Ch15 General Approaches to Neurological Full Test Bank

Chapter 15: General Approaches to Neurological Rehabilitation

Kathy L. Mercuris, PT, DHS

Jeannie B. Stephenson, PT, PhD, NCS

Multiple Choice

1. Which of the following is the most eclectic intervention approach which focuses on patient problem solving in varied environments?

a. Body-weight supported treadmill training

b. Motor Relearning Programme (MRP)

c. Neurodevelopmental treatment (NDT)

d. Proprioceptive neuromuscular facilitation (PNF)

2. Which of the following intervention approaches utilize specific developmental sequence positions?

a. Rood

b. Neurodevelopmental treatment (NDT)

c. Motor relearning programme

d. Yoga

3. Which task is the best example of the skill level of motor control as defined by Rood?

a. Six month-old infant rocking back and forth in a quadruped position

b. Lifting a foot to step onto a curb

c. Performing squats during an exercise class

d. Standing quietly while waiting in a checkout line

4. Following an upper motor neuron lesion, a patient initially presents with hypotonia in the right extremities. Which of the following sensory stimuli would be best to facilitate a muscle contraction.

a. Deep pressure

b. Neutral warmth

c. Prolonged stretch

d. Quick ice

5. Approximation is an appropriate technique to utilize with which of the following levels of motor control?

a. Mobility

b. Stability

c. Controlled mobility

d. Skill

6. Based on Ayre’s work, the primary sensory systems prioritized during development are tactile, vestibular, and _________.

a. Hearing

b. Proprioception

c. Smell

d. Vision

7. Which of the following tests and measures includes a component of assessment of synergistic movement patterns as described by Brunnstrom?

a. Bruininks-Oseretsky Test of Motor Proficiency, 2nd ed. (BOT 2)

b. Fugl-Meyer Assessment (FMA)

c. Modified Ashworth Scale

d. Motor Activity Log

8. The upper extremity of a female patient with hemiplegia moves from her side into shoulder adduction, internal rotation, slight elbow flexion, and wrist/finger flexion as she ascends a curb. This upper extremity movement should be documented as:

a. A normal response

b. An associated reaction

c. An upper extremity flexion synergy

d. Isolated movement

9. Which upper extremity PNF pattern or activity would most improve trunk extension?

a. Bilateral D2 flexion patterns

b. Bilateral D2 reciprocal patterns

c. Unilateral D1 extension pattern

d. Chopping

Bilateral D2 Flexion results in shoulder elevation, scapular adduction, and elevation, which facilitates thoracic extension. Chopping and unilateral D1 extension would promote thoracic and trunk flexion. D2 reciprocal pattern results in the upper extremities and scapula moving in opposite directions so the same degree of thoracic extension is not as evident.

10. A patient presents with decreased passive range of motion in shoulder flexion. Which of the following PNF techniques would be best for the goal of increased shoulder mobility?

a. Autogenic inhibition

b. Contract relax

c. Isotonic reversal

d. Rhythmic stabilization

Mobility is defined as the ability to initiate movement and the available range to do so. Contract relax is a technique designed to increase range of motion using either reciprocal or autogenic inhibition. Isotonic reversal would be an appropriate strengthening technique following the improved mobility. Rhythmic stabilization is used to improve stability of the limb.

11. Taub’s original constraint induced movement therapy (CIMT) protocol required patients to have the following active movements at the onset of the treatment sessions:

a. 10 degrees metacarpal phalangeal joints (MCP) extension, 10 degrees intercarpal phalangeal joints (ICP) extension, and 20 degrees wrist extension

b. 10 degrees thumb abduction, 10 degrees extension of any two other digits, 10 degrees wrist extension

c. 20 degrees metacarpal phalangeal joints (MCP) extension, 20 degrees intercarpal phalangeal joints (ICP) extension, and 10 degrees of wrist extension

d. Movement necessary to lift and release a washcloth

12. Which of the following body weight-supported treadmill training protocols should be followed to enhance the effect of the intervention for individuals post-stroke?

a. Forty percent of the patient’s body weight or greater is unweighted

b. Physical therapist’s manual assistance is provided for pelvic and lower extremity placement

c. Speed of 1.25 miles per hour is used for greatest improvement in over ground walking speed

d. The patient performs 10 minutes of cycling after treadmill training for transference of learning.

13. A patient is having difficulty moving from a posterior pelvic tilt to neutral pelvic alignment in short sitting. The BEST option to improve the patient’s alignment is by instructing the patient to perform:

a. Pelvic clock in a seated position

b. Posterior pelvic tilts in supine hooklying

c. Diaphragmatic breathing in stance

d. Partial sit-ups

14. Evidence supports the use of_____ to improve overall cardiovascular endurance in a population with neurologic dysfunction.

a. Sun style tai chi

b. Yoga

c. Aquatic exercise

d. Brunnstrom’s exercises

Tai chi improves balance, yoga is effective for flexibility and balance, whereas aquatic exercise will have the most impact on cardiovascular fitness and endurance.