Chap 14

Question 1

. In designing an individualized therapeutic exercise program, the first step is to
a. assess the present level of function and dysfunction.
b. develop a treatment plan.
c. develop short- and long-term goals.
d. formulate a list of patient problems.

Answer 1

A

Question 2

Which of the following is NOT considered a long-term goal?
a. Bilateral equal range of motion
b. Control of inflammation
c. Relaxation training
d. Maintenance of cardiovascular fitness

Answer 2

B

Question 3

3. What is the optimal time for beginning therapeutic exercise following surgery or an injury?
   a. Immediately after
   b. 24 hours later
   c. 3 to 4 days later
   d. When pain subsides

Answer 3

A

Question 4

4. Which of the following statements is TRUE concerning collagenous scar formation compared with the original mature injured tissue?
   a. It is less efficient and tolerant of shearing forces.
   b. It is less efficient and tolerant of tensile forces.
   c. It is more efficient and tolerant of tensile forces.
   d. It is more efficient and tolerant of shearing forces.

Answer 4

B

Question 5

5. The longer the inflammatory process progresses, the more likely the resulting scar tissue will be
   a. less dense and weaker in resisting applied stress.
   b. more dense and stronger in resisting applied stress.
   c. more dense and weaker to resisting applied stress.
   d. able to resist applied stress at the same level as the previously injured tissue.

Answer 5

A

Question 6

. Which of the following are physiological effects of cryotherapy?
a. Decreased vasoconstriction, increased nerve conduction velocity, and decreased pain perception
b. Increased vasoconstriction and metabolism, decreased pain
c. Decreased metabolism, nerve conduction, and pain perception
d. Increased vasodilation, increased metabolism, decreased capillary permeability

Answer 6

C

Question 7

7. _____ uses gravity to reduce the pooling of fluids and pressure inside the venous and lymphatic vessels to prevent fluid from filtering into surrounding tissue spaces.
   a. Compression
   b. Immobilization
   c. Cold application
   d. Elevation

Answer 7

D

Question 8

8. Which of the following would NOT be used if the goal is to control hemorrhage and eliminate edema?
   a. Cryotherapy
   b. Electrical muscle stimulation
   c. Transcutaneous electrical nerve stimulation
   d. Intermittent compression

Answer 8

B

Question 9

9. Prolonged immobilization can lead to muscles losing their flexibility and assuming a shortened position. This is referred to as
   a. a contracture.
   b. hypomobility.
   c. hypermobility.
   d. Sharpey fibrosis.

Answer 9

A

Question 10

10. The effects of immobilization of the articular cartilage are dependent on
    a. length of immobilization.
    b. position of the joint.
    c. joint loading.
    d. All of the above.

Answer 10

D

Question 11

11. In fitting crutches, the hand grips should be placed at a height that allows the elbow to be flexed about
    a. 15°.
    b. 20°.
    c. 25°.
    d. 30°.

Answer 11

D

Question 12

12. An individual can move into phase 3 of the rehabilitation program when what percentage of normal passive and active range of motion is achieved?
    a. 60%
    b. 70%
    c. 80%
    d. 90%

Answer 12

C

Question 13

13. Hypomobility can
    a. promote healing.
    b. predispose an individual to microtraumatic injuries.
    c. prevent pain-free return to activity.
    d. lead to degenerative joint changes.

Answer 13

A

Question 14

14. A large-amplitude movement up to the pathological limit in the range of motion is considered a ______ joint mobilization.
    a. grade II
    b. grade III
    c. grade IV
    d. grade V

Answer 14

B

Question 15

15. When performing joint mobilization, if the concave surface is stationary and the convex surface is mobilized, a glide of the convex segment should be in
    a. the same direction as the restriction of joint movement.
    b. the opposite direction to the restriction of joint movement.
    c. a posterior direction.
    d. an anterior direction.

Answer 15

B

Question 16

16. The technique in which an individual consciously relaxes a muscle prior to stretching is termed
    a. active movement.
    b. reciprocal inhibition.
    c. active inhibition.
    d. imagery.

Answer 16

C

Question 17

17. Joint mechanoreceptors sensitive to the intra-articular pressure and stretching of the joint capsule are called
    a. Golgi receptors.
    b. muscle spindles.
    c. Pacinian corpuscles.
    d. Ruffini corpuscles.

Answer 17

D

Question 18

18. Closed kinetic chain (CKC) exercises are recommended for several reasons. One such reason is
    a. CKC exercises increase strength at a faster rate than open kinetic chain.
    b. CKC exercises increase range of motion faster.
    c. CKC exercises reduce shearing forces about the joint.
    d. CKC exercises facilitate the inflammatory process.

Answer 18

C

Question 19

19. A Biomechanical Ankle Platform System is often used to
    a. increase range of motion.
    b. decrease swelling.
    c. improve sensory cues and balance of the lower extremity.
    d. decrease inflammation.

Answer 19

C

Question 20

20. A method of promoting or hastening the recovery process of muscles through the use of diagonal or spiral patterns is characteristic of
    a. Delorme progressive resistive exercises.
    b. hydrotherapeutic exercise.
    c. isokinetic exercise.
    d. proprioceptive neuromuscular facilitation exercises

Answer 20

D

Question 21

21. Which of the following is NOT an open kinetic chain exercise?
    a. Knee extension
    b. Bench press
    c. Throwing a ball
    d. Wall push-up

Answer 21

D

Question 22

22. An individual is performing a bicep curl as an exercise for a bicep strain. This exercise is considered
    a. an isometric exercise.
    b. an open kinetic chain exercise.
    c. a closed kinetic chain exercise.
    d. an isokinetic exercise.

Answer 22

B

Question 23

23. A patient’s quadriceps atrophy/hypertrophy should be managed during the rehabilitation process by
    a. using a goniometer every other week.
    b. using a goniometer every day.
    c. taking circumference measurements.
    d. using an isokinetic device.

Answer 23

C

Question 24

24. DAPRE requires the first set of exercises to be _____ of one’s max.
    a. 10%
    b. 25%
    c. 50%
    d. 75%

Answer 24

C

Question 25

25. A disadvantage of isotonic training is that
    a. the expense of the equipment.
    b. a muscle can only move a load through the ROM with as much force as the muscle provides at its weakest point.
    c. it only permits concentric contractions.
    d. it does not permit exercise of multiple joints simultaneously.

Answer 25

B

Question 26

26. Which of the following is NOT an example of a plyometric exercise?
    a. Using a StairMaster
    b. Performing double leg hops
    c. Using a medicine ball
    d. Performing a standing jump

Answer 26

A

Question 27

27. A functional exercise program designed for a soccer athlete should include
    a. walking, light jogging, sprinting, and soccer drills.
    b. walking, light jogging, side slides, carioca, ball kicks, and dribbling drills.
    c. light jogging, side slides, sprints, dribbling drills, and ball kicks.
    d. walking, jogging, figure eights, dribbling drills, and running drills.

Answer 27

B

Question 28

28. Proprioception and coordination can be improved through performing
    a. closed kinetic chain exercises.
    b. open kinetic chain exercises.
    c. plyometric exercises.
    d. isokinetic exercises.

Answer 28

A

Question 29

29. True or False? Phase 2 of a therapeutic exercise program focuses on the regaining any deficits in range of motion and restoring proprioception.
    a. True
    b. False

Answer 29

A

Question 30

30. True or False? A therapeutic exercise program begins with patient assessment.
    a. True
    b. False

Answer 30

T

Question 31

31. True or False? Acute care of soft-tissue injuries includes application of crushed ice directly to the skin for 30 to 40 minutes.
    a. True
    b. False

Answer 31

A

Question 32

32. True or False? Bone loss can be detected as early as 2 weeks after immobilization.

Answer 32

T

Question 33

33. True or False? Along with primary deficits such as weakness or pain, secondary factors such as problems associated with prolonged immobilization or lack of intervention should be organized into a priority list of concerns and be recorded in the assessment part of the SOAP note.
    a. True
    b. False

Answer 33

A

Question 34

34. True or False? Following an injury, early motion through partial weight-bearing exercise can interfere with proper joint lubrication.
    a. True
    b. False

Answer 34

B

Question 35

35. True or False? Patient education about relaxation to relieve muscle spasm and stress should be initiated in phase 4 of the exercise program.
    a. True
    b. False

Answer 35

B

Question 36

36. True or False? Periodic measurement of girth, range of motion, muscle strength, endurance, power, and cardiovascular fitness will determine if progress is occurring in the exercise program.
    a. True
    b. False

Answer 36

A

Question 37

37. True or False? Collagenous scar formation is more efficient and tolerant of tensile forces than the original mature tissue.
    a. True
    b. False

Answer 37

B

Question 38

38. True or False? Immobilization for more than 2 weeks may lead to joint adhesions that inhibit muscle fiber regeneration.
    a. True
    b. False

Answer 38

A

Question 39

39. True or False? Muscle spindles are encapsulated receptors found in muscle tissue and are sensitive to stretch.
    a. True
    b. False

Answer 39

A

Question 40

40. True or False? Hemorrhage and edema cause pooling of tissue fluids and blood products that increases pain and muscle spasm.
    a. True
    b. False

Answer 40

A

Question 41

41. True or False? Application of cold immediately after injury leads to vasoconstriction and increases capillary permeability, resulting in an increase in the time needed for blood coagulation.
    a. True
    b. False

Answer 41

B

Question 42

42. True or False? The Golgi tendon organs fail to fire during static stretching, leading to microscopic tears of the muscle tissue.
    a. True
    b. False

Answer 42

B

Question 43

43. True or False? In applying the overload principle, strength gains depend primarily on the specific training method used to improve strength.
    a. True
    b. False

Answer 43

B

Question 44

44. True or False? Muscular strength is improved with a minimum of 3 days per week of training that includes 12 to 15 repetitions per bout of 8 to 10 exercises for the major muscle groups.
    a. True
    b. False

Answer 44

A

Question 45

45. True or False? Variable speed/fixed resistance is associated with isokinetic strength training.
    a. True
    b. False

Answer 45

B

Question 46

46. True or False? An advantage of isokinetic training is that a muscle group can be exercised to its maximum potential throughout the full range of motion.
    a. True
    b. False

Answer 46

A

Question 47

47. True or False? Joint congruity can be enhanced through closed kinetic chain exercises.
    a. True
    b. False

Answer 47

A

Question 48

48. Match the following terms and definitions.
49. Contracture a. active contraction of the agonist to cause a reflex relaxation in the antagonist
50. Flexibility b. slow deliberate muscle stretching
51. Plyometric training c. limited passive range of motion
52. Static stretching d. adhesions in an immobilized muscle leading to a shortened state
53. Valsalva effect e. distal end is firmly fixed and not free in space
54. Reciprocal inhibition f. holding one’s breath against a closed glottis
55. Active stretching g. insufficient strength to move a body segment through a range of motion
56. Active inhibition h. total range of motion of a joint
57. CKC exercise i. accessory motion
58. Arthrokinematics j. flexibility exercises performed by the patient not clinician
59. Hypomobility k. explosive movements used to develop muscular power
60. Sticking point l. individual consciously relaxes a muscle prior to stretching

Answer 48

Answer: 1-d, 2-h, 3-k, 4-b, 5-f, 6-a, 7-j, 8-l, 9-e, 10-i, 11-c, 12-g

Question 49

49. A high school athletic trainer has a limited budget. What type of therapeutic exercise equipment could the individual purchase to increase muscle strength, endurance, and power without overextending their budget?

Answer 49

Answer: free weights, Thera-Band, elastic and surgical tubing can be purchased relatively inexpensively

Question 50

50. Describe how to stretch the hamstrings muscle group using the contract–relax technique.

Answer 50

Answer: The clinician stabilizes the thigh and passively flexes the hip into the agonist pattern until limitation is felt in the hamstrings. The patient then performs an isotonic contraction with the hamstrings through the antagonist pattern. Next, the therapist applies a passive stretch into the agonist pattern until limitation is felt.

Question 51

51. What are the sequential steps that should be followed to identify the needs of the patient when designing an individualized therapeutic exercise program?

Answer 51

Answer: The sequential steps are as follows:
1. Assess the present level of function and dysfunction from girth measurements, goniometric assessment, strength tests, neurological assessment, stress tests, and functional activities.
2. Organize and interpret the assessment to identify primary and secondary structural or functional deficits.
3. Establish short- and long-term goals to return the individual safely to participation.
4. Develop and supervise the treatment plan, incorporating therapeutic exercise, therapeutic modalities, and medication.
5. Reassess the progress of the plan and adjust as needed.

Question 52

52. A basketball player has sustained a sprained ankle. Identify and explain the actions that should be included in phase 1 of the therapeutic exercise program for this particular individual.

Answer 52

Answer: The response should address the following areas:
Control swelling by applying PRICE; help control hemorrhage, eliminate edema, and control pain by choosing either intermittent compression, electrical muscle stimulation, or TENS; protect and restrict activity at the ankle by immobilization through the use of an elastic wrap, tape, brace, and/or crutch.

Question 53

53. Identify the four phases of a therapeutic exercise program and briefly state the main goals in each phase.

Answer 53

Answer:
Phase 1: Control inflammation
* Control the inflammatory stage, and minimize scar tissue with cryotherapy using PRICE principles (protect, restrict activity, ice, compression, and elevation).
* Instruct the patient on relaxation and coping techniques.
* Maintain range of motion (ROM), joint flexibility, strength, endurance, and power in the unaffected body parts.
* Maintain cardiovascular endurance.