Question 1

What two goals do biofeedback and electrotherapy have in common?&#10;A) Stimulation and recruitment of muscle fibers&#10;B) Enhancement of circulatory dynamics and reduction of muscle spasm&#10;C) Increase in muscle strength and motor unit recruitment&#10;D) Reduction of pain

Accepted Answer

C

Question 2

The recommended amplitude for NMES to achieve a given level of muscle force is termed which of the following?&#10;A) Dosage&#10;B) Quantum&#10;C) Threshold&#10;D) Frequency

Accepted Answer

The recommended amplitude for NMES (Neuromuscular Electrical Stimulation) to achieve a given level of muscle force is termed "Dosage." This term is used to describe the intensity, frequency, and duration of the electrical stimulation applied to achieve the desired therapeutic effect.

Question 3

Research studies on the effect of NMES on quadriceps strength following anterior cruciate ligament (ACL) reconstruction found increased strength in the quadriceps using which of the following stimulation intensities?

A) 10% below muscle contraction
B) 50% of maximum voluntary contraction
C) 100% maximum voluntary contraction
D) Maximum tolerated current

D

Accepted Answer

Maximum tolerated current is often used in NMES to achieve the greatest muscle contraction and strength gains, as it recruits more muscle fibers effectively.

Question 4

When selecting a stimulator for NMES, which of the following types of stimulators will be effective?&#10;A) Only large line-powered NMES devices&#10;B) Only portable battery-operated NMES devices&#10;C) Either line-powered or battery-operated NMES devices&#10;D) Any device, including TENS and direct current (DC) devices

Accepted Answer

Either line-powered or battery-operated NMES devices can be effective for NMES. TENS and direct current (DC) devices are not specifically designed for NMES and may not provide the appropriate stimulation parameters needed for effective muscle contraction.

Question 5

During NMES, what pattern of recruitment of motor units will most likely occur?&#10;A) Spatial and temporal&#10;B) Smallest to largest&#10;C) Largest to smallest&#10;D) Only the largest motor units will be recruited.

Accepted Answer

During NMES, motor units are recruited in a spatial and temporal pattern, meaning that smaller motor units are recruited before larger motor units, and there is a gradual increase in the number of motor units recruited as the intensity of stimulation increases. This allows for a smooth and gradual increase in muscle tension and contraction. Therefore, choice A is the correct answer. Choice B and C are incorrect as they only consider size of motor units and not their recruitment pattern. Choice D is also incorrect as it implies that only the largest motor units are recruited during NMES, which is not the case.

Question 6

Which of the following ranges of frequencies represents the force-frequency relationship?&#10;A) 10 to 20 Hz&#10;B) 30 to 50 Hz&#10;C) 50 to 80 Hz&#10;D) 80 to 100 Hz

Accepted Answer

The force-frequency relationship refers to an increase in force generated by a muscle in response to an increase in stimulation frequency. Typically, the relationship is seen between 30 to 80 Hz, with increasing force as frequency increases. Therefore, the best choice is C, with a range of 50 to 80 Hz falling within the typical force-frequency relationship range.

Question 7

Increases in strength of the quadriceps following the first 2 weeks of neuromuscular electrical stimulation (NMES) treatments are most likely secondary to which of the following?&#10;A) Changes in motor unit recruitment&#10;B) Increases in nerve conduction velocity&#10;C) Hypertrophy of muscle size&#10;D) Decreases in tissue resistance to current

Accepted Answer

Increases in strength following the first 2 weeks of NMES treatments are most likely due to changes in motor unit recruitment. NMES can increase activation of motor units, leading to improved muscle contraction and strength. There is typically not enough time in the first 2 weeks for significant muscle hypertrophy to occur, and changes in nerve conduction velocity or tissue resistance to current are not major contributors to increases in strength.

Question 8

Which of the following is a contraindication for biofeedback?&#10;A) Muscle spasticity&#10;B) Diabetes&#10;C) Peripheral neuropathy&#10;D) There are no contraindications for biofeedback.

Accepted Answer

Biofeedback is generally considered safe and does not have specific contraindications, as it is a non-invasive technique used to help individuals learn to control physiological functions.

Question 9

Studies using magnetic resonance imaging (MRI) to determine the amount of muscle used during NMES have found which of the following?&#10;A) Only motor units near the skin's surface are activated.&#10;B) Motor units throughout the muscle are activated.&#10;C) Only motor units directly under the electrodes are activated.&#10;D) Motor units in the deep part of the muscle near bone are not activated.

Accepted Answer

Studies using MRI have shown that motor units throughout the muscle are activated during NMES, not just those near the skin's surface or directly under the electrodes. Additionally, motor units in the deep part of the muscle near bone are also activated.

Question 10

Which of the following sensitivity settings when performing biofeedback is the most sensitive setting for detecting muscle activity?&#10;A) 1 &#956;V&#10;B) 10 &#956;V&#10;C) 100 &#956;V&#10;D) 1,000 &#956;V

Accepted Answer

A lower sensitivity setting allows for the detection of smaller muscle activity, making it ideal for biofeedback.

Question 11

An advantage of NMES recruitment of muscle fiber type compared to voluntary recruitment is which of the following?&#10;A) Activation of slow fibers at higher contraction intensities&#10;B) Asynchronous recruitment of muscle fibers&#10;C) Activation of fast fibers at lower contraction intensities&#10;D) Instantaneous recruitment of muscle fibers

Accepted Answer

The answer of An advantage of NMES recruitment of muscle...

Question 12

A possible limitation of NMES is which of the following?&#10;A) The inability of NMES to achieve greater than 50% maximum voluntary contraction (MVC).&#10;B) Recruitment of fast fibers occurs before recruitment of slow fibers.&#10;C) Firing frequencies of muscle fibers are lower than frequencies used during NMES.&#10;D) Duration of NMES treatments is much longer than comparable voluntary strengthening programs.

Accepted Answer

The answer of A possible limitation of NMES is which...

Question 13

Which of the following is the key factor in the efficacy of NMES strengthening protocols?&#10;A) Size of electrodes placed over the muscle to be stimulated&#10;B) Selection of electrical stimulation (ES) waveform&#10;C) Age and sex of the patient&#10;D) Intensity of training

Accepted Answer

The answer of Which of the following is the key...

Question 14

Which of the following types of ES is required for ES of denervated muscle?&#10;A) Direct current (DC)&#10;B) Alternating current (AC)&#10;C) Biphasic pulsed&#10;D) Interferential

Accepted Answer

The answer of Which of the following types of ES...

Question 15

Electrode placements for NMES applications depend on which of the following?&#10;A) Location of the joint line&#10;B) Ratio of muscle fiber size to the size of the entire muscle&#10;C) Predominant type of muscle fibers in the muscle to be stimulated&#10;D) Size and location of the targeted muscle

Accepted Answer

The answer of Electrode placements for NMES applications depend on...

Question 16

Which of the following parameters can be decreased to help limit fatigue during NMES?&#10;A) Frequency&#10;B) Fall-time&#10;C) Off-time&#10;D) Interpulse interval

Accepted Answer

The answer of Which of the following parameters can be...

Deck 13: Electrotherapy for Musculoskeletal Disorders