heat in the tissues is the definition of what modality? a. diathermy b. Electrical stimulation c. ultrasound d. Iontophoresis

c. ultrasound

The ability to elongate and return to normal length is a. flexibility b. mechanical creep c. viscoelasticity d. adaptive range of motion

c. viscoelasticity

Which of the following is correct regarding a patient or athlete's emotional response to injury? a. The emotional response only resolves once the athlete has returned to play. b. Level of self-perception does not affect the emotional response to injury. c. Emotional responses usually last several weeks after the injury. d. It is a complex and dynamic process.

d. It is a complex and dynamic process.

Of the following, which is true regarding collagen? a. It is the principal component of ground substance. b. ROS-activated proteases synthesize collagen and extracellular matrix. c. It is formed by the conversion of fibrin to fibrinogen. d. It is synthesized by fibroblasts.

d. It is synthesized by fibroblasts.

All of the following regarding patterned electrical neuromuscular stimulation are true EXCEPT a. It is used to re-create proper firing patterns through reeducation. b. It involves precisely timed electrical stimulation. c. It has been found to decrease pain and improve function in patients with knee osteoarthritis. d. It uses a biphasic pattern to primarily stimulate the agonist muscle.

d. It uses a biphasic pattern to primarily stimulate the agonist muscle.

Which of the following related to mechanobiology in muscle is true? a. Muscle cell repair is activated after calcium efflux following an overstretch injury. b. Mechanotransduction primarily influences protein synthesis, but not homeostasis. c. Satellite cells are mature skeletal muscle cells that produce new cells after injury. d. Muscle satellite cells reside in the basal lamina of skeletal muscle.

d. Muscle satellite cells reside in the basal lamina of skeletal muscle.

Of the following, which is INCORRECT regarding mechanical lumbar traction techniques? a. The harnesses must be very snug so that no slipping occurs. b. Supine positioning may increase radicular symptoms in patients suffering from disc herniation. c. Intermittent mode is generally more comfortable and better tolerated by the patient. d. Prone or supine positioning has little impact on treatment outcome in the treatment of patients with low back pain.

d. Prone or supine positioning has little impact on treatment outcome in the treatment of patients with low back pain.

Which of the following acoustical interfaces is most reflective of ultrasound energy? a. Water - soft tissue b. Soft tissue - adipose tissue c. Soft tissue - bone d. Soft tissue - air

d. Soft tissue - air

Which of the following is correct regarding muscle pain during exercise after injury? a. Pain is not expected and may alter neuromuscular control. b. Some pain is expected and does not alter neuromuscular control. c. Pain is not expected and does not alter neuromuscular control. d. Some pain is expected, yet it may alter neuromuscular control.

d. Some pain is expected, yet it may alter neuromuscular control.

Of the following, which is correct regarding diathermy application and outcomes? a. Treatment time is typically 5 to 10 minutes. b. Skin should be moistened to allow for greater heat exchange. c. A warm sensation should only be felt after the treatment has finished. d. There is limited data on diathermy efficacy.

d. There is limited data on diathermy efficacy.

What medium doesn't transit ultrasound waves? a. water b. gel c. body lotion d. air

d. air

The most significant effect of histamine is to a. increase capillary membrane permeability b. stimulate clotting c. attract neutrophils d. cause vasodilation

d. cause vasodilation

Indirect release techniques are most likely to a. increase alpha gain b. stimulate the release of enkephalins in the dorsal horn of the spinal column c. stretch tight fascial bands d. decrease gamma gain

d. decrease gamma gain

To distract the lower region of the cervical spine, the neck should be placed in a. a side-bending position b. a neutral position c. rotation d. flexion

d. flexion

Which of the following would be the best treatment choice for the following patient problem? The athlete is a 45-year-old tennis player who underwent ORIF for a displaced fracture of the proximal phalanx of the index finger 8 weeks ago. The pin fixation was recently removed. The primary complaint is lack of motion in the M-P and PIP joints. a. contrast bath b. paraffin c. hot pack d. fluidotherapy

d. fluidotherapy

All of the following regarding extracellular matrix (ECM) is true EXCEPT a. a majority of tissue cells must remain attached to the ECM for survival b. it is comprised of fibrous proteins and polysaccharides c. it adds strength and resilience to tissue d. it is a cellular component of connective tissue

d. it is a cellular component of connective tissue

All of the following are correct with regard to the ERA of ultrasound EXCEPT a. it is characterized by an area of high and low intensity b. it is smaller than the surface area of the sound head c. it is the area that receives at least 5% of the peak sound energy d. it stands for effective ramping amplitude

d. it stands for effective ramping amplitude

All of the following are contraindications for muscle energy techniques EXCEPT a. severe osteoporosis b. bony instability c. joint fusion and joint instability d. low back pain with muscle spasm

d. low back pain with muscle spasm

Resolution of swelling following acute tissue injury is primarily due to a. increased capillary membrane permeability b. absorption of fluid in the postcapillary venule c. decreased capillary hydrostatic pressure d. lymphatic drainage

d. lymphatic drainage

Joint instability is a contraindication or cautionary factor for all of the following EXCEPT a. strain-counterstrain b. myofascial release c. traction d. massage

d. massage

Electrical stimulation device settings of 50 pulses per second, amplitude to elicit motor response, targets A-alpha fibers, and has a phase duration of 250 equations describes TENS pain control via ________________________ stimulation. a. motor b. sensory c. noxious d. neuromuscular

d. neuromuscular

An infrared heat lamp is an example of which form of thermal energy transfer? a. convection b. conduction c. conversion d. radiation

d. radiation

All of the following have been reported as physiological effects of LLLT EXCEPT a. promotion of tissue healing b. decreased pain c. expedited inflammatory process d. reduced swelling

d. reduced swelling