Test Bank Chapter 21 Intervention for Ataxia/Incoordination

Chapter 21: Intervention for Ataxia/Incoordination

Carina Eksteen, PT, PhD

Reva P. Rauk, PT, PhD, MMSc, NCS

Multiple Choice

1. You are working with a 32 year-old female with cerebellar dysfunction who presents with significant ataxia that includes gait ataxia, eye-hand incoordination, dizziness, frequent nausea. On testing, you find nystagmus with gaze stabilization and head turns, delayed saccadic movement and impaired VORx1. What area of the cerebellum is most likely responsible?

A. Vermal and paravermal areas

B. Lateral hemispheres

C. Flocculonodular lobe

D. Anteror lobe

2. Which of the following statements distinguishes the tremor and dysmetria typical of cerebellar disorders?

A. Dysmetria is difficulty with performing rapid alternating movements, whereas tremor is impairment in measuring the distance of muscular acts (overreaching or underreaching)

B. Dysmetria is impairment in measuring the distance of muscular acts (overreaching or underreaching), whereas tremor is an involuntary, rhythmic, oscillatory movement of a body part seen during movement toward the target

C. Cerebellar tremor is difficulty with performing rapid alternating movements, whereas dysmetria is impairment in measuring the distance of muscular acts (overreaching or underreaching)

D. Cerebellar tremor is involuntary, rhythmic, oscillatory movement of a body part typically seen at rest, whereas dysmetria is impairment in measuring the distance of muscular acts (overreaching or underreaching)

3. You are working with a patient post recent cerebellar stroke. Which of the following would be an example of impaired feedforward control?

A. Unexpectedly tripping over a crack in the sidewalk

B. Difficulty maintaining balance during negotiation of an obstacle course

C. Slipping on the ice

D. Maintaining balance while walking with eyes closed

4. Which of the following neuromuscular conditions results in ataxia/incoordination of genetic origin?

A. Multiple sclerosis

B. Cerebellar or brainstem tumors

C. Diabetic ataxia

D. Friedreich’s ataxia

5. A 36 year-old female has been referred to you with a medical diagnosis of spinocerebellar atrophy. Which the following tests would allow you to best discriminate between upper extremity tremor, dysmetria, speed/accuracy deficits, and movement decomposition?

A. Finger to therapist’s finger at various locations

B. Rapid alternating pronation/supination

C. Observation during functional activities

D. Observational gait analysis

6. A 72 year-old male is admitted to the inpatient rehabilitation unit following the removal of a lateral hemisphere cerebellar tumor. Which of the following is NOT a sign/symptom you would expect to see?

A. Dysdiadochokinesia

B. Abnormal timing of limb movement

C. Decomposition of limb movement

D. Proprioception loss

7. A 24 year-old male has been referred to you with a medical diagnosis of hereditary spinocerebellar atrophy resulting in severe gait abnormalities, difficulty in static and dynamic standing activities, and ataxic/staccato speech. Which of the following outcome measures would provide the best overall outcome measure of his ataxia?

A. SARA (Scale for the Assessment and Rating of Ataxia) Scale

B. Berg Balance Scale

C. Neuro Quality of Life Scale

D. Goal Attainment Scale

8. You are working with an 85 year-old male with cerebellar deficits as a result of longstanding alcohol use. You elect to use proprioceptive neuromuscular facilitation (PNF) to improve coordination. Which of the following is NOT a benefit to using PNF to improve coordination?

A. Enhances learning of coordinated movement through the use of verbal cuing in combination with visual input

B. Improves the coordination between antagonists, and address ataxia/incoordination, by implementing reciprocal or reversing movements combined with appropriate resistance

C. Enhances the normal sequence of movement by emphasizing the distal to proximal sequencing of normal movement patterns

D. Confuses the direction of movement with specific manual contacts

9. You are working with a 39 year-old female with ataxia as a secondary effect of multiple sclerosis. You are putting together a comprehensive training program geared to challenge all aspects of her coordination deficits and improve her functional ability. Which of the following would be the best overall therapeutic approach?

A. Frenkel coordination exercises

B. Cawthorne-Cooksey exercises

C. Intensive coordinative exercises

D. PNF of the upper extremities

10. You are working with a 45 year-old female with ataxia as a secondary effect of multiple sclerosis in a 2-week-long intensive ataxia camp. Your patient comes in for 4 hours of therapy daily. Your therapeutic approach includes a comprehensive coordinative physical therapy program. Which of the following is NOT a necessary precaution?

A. Consideration the activity intensity and frequency to avoid overexertion

B. Mental fatigue

C. Avoid compensatory strategies

D. Perform upper extremity activities with heavier objects to provide additional resistance and enhance somatosensory feedback