Upper Extremity Management

Question 1

What is the primary function of the clavicle in upper extremity biomechanics?

A) Acts as a stabilizer for the scapula
B) Provides muscle attachment for shoulder motion
C) Serves as a bridge between the trunk and upper extremity complex
D) Connects the scapula to the humerus

Answer 1

C) Serves as a bridge between the trunk and upper extremity complex

Question 2

What can lead to scapular malalignment?

A) Increased muscle strength
B) Trunk malalignment and muscle imbalance around the scapula
C) Proper scapular positioning
D) Overuse of the upper extremity

Answer 2

B) Trunk malalignment and muscle imbalance around the scapula

Question 3

Which of the following is NOT commonly associated with hemiplegic shoulder pain (HSP)?

A) Subluxation
B) Adhesive capsulitis
C) Tendinitis of the long head of the biceps
D) Excessive external rotation

Answer 3

D) Excessive external rotation

Question 4

What is the most common pattern of subluxation in the hemiplegic shoulder?

A) Inferior subluxation
B) Anterior subluxation
C) Superior subluxation
D) Lateral subluxation

Answer 4

A) Inferior subluxation

Question 5

What is one suggested cause of shoulder-hand syndrome (SHS) in hemiplegia?

A) Central nervous system damage
B) Peripheral lesions and tissue or nerve injury
C) Proprioceptive deficits
D) Overuse of the unaffected arm

Answer 5

B) Peripheral lesions and tissue or nerve injury

Question 6

What is one key prevention protocol for shoulder-hand syndrome (SHS) in hemiplegia?

A) Aggressive passive range of motion (PROM) exercises
B) Mobilization of the scapula before PROM
C) Avoiding the use of any positioning devices
D) Ignoring any signs of discomfort in the upper extremity

Answer 6

B) Mobilization of the scapula before PROM

Question 7

Which standardized assessment is considered the “Gold Standard” for assessing upper extremity recovery post-stroke?

A) Wolf Motor Function Test (WMFT)
B) Fugl-Meyer Assessment-Upper Extremity (FMA-UE)
C) Action Research Arm Test (ARAT)
D) Jebsen-Taylor Hand Function Test (JTHFT)

Answer 7

B) Fugl-Meyer Assessment-Upper Extremity (FMA-UE)

Question 8

Which assessment focuses on motor ability through timed and functional tasks for stroke patients?

A) Stroke Upper Limb Capacity Scale (SULCS)
B) Wolf Motor Function Test (WMFT)
C) Motor Activity Log (MAL)
D) ABILHAND

Answer 8

B) Wolf Motor Function Test (WMFT)

Question 9

What is a key goal of treatment for excessive spasticity in the upper extremity?

A) Encourage fast, uncontrolled movements
B) Maintain soft tissue length through PROM
C) Eliminate weight-bearing activities
D) Avoid all physical activity to reduce spasticity

Answer 9

B) Maintain soft tissue length through PROM

Question 10

What is one purpose of using slings for the upper extremity in early rehabilitation?

A) To position the shoulder in internal rotation
B) To prevent overstretch of the supraspinatus and support the weight of the arm
C) To immobilize the arm permanently
D) To encourage maximum movement immediately after injury

Answer 10

B) To prevent overstretch of the supraspinatus and support the weight of the arm

Question 11

What is a primary benefit of weight-bearing activities for upper extremity recovery?

A) Increase speed of arm movement
B) Strengthen proximal muscle groups and provide sensory input
C) Increase spasticity in the affected limb
D) Encourage faster healing of fractures

Answer 11

B) Strengthen proximal muscle groups and provide sensory input

Question 12

What is an important factor in performing weight-bearing activities?

A) Eliminate all assistance from therapists
B) Engage in slow, controlled movements to elongate shortened muscles
C) Increase resistance as quickly as possible
D) Avoid sensory input during the activity

Answer 12

B) Engage in slow, controlled movements to elongate shortened muscles

Question 13

Which assessment examines performance of simple and complex tasks in upper extremity recovery?

A) Fugl-Meyer Assessment
B) Stroke Upper Limb Capacity Scale (SULCS)
C) Wolf Motor Function Test (WMFT)
D) Motor Activity Log (MAL)

Answer 13

B) Stroke Upper Limb Capacity Scale (SULCS)

Question 14

What is the purpose of the Jebsen-Taylor Hand Function Test (JTHFT)?

A) Assess gross motor strength
B) Measure fine motor coordination and hand function during daily activities
C) Evaluate shoulder range of motion
D) Test walking speed

Answer 14

B) Measure fine motor coordination and hand function during daily activities

Question 15

What is the purpose of mirror therapy in stroke rehabilitation?

A) Strengthen the unaffected arm
B) Trick the brain into thinking the affected arm is moving by using visual feedback
C) Eliminate the need for other forms of therapy
D) Speed up the process of muscle atrophy

Answer 15

B) Trick the brain into thinking the affected arm is moving by using visual feedback

Question 16

Which therapy involves mental rehearsal with the goal of improved performance without physical practice?

A) Action observation
B) Virtual reality
C) Mental practice
D) Robotic therapy

Answer 16

C) Mental practice

Question 17

Which intervention involves observing a person perform a task and then practicing the task after observation?

A) Mental practice
B) Action observation
C) Mirror therapy
D) Constraint-induced movement therapy (CIMT)

Answer 17

B) Action observation

Question 18

What is the primary goal of robotic therapy in upper extremity rehabilitation?

A) Improve fine motor coordination
B) Provide consistent practice and assist hand movements through programmable manipulators
C) Completely replace therapist involvement
D) Improve shoulder strength alone

Answer 18

B) Provide consistent practice and assist hand movements through programmable manipulators

Question 19

What is the role of neuromuscular electrical stimulation (NMES) in upper extremity management?

A) Provide electrical stimulation during voluntary movement to facilitate limb movements
B) Immobilize the limb for prolonged periods
C) Increase tone in the unaffected limb
D) Replace traditional physical therapy

Answer 19

A) Provide electrical stimulation during voluntary movement to facilitate limb movements

Question 20

How does virtual reality (VR) benefit patients with upper extremity impairments?

A) Creates realistic simulations that engage patients in task-oriented environments
B) Focuses only on passive movement
C) Replaces real-life therapy tasks
D) Reduces the need for physical effort

Answer 20

A) Creates realistic simulations that engage patients in task-oriented environments

Question 21

What is the Saeboflex used for in stroke recovery?

A) Immobilize the wrist
B) Assist hand function during repetitive task practice
C) Increase spasticity in the hand
D) Stretch the shoulder

Answer 21

B) Assist hand function during repetitive task practice

Question 22

Which therapy involves constraining the unaffected arm to encourage the use of the affected arm?

A) Mental practice
B) Constraint-induced movement therapy (CIMT)
C) Action observation
D) Virtual reality

Answer 22

B) Constraint-induced movement therapy (CIMT)

Question 23

What is a primary criterion for participating in constraint-induced movement therapy (CIMT)?

A) No movement in the affected arm
B) 20 degrees of wrist extension and 10 degrees of finger extension
C) Complete recovery of arm function
D) Severe spasticity in the unaffected limb

Answer 23

B) 20 degrees of wrist extension and 10 degrees of finger extension

Question 24

What does task-oriented training focus on in upper extremity rehabilitation?
A) Isolating muscle groups without functional application
B) Repetitive, goal-directed tasks to improve motor control and functional abilities
C) Passive range of motion exercises
D) Strengthening muscles without incorporating daily activities

Answer 24

B) Repetitive, goal-directed tasks to improve motor control and functional abilities

Question 25

What is a critical factor in preventing shoulder-hand syndrome (SHS) in patients with hemiplegia? A) Immediate use of shoulder pulleys for stretching B) Proper positioning of the arm and scapular mobilization C) Complete immobilization of the upper limb D) Continuous use of arm slings

Answer 25

B) Proper positioning of the arm and scapular mobilization

Question 26

Which handling technique should be avoided for a hemiplegic shoulder? A) Overhead pulley exercises B) Weight-bearing activities C) Passive range of motion without scapular mobilization D) Task-oriented training

Answer 26

A) Overhead pulley exercises

Question 27

Why should slings that position the shoulder in internal rotation be minimized during rehabilitation? A) They reduce spasticity in the upper limb B) They increase shoulder mobility C) They contribute to muscle shortening and internal rotation contractures D) They improve functional use of the upper limb

Answer 27

C) They contribute to muscle shortening and internal rotation contractures

Question 28

What is the effect of electrical stimulation (ES) on shoulder subluxation in stroke patients? A) It significantly improves upper limb motor recovery B) It reduces the severity of shoulder subluxation but does not significantly improve motor recovery C) It increases spasticity in the upper limb D) It has no impact on shoulder subluxation

Answer 28

B) It reduces the severity of shoulder subluxation but does not significantly improve motor recovery

Question 29

Which intervention has been shown to be more effective than traditional approaches like NDT in upper extremity rehabilitation? A) Mirror therapy B) Task-oriented training C) Overhead slings D) Neuromuscular electrical stimulation (NMES)

Answer 29

B) Task-oriented training

Question 30

Which adjunctive intervention can improve limb and ADL function post-stroke through visual feedback? A) Robotics B) Mirror therapy C) Virtual reality D) Mental practice

Answer 30

B) Mirror therapy

Question 31

What is anticipatory postural control? A) Adjusting posture after a movement has already occurred B) The body's ability to prepare and adjust posture in anticipation of movement C) The inability to maintain balance during movement D) The compensation for trunk malalignment

Answer 31

B) The body's ability to prepare and adjust posture in anticipation of movement

Question 32

Why is dynamic trunk control important for upper extremity tasks? A) It prevents muscle fatigue in the arms B) It allows the upper extremities to reach beyond arm’s length while maintaining balance C) It eliminates the need for scapular mobility D) It ensures the use of proximal muscle strength

Answer 32

B) It allows the upper extremities to reach beyond arm’s length while maintaining balance

Question 33

What is abnormal scapulohumeral rhythm, and why is it important in stroke rehabilitation? A) A typical pattern of movement between the scapula and humerus B) An impaired rhythm that can lead to shoulder pain and decreased upper extremity function C) A strengthening exercise to improve shoulder mobility D) A way to assess trunk rotation

Answer 33

B) An impaired rhythm that can lead to shoulder pain and decreased upper extremity function

Question 34

What are common signs of scapular malalignment in stroke survivors? A) Normal scapular glide and rotation B) Scapular winging and tipping C) Excessive external rotation of the scapula D) Normal scapular positioning during movement

Answer 34

B) Scapular winging and tipping

Question 35

What does the Motor Activity Log (MAL) assess in stroke patients? A) Quality and amount of movement in the affected upper extremity during daily activities B) Coordination between the trunk and arm during functional tasks C) Range of motion in the shoulder and elbow D) Strength in the unaffected arm

Answer 35

A) Quality and amount of movement in the affected upper extremity during daily activities

Question 36

What is the purpose of the ABILHAND assessment? A) Measures shoulder strength and coordination B) Assesses bimanual hand function and difficulty with daily tasks C) Tests gait and walking speed D) Evaluates the strength of individual fingers

Answer 36

B) Assesses bimanual hand function and difficulty with daily tasks

Question 37

The Action Research Arm Test (ARAT) is commonly used to: A) Measure gross motor strength in the trunk B) Evaluate arm and hand function in stroke patients C) Test lower extremity coordination D) Assess vision during upper limb tasks

Answer 37

B) Evaluate arm and hand function in stroke patients

Question 38

What is the primary focus of using Saeboflex in stroke rehabilitation? A) Immobilize the wrist to prevent further injury B) Assist in repetitive task practice to improve hand function C) Increase spasticity in the hand and fingers D) Prevent arm movement

Answer 38

B) Assist in repetitive task practice to improve hand function

Question 39

Constraint-induced movement therapy (CIMT) requires patients to: A) Use both arms equally during daily tasks B) Constrain the unaffected arm to encourage use of the affected arm C) Focus only on passive movements D) Avoid all movement in the affected arm

Answer 39

B) Constrain the unaffected arm to encourage use of the affected arm

Question 40

Who is an ideal candidate for Saeboflex therapy? A) A person with no wrist or shoulder movement B) A stroke survivor with at least 15 degrees of active wrist extension and some hand function C) An individual with severe spasticity D) A person with no interest in task-oriented training

Answer 40

B) A stroke survivor with at least 15 degrees of active wrist extension and some hand function

Question 41

What is one key prevention strategy for shoulder-hand syndrome (SHS) in patients with hemiplegia? A) Use aggressive passive range of motion without scapular mobilization B) Educate patients, families, and staff on proper handling and positioning of the affected arm C) Encourage fast, repetitive movements to increase blood flow D) Use only overhead pulley exercises

Answer 41

B) Educate patients, families, and staff on proper handling and positioning of the affected arm

Question 42

How can you prevent further injury in a hemiplegic shoulder during passive range of motion (PROM)? A) Begin PROM exercises without assessing scapular mobility B) Always mobilize the scapula before moving the arm through its range C) Only perform exercises in internal rotation D) Use pulleys to increase mobility in the early stages of recovery

Answer 42

B) Always mobilize the scapula before moving the arm through its range

Question 43

What is the purpose of neuromuscular electrical stimulation (NMES) in upper extremity rehabilitation? A) Immobilize the arm during therapy B) Facilitate movement through electrical stimulation of paretic muscles during voluntary movement C) Replace traditional physical therapy entirely D) Increase spasticity to improve muscle tone

Answer 43

B) Facilitate movement through electrical stimulation of paretic muscles during voluntary movement

Question 44

What are the expected benefits of using robotics in upper extremity rehabilitation? A) Increase muscle tone in the unaffected limb B) Provide consistent, repetitive practice for improved motor function, especially in the proximal arm C) Eliminate the need for therapy staff involvement D) Focus exclusively on fine motor coordination

Answer 44

B) Provide consistent, repetitive practice for improved motor function, especially in the proximal arm

Question 45

What has research shown about the effectiveness of virtual reality (VR) in stroke rehabilitation? A) It leads to rapid recovery with minimal movement B) It improves motor function by engaging patients in task-oriented virtual environments that simulate real-life situations C) It decreases patient motivation by making therapy too challenging D) It eliminates the need for physical movement during therapy

Answer 45

B) It improves motor function by engaging patients in task-oriented virtual environments that simulate real-life situations

Question 46

Why is task-oriented training favored over traditional approaches like NDT in stroke rehabilitation? A) It allows patients to remain passive during recovery B) It is more effective in improving functional outcomes through repetitive, goal-directed activities C) It focuses solely on increasing muscle strength D) It eliminates the need for patient participation

Answer 46

B) It is more effective in improving functional outcomes through repetitive, goal-directed activities

Question 47

What are the main components of constraint-induced movement therapy (CIMT)? A) Restraining both arms during daily tasks B) Constraining the unaffected arm and engaging in repetitive task practice with the affected arm C) Avoiding all arm movement during the therapy period D) Strengthening the unaffected limb

Answer 47

B) Constraining the unaffected arm and engaging in repetitive task practice with the affected arm