Question 1

On Tuesday afternoon the patient practiced transfers from the wheelchair to the mat with assistance from the therapist and progressed from minimal assist to stand-by assist.On Wednesday morning the therapist asks the patient to perform the same transfer.What type of assessment of motor learning is the therapist using?

Accepted Answer

The therapist is using a retention test, which assesses the patient's ability to retain and apply previously learned movements or skills. The fact that the therapist is asking the patient to perform the same transfer on a different day after having previously shown improvement suggests that the therapist wants to evaluate if the patient retained the skill.

Question 2

What is included in examination of sensory organization of postural control and balance?

Accepted Answer

The examination of sensory organization of postural control and balance includes assessing visual, somatosensory (including lower extremity sensation), and vestibular function. Referring to answer choices B and D, range of motion and reflex integration are not specific components of this examination, and hearing is not as vital as the other three aforementioned sensory systems.

Question 3

After gently pushing on a patient's sternum in standing,the therapist observes the patient shifting her center of mass forward at the ankles.How would the therapist document this finding?

Accepted Answer

The observation of the patient's center of mass shifting forward at the ankles indicates an ankle strategy for maintaining balance. Therefore, choice C, "The patient demonstrates an ankle strategy with gentle perturbations in standing," is the best choice for documenting this finding. The other choices are either too general (A and D) or do not specifically mention the ankle strategy (B).

Question 4

The therapist observes the patient walking in the grass at a hospital picnic with many people in the area.What type of skill is the patient demonstrating?

Accepted Answer

The therapist is observing the patient's walking in an open environment with many people around, which indicates that the skill being demonstrated is an open skill. Open skills involve performing a task in an unpredictable environment where the conditions are constantly changing. In this case, the presence of many people and the grass surface make it difficult to predict how the patient will walk.

Question 5

The therapist observes the patient maintaining her center of mass over the base of support in a sitting position while reaching.What type of motor task is this patient demonstrating?

Accepted Answer

The patient is demonstrating dynamic postural control, as she is maintaining her center of mass over the base of support while reaching. Static postural control refers to maintaining balance in a stationary position, while mobility refers to the ability to move from one position to another. Skill would refer to a more complex movement pattern that typically involves multiple components.

Question 6

Which of the following could a therapist use to document changes in motor performance?

Accepted Answer

The number and type of errors are objective measures that can be used to document changes in motor performance.

Question 7

When performing the Clinical Test for Sensory Interaction in Balance,how long must the patient maintain standing in Condition 4 with eyes open and a moving surface?

Accepted Answer

According to the Clinical Test for Sensory Interaction in Balance, the patient must maintain standing in Condition 4 with eyes open and a moving surface for at least 30 seconds.

Question 8

What score on the Berg Balance test has been shown to be useful in evaluating risk of falling in older adults?

Accepted Answer

A score of 45 or below on the Berg Balance test indicates a higher risk of falling in older adults.

Question 9

The patient demonstrates the ability to move from supine to sitting while maintaining postural control.What type of motor task is this patient demonstrating?

Accepted Answer

The answer of The patient demonstrates the ability to move...

Question 10

How should the therapist examine a patient's limits of stability in a standing position?

Accepted Answer

Observing postural sway with the patient standing against a grid is the best choice for examining a patient's limits of stability in a standing position. This allows for a detailed analysis of the patient's ability to maintain stability and balance in various directions and can help identify areas of weakness or potential issues. Asking the patient to reach until he begins to fall or gently pushing on the sternum can be potentially dangerous and should not be used as assessment methods. Watching the patient attempt to reach with feet in a tandem position can be useful for assessing balance, but does not provide as comprehensive of an analysis as observing postural sway against a grid.

Question 11

The therapist observes the patient walking on a stable surface in a quiet hallway.What type of skill is the patient demonstrating?

Accepted Answer

The patient walking on a stable surface in a quiet hallway is demonstrating a closed skill, which is a skill that is performed in a predictable environment with little variation. The environment is stable, and the task is not affected by external factors, making it a closed skill.

Question 12

A patient who presents with significant deficits in lower extremity somatosensation will have to depend on what systems to maintain balance?

Accepted Answer

When a patient has deficits in lower extremity somatosensation, they rely heavily on the vestibular and visual systems to maintain balance. The vestibular system is responsible for detecting head movement and acceleration, while the visual system provides information about the position of the body and surrounding environment. Together, these systems can help compensate for the lack of sensation in the lower extremities.

Question 13

In addition to exhibiting a stepping strategy with large,fast postural perturbations,what else will many individuals demonstrate?

Accepted Answer

Many individuals will demonstrate grasping movements with their upper extremities as an additional strategy to maintain balance during large, fast postural perturbations.

Question 14

What would be a positive finding on the Romberg Test?

Accepted Answer

The Romberg Test assesses the integration of sensory and motor functions for balance. A positive finding, indicating a potential issue, occurs when a patient is unable to maintain balance with their eyes closed, as this suggests a problem with proprioception or vestibular function.

Question 15

How should the therapist examine for abnormal synergies in individuals with upper motor neuron disease?

Accepted Answer

Abnormal synergies are best examined by asking the patient to perform specific movements and observing how these movements are carried out, as this can reveal involuntary movements or patterns typical of upper motor neuron disease.

Question 16

How should ambient vision be examined?

Accepted Answer

Ambient vision involves the ability to perceive and interact with the environment, particularly in terms of spatial awareness and movement. Examining ambient vision by observing a patient's ability to navigate safely in a busy area, such as a gym, while avoiding obstacles, effectively assesses this aspect of vision.

Question 17

The therapist observes that the patient is able to maintain his center of mass over the base of support in a standing position without upper extremity support.What type of motor task is this patient demonstrating?

Accepted Answer

The patient is demonstrating static postural control, which refers to the ability to maintain a stable standing position without the need for external support.

Question 18

When might the therapist expect the patient to demonstrate a hip strategy for balance while in a standing position?

Accepted Answer

The therapist would expect the patient to demonstrate a hip strategy for balance while in a standing position with large perturbations while standing with a narrow base of support. This is because the hip strategy is used primarily for larger perturbations and when the base of support is narrow, making it more difficult to maintain balance without extra compensation from other parts of the body.

Question 19

What is the best use of the Timed Up and Go Test?

Accepted Answer

The Timed Up and Go Test is best used as a reliable, quick screening tool to assess balance in functional mobility tasks. It involves timing a person as they rise from a chair, walk a short distance, turn, walk back, and sit down again, thus evaluating their balance during various movements.

Question 20

How should peripheral vision be examined?

Accepted Answer

Instructing the patient to look at the therapist's nose while the therapist slowly brings a pencil into the patient's field of view from the right or left is the best way to test peripheral vision. This is known as the confrontation test, wherein the therapist holds an object in each hand and brings them into the patient's field of view from different angles while the patient looks straight ahead. This allows the therapist to assess any deficits in peripheral vision.

Quiz 8: Examination of Motor Function: Motor Control and Motor Learning