Deck 21: Parkinsons Disease

Question 1

When examining standing balance in a patient with early PD it is important to

A)begin with standing on a wobble board.
B)utilize the Berg Balance scale,basic items.
C)increase the attentional demands with dual tasking.
D)time static holding in the posture.

Answer 1

C

Question 2

In patients with PD

A)visual and auditory cues can be used to improve gait.
B)visual cues should be used but auditory cues should not; most elderly patients suffer from hearing loss.
C)auditory cues should be used but not visual; visual cues often cause episodes of freezing.
D)neither auditory nor visual cues should be used because they increase the attentional demands of the activity.

Answer 2

A

Question 3

The four cardinal signs of Parkinson's disease are

A)rigidity,sensory loss,akinesia,micrographia.
B)bradykinesia,tremor,festinating gait,paresthesia
C)rigidity,festinating gait,incontinence,sensory loss
D)bradykinesia,rigidity,tremor,postural instability

Answer 3

D

Question 4

Which of the following terms refers to the slowness and difficulty maintaining movement that commonly occurs in patients with PD?

A)Akinesia
B)Hypokinesia
C)Rigidity
D)Bradykinesia

Question 5

The use of external cues in patients with PD

A)is thought to facilitate movement by utilizing different brain areas and more conscious motor control pathways.
B)is thought to increases the production of dopamine thus temporarily improving symptoms of the disease
C)is most appropriate in patients with severe cognitive deficits and dementia.
D)is most appropriate with dual task training.

Question 6

Two distinct clinical subgroups have been identified in patients with PD.These two groups are those whose dominant symptoms include

A)postural instability/gait disturbances and primary rigidity.
B)primary rigidity and cognitive impairments.
C)cognitive impairment and tremor.
D)tremor and postural instability/gait disturbances.

Question 7

Tremors in patients with PD

A)are often the first symptom.
B)are present even during sleep significantly increasing morning fatigue.
C)are typically present at rest and diminish with voluntary movement.
D)are easily controlled with cognitive techniques.

Question 8

Locomotor training in patients with PD should focus on

A)increasing stride length using floor markers.
B)narrowing the base of support using line walking.
C)working on toe and then heel walking with light touchdown support.
D)paced walking using low beat music.

Question 9

Which of the following is not a potential cause of secondary parkinsonism?

A)Vitamin C deficiency
B)Disorders of calcium metabolism
C)Industrial poisons and chemicals (such as manganese)
D)Drugs

Question 10

A patient is sweating profusely during a PT session,although the intervention that day is not very demanding,and the gym is cool.The sweating is most likely the result of

A)cardiovascular involvement.
B)autonomic nervous system dysfunction.
C)increased effort to overcome the effects of rigidity.
D)an anxiety disorder.

Question 11

Which of the following proprioceptive neuromuscular facilitation techniques would be most appropriate to improve mobility and reduce the effects of rigidity in patients with PD?

A)Alternating isometrics
B)Rhythmic initiation
C)Rhythmic stabilization
D)Hold-relax-active movement

Question 12

A therapist is treating a patient with bradykinesia.The most appropriate examination strategy to document the effects of this impairment on the patient's function is

A)time how long it takes him to complete a task.
B)document his level of independence when completing a task.
C)complete a manual muscle test.
D)assess functional performance both with and without manual guidance.

Question 13

Which of the following is not true concerning rigidity in patient's with PD?

A)It occurs in both agonist and antagonist muscles.
B)It increases proportionally to the speed of a movement.
C)It occurs as the first symptom of PD in the majority of people.
D)It is fairly constant regardless of task.

Question 14

L-dopa is the mainstay of symptomatic treatment for PD.One of its adverse side effects that physical therapists must be aware of when treating patients taking this drug is

A)sensory loss.
B)blurred vision.
C)orthostatic hypotension.
D)muscle spasm and cramping.

Question 15

To compensate for motor learning deficits in patients with PD,the physical therapist should

A)incorporate only one or two repetitions of each activity because patients with PD have cognitive deficits.
B)break down complex movement sequences into component parts using parts to whole practice.
C)use random practice of complex tasks and activities.
D)practice dual tasking to improve functional performance.