Question 1

What is an advantage of using manual resistance for proprioceptive neuromuscular facilitation patterns to facilitate strengthening?

Accepted Answer

Manual resistance allows the therapist to adjust resistance throughout the range, which allows for more targeted and personalized strengthening.

Question 2

The patient is referred to physical therapy with moderate hemiparesis following a LCVA 4 days ago.The therapist determines that the patient can benefit from a strengthening program.What types of exercises should the therapist begin with?

Accepted Answer

Isometric contractions at mid-range of motion are often recommended initially for patients with moderate hemiparesis following a stroke (LCVA - Left Cerebral Vascular Accident). This approach allows for strengthening without the need for limb movement, which can be beneficial in early stages of rehabilitation when movement control may be limited.

Question 3

A therapist chooses an intervention approach that includes primarily hands-on interventions,focusing on the affected extremities while limiting compensatory movements.The therapist's framework is

Accepted Answer

Neuromotor development training focuses on hands-on interventions and emphasizes the use of affected extremities while limiting compensatory movements.

Question 4

During stair climbing the patient demonstrates poor control of hip flexion secondary to weakness placing the foot on the step.What instruction could the therapist give the patient to improve control?

Accepted Answer

Moving slowly at first can help the patient focus on their movement and gain control, while gradually increasing speed can help them improve their speed and efficiency of movement. Option A is not recommended as speed should not be prioritized over control. Option B is not necessary and may be too challenging for the patient's current level of ability. Option D focuses more on strength and may not address the issue of poor control.

Question 5

The therapist provides the patient with feedback about performance on a motor task after every four trials.What type of feedback is this?

Accepted Answer

Summed feedback is provided after a set number of attempts, which matches the description given.

Question 6

A therapist chooses interventions that utilize a hands-off approach.The patient is encouraged to perform as much of the motor task as possible while focusing on the specific task.The therapist's framework is

Accepted Answer

The hands-off approach suggests the use of functional training where the therapist focuses on enhancing the patient's ability to perform specific motor tasks rather than compensating for their deficits. This approach encourages the patient to perform as much of the task as possible while targeting the specific task. Functional training emphasizes the use of real-life activities and tasks to improve a patient's functional abilities. Proprioceptive neuromuscular facilitation and neuromotor development training involve a more hands-on approach and often use facilitation techniques to guide and assist the patient through the task.

Question 7

After examining the patient the therapist determines that distributed practice will benefit the patient most.Which of the following best describes a possible reason for this decision?

Accepted Answer

Distributed practice involves breaking up practice sessions into shorter, more frequent sessions with periods of rest in between. This is often beneficial for patients who have limited endurance or impaired motor planning skills for a task, as it allows them to practice the skill in shorter, more manageable sessions without becoming fatigued or overwhelmed. Therefore, choice D is the correct answer.

Question 8

A patient participating in a strengthening program is using resistance that requires strong contraction of the muscle,80% of MVC.What principle of strengthening does this demonstrate?

Accepted Answer

The overload principle states that in order to improve muscle strength, a greater than normal stress or load must be placed on the muscle. In this case, using resistance that requires strong contraction of the muscle at 80% of maximum voluntary contraction (MVC) represents an overload, as it requires the muscle to work harder than it normally would.

Question 9

The therapist has decided to work with the patient on transfers by having the patient perform bed to wheelchair,wheelchair to mat,wheelchair to couch,and wheelchair to tub transfers during one treatment session.What is the benefit of having the patient practice this way?

Accepted Answer

Random practice has been shown to be more effective for retention because it challenges the patient to adapt and problem-solve in different contexts, leading to better long-term memory and skill transfer to real-life situations.

Question 10

Which of the following motor tasks would benefit the most from whole versus part practice?

Accepted Answer

Walking is a continuous task that flows naturally from start to finish, making it more suitable for whole practice to maintain the fluidity and rhythm of the movement. Other tasks like wheelchair transfers, bed mobility, and sit to stand involve distinct phases that can be practiced separately, making them more amenable to part practice.

Question 11

The therapist provides the patient with feedback about performance on a motor task after every trial at first,and then after every second,then every third trial,until the therapist is providing feedback after every fifth or sixth trial.What type of feedback is this?

Accepted Answer

This type of feedback is called faded feedback, where the frequency of feedback decreases gradually as the patient's performance improves.

Question 12

The therapist provides the patient with feedback about her performance on a motor task after a 3- to 5-second delay.What type of feedback is this?

Accepted Answer

The type of feedback provided in this scenario is delayed feedback, as the patient is provided with feedback about her performance after a brief delay.

Question 13

The patient is instructed to practice walking at the mall after walking in a physical therapy clinic 3 times a week for 3 weeks.How does this change the practice?

Accepted Answer

Moving the practice from a physical therapy clinic to a mall transitions the task from a controlled, predictable (closed) environment to a more unpredictable, variable (open) environment where the patient has to navigate around people, objects, and potentially uneven surfaces.

Question 14

Why would a therapist choose contract-Relax (CR)over passive stretching?

Accepted Answer

CR can provide a better stretch because it involves contracting the muscle being stretched before relaxing it, causing inhibition of the antagonist muscle and allowing for a greater range of motion. This is not achieved with passive stretching.

Question 15

To facilitate hip and knee extensor strength for sit to stand the therapist has the patient performing partial squats.What is the benefit of this activity?

Accepted Answer

Stimulation of joint proprioceptors using a closed-chain exercise

Question 16

The therapist provides the patient with feedback about performance on a motor task only when the patient's performance falls outside of a prescribed range of performance.What type of feedback is this?

Accepted Answer

This is an example of bandwidth feedback, where feedback is only provided when the performance falls outside of a certain range or bandwidth. This can be useful for encouraging self-assessment and self-correction, as well as reducing dependence on external feedback. The other options do not accurately describe this type of feedback. Summed feedback involves providing feedback on multiple trials of a task, delayed feedback involves providing feedback after a delay, and faded feedback involves gradually reducing the frequency of feedback.

Question 17

A patient has been unable to participate in the prescribed exercise program during the last week because of a pulmonary embolus and demonstrates significantly decreased strength on re-examination.What principle of strengthening does this demonstrate?

Accepted Answer

The principle of reversibility states that gains in muscular strength and/or endurance are lost when the muscles are not exercised or when there is an interruption in the exercise program. In this case, due to the pulmonary embolus, the patient was unable to participate in the prescribed exercise program for a week, leading to significant decrease in strength on re-examination.

Question 18

After a brain injury,an individual demonstrates functional gains as a result of constraint-induced movement therapy.This recovery is most likely a result of what mechanism?

Accepted Answer

Constraint-induced movement therapy is a type of rehabilitative intervention designed to improve motor function in individuals with neurological deficits, particularly after stroke or brain injury. This therapy involves restricting the use of the less affected limb while simultaneously engaging the more affected limb in intensive repetitive motor practice. This technique is thought to promote cortical reorganization within the brain, as the brain adapts to the increased demand on the more affected limb. Therefore, the recovery seen in this individual is most likely a result of cortical reorganization.

Question 19

The patient demonstrates strength deficits for the concentric contraction of the hip flexors for swing phase of gait.The therapist chooses to provide resistance to the hip flexors in standing through the range of motion from 10º hip extension to 30º hip flexion.What principle of strengthening programs does this demonstrate?

Accepted Answer

The specificity principle states that to improve a particular skill or strength in a specific area, the training should be specific to the muscles involved and the type of action required. In this case, providing resistance to the hip flexors through their specific range of motion used during the swing phase of gait directly applies this principle, aiming to strengthen the muscles in a way that directly improves the patient's functional movement.

Question 20

A therapist chooses an intervention approach that focuses on use of the less involved extremity so the patient could regain functional tasks.The therapist's framework is

Accepted Answer

The therapist's approach of focusing on the use of the less involved extremity to regain functional tasks aligns with compensatory training. This method involves adapting or compensating with the less affected side or other strategies to accomplish tasks, rather than directly rehabilitating the impaired function.

Quiz 13: Strategies to Improve Motor Function