Clinical Procedures in Physical Therapy
Exam Questions
Course Introduction
This course provides an in-depth exploration of fundamental clinical procedures used in physical therapy practice. Students will develop competency in basic assessment techniques, patient handling skills, and therapeutic interventions, including modalities such as therapeutic exercise, manual therapy, and electrotherapy. Emphasis is placed on safe, evidence-based approaches for treating diverse patient populations, fostering clinical reasoning, documentation, and professionalism. Through lectures, demonstrations, and supervised practice, learners gain the foundational skills necessary for effective patient care in a variety of physical therapy settings.
Recommended Textbook Michlovitzs Modalities for Therapeutic Intervention 6th Edition by James W. Bellew PT EdD
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2
Roles in the Patient Care Management Model
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Sample Questions
Q1) What type of energy does diathermy use to heat biological tissues?
A) High-frequency sound waves
B) Electromagnetic radiation
C) Compressive and distractive forces
D) Convective currents
Answer: B
Q2) Which of the following best describes the appropriate use of therapeutic modalities for rehabilitation programs?
A) Adjunctive components of a comprehensive therapy program
B) Primary components of most therapy programs
C) Exclusive application for curative purposes
D) Promotion of post-therapy goals and outcomes
Answer: A
Q3) Modalities used to decrease pain primarily stimulate which part of the peripheral nervous system?
A) Large A-beta fibers
B) Small A-delta fibers
C) Alpha motor neurons
D) Small C fibers
Answer: A
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Chapter 2: Cold Therapy Modalities
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Sample Questions
Q1) Which of the following is true regarding cold therapy application methods?
A) A bag of frozen peas can be used for home cold pack application.
B) Recommendations for temperature and duration of water baths are inversely related.
C) The risk of frostbite is very high with ice massage, so treatments should not exceed 3 minutes.
D) Menthol gels or creams decrease subcutaneous tissue temperature as well as a cold pack.
Answer: A
Q2) Which of the following cold therapy applications best fits the given patient problem?
A) Ice massage for acute exacerbation of metacarpophalangeal joint pain in patient with rheumatoid arthritis
B) Cold whirlpool for patient with acute anterior thigh contusion
C) Vapocoolant spray for limited knee flexion in patient who is 3 days post total knee surgery
D) Cold pack for patient with shoulder pain 2 days following traumatic subluxation
Answer: D
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Chapter 3: Therapeutic Heat
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Sample Questions
Q1) Which of the following represents a risk one should consider when applying external heating modalities?
A) Increased tissue oxygen demand exceeds delivery of oxygen-rich blood.
B) Anti-inflammatory effect of heat results in increased joint effusion.
C) Heating a large volume of tissue results in compensatory cutaneous vasodilation, which increases risk for surface burns.
D) Systemic response of decreased heart rate results in cardiovascular complications.
Answer: A
Q2) Which of the following is an expected neuromuscular response to heat?
A) Changes in pain threshold of the cutaneous area of a nerve following heat to the nerve
B) Decreased nerve conduction velocity
C) Increased muscle strength that declines after the source of heat is removed
D) Increased muscle spindle firing rates
Answer: A
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Chapter 4: Therapeutic Ultrasound
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Sample Questions
Q1) Evidence is moderate to strong for the contraindication of the use of continuous US in all of the following areas and conditions EXCEPT
A) Cancer-over a known or suspected area of malignancy
B) Active bone growth at the epiphysis
C) Pregnancy-over the shoulders, upper back, and cervical regions
D) Hemorrhagic conditions-over an area of active bleeding
Q2) Which of the following does NOT have an influence on the amount of heating produced in a tissue by US?
A) US frequency
B) US intensity
C) Movement speed of the US applicator
D) Use of pulsed or continuous US
Q3) Which of the following proposed effects of nonthermal ultrasound have been clearly demonstrated in human tissues in vivo?
A) Cavitation
B) Acoustic streaming
C) Changes in cellular permeability
D) None of the proposed effects of nonthermal ultrasound have been clearly demonstrated in human tissues in vivo.
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Page 6
Chapter 5: Hydrotherapy: the Use of Water As a Therapeutic Agent
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Sample Questions
Q1) Which of the following patients will most likely have the greatest ability to float in water?
A) A 200-pound female with low bone density
B) A 150-pound male without air in lungs
C) A 110-pound female with high bone density
D) A 200-pound male with air in lungs
Q2) A 38-year-old male with cerebral palsy is referred for balance and gait training secondary to severe balance and endurance problems that were the result of a medication reaction used to treat anxiety. Which of the following is true regarding pool therapy for this patient?
A) Pool therapy is contraindicated for this patient because of his severe balance problems.
B) He would likely benefit from exercise on a treadmill in a pool to improve endurance.
C) Pool therapy can be used to improve endurance, balance, and gait.
D) He cannot begin pool therapy until his anxiety is controlled by medication.
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Chapter 6: Electromagnetic Modalities: Laser, Diathermy, and
Pulsed Electromagnetic Fields
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Q1) Which of the following should not be treated with LLLT?
A) Chronic epicondylitis
B) Herpes simplex wounds
C) Carpal tunnel syndrome
D) Open growth plates of bones
Q2) Your patient has a medical history of impaired sensation in her lower extremities. If you chose laser for treatment of a condition in her lower extremities, which of the following laser therapy treatments must be performed with caution?
A) High-intensity lasers and superluminescent light-emitting diode (SLED) arrays
B) Infrared laser at a dosage of 2 J/point
C) HeNe laser at a dosage of 8 J/point
D) Nd-YAG pulsed laser at 12 J/point
Q3) Which of the following is true about electromagnetic energy?
A) Has matter that is equal in mass to its frequency
B) Transfers heat via conduction
C) Travels through space without a transport medium
D) Requires contact with the body or another conducting pathway
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Page 8
Chapter 7: Spinal Traction
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Sample Questions
Q1) Which of the following is correct with regard to cervical traction?
A) Approximately 30 to 45 pounds of traction force is required to achieve vertebral separation in the cervical spine.
B) Patients always have better outcomes when the traction force is as high as they can tolerate.
C) Cervical traction applied with the patient sitting requires more force to achieve the desired effect than when applied with the patient supine.
D) A person with a history of temporomandibular joint problems should not have any form of cervical traction.
Q2) A recently published clinical prediction rule for cervical traction includes which of the following?
A) Positive shoulder abduction test
B) Age of 50 years or younger
C) Negative upper limb tension test
D) Increased symptoms with manual distraction
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Chapter 8: Intermittent Pneumatic Compression
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Sample Questions
Q1) What should you do if your patient complains of numbness or tingling of her distal extremity during IPC?
A) Instruct the patient to contract her muscles in the garment to decrease this sensation.
B) Stop treatment and check for possible deep vein thrombosis or nerve compression.
C) Decrease elevation of the limb and adjust parameters until the sensation subsides.
D) This is a normal response to IPC and there is no cause for concern.
Q2) Which of the following is a contraindication for IPC?
A) Persistent lower extremity edema secondary to congestive heart failure
B) Chronic venous stasis ulcer on the foot
C) Acute local dermatological infection
D) Lymphatic edema following mastectomy
Q3) What is the most important factor to consider for setting the on-and-off times for IPC treatments?
A) Patient's weight
B) Patient's comfort
C) Length of limb
D) Limb circumference
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Chapter 9: Foundations of Clinical Electrotherapy
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Q1) Which of the following is true regarding the strength-duration curve for electrical stimulation?
A) It depicts the response of a nerve to stimulation for a given pulse amplitude and duration.
B) The area below the curve depicts the amplitudes and durations for sensory responses.
C) Values on the curve indicate the threshold for fatigue of a muscle following stimulation.
D) The area above the curve depicts the amplitudes and duration for motor responses.
Q2) Which of the following is the correct description of "charge"?
A) An object that has an equal number of protons and electrons
B) Movement of a current along a conductor
C) Gain or loss of protons by an atom
D) Addition or removal of electrons, creating an electromagnetic force
Q3) Which of the following statements is true about charge?
A) There are three types of charge: positive, negative, and neutral.
B) Like charges attract, whereas opposite charges repel.
C) Charge is neither created nor destroyed.
D) Charge cannot be transferred between objects.
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Page 11
Chapter 10: Clinical Electrical Stimulation: Application and Techniques
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Q1) Inhibition of edema following trauma may be effective if the following is performed
A) Sensory level stimulation for 10 minutes every hour for the first week following trauma
B) Motor level stimulation for 30 minutes two to three times a day for the first 2 days after trauma
C) Sensory level stimulation for 30 minutes or several hours during the first 24 to 72 hours
D) Neuromuscular electrical stimulation (NMES) performing rhythmic contractions of muscles in the area of the trauma
Q2) Which of the following is NOT believed to occur during treatments using iontophoresis?
A) Electromigration
B) Electroporation
C) Electrosaturation
D) Electroosmosis
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12
Chapter 11: Mechanisms of Pain and Use of Therapeutic Modalities
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Sample Questions
Q1) Modulation of the beat frequency when using interferential current is known as which of the following?
A) Swing
B) Sweep
C) Scan
D) Swift
Q2) What is the correct term for the amplification of neural signaling within the central nervous system resulting in an increased perception of pain?
A) Peripheral summation
B) Temporal aggregation
C) Central sensitization
D) Nociceptive downregulation
Q3) Which of the following best describes the evidence regarding concurrent use of caffeine and TENS for pain modulation?
A) Caffeine consumption may decrease the effectiveness of TENS.
B) Caffeine consumption increases the analgesic effect of TENS.
C) Concurrent use of caffeine and TENS may result in analgesic tolerance.
D) Caffeine acts as a competitive agonist on the opioid receptors, thereby increasing the analgesic effect of TENS.
Page 13
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Chapter 12: Therapeutic Modalities for Improving Range of Motion
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Sample Questions
Q1) For a patient having undergone ankle immobilization following a sprain, which of the following clinical measures best supports the administration of therapeutic modalities?
A) Active range of motion (AROM) ankle dorsiflexion of +2 degrees
B) AROM ankle inversion of 40 degrees
C) 4+/5 strength of the ankle evertors
D) Decreased stance time during gait
Q2) Which of the following recommendations is most critical when using therapeutic modalities to increase ROM?
A) Stretching of the restricted tissue should occur during and/or immediately after administration of the therapeutic modality.
B) Thermal modalities should never be used to increase ROM in tissues that are restricted as a result of a burn.
C) Only aggressive manual stretching should be used after administration of a therapeutic modality to increase ROM.
D) Benefits from using therapeutic modalities to increase ROM are only observed for chronic conditions resulting in restricted ROM.
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Chapter 13: Electrotherapy for Musculoskeletal Disorders
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Sample Questions
Q1) Studies using magnetic resonance imaging (MRI) to determine the amount of muscle used during NMES have found which of the following?
A) Only motor units near the skin's surface are activated.
B) Motor units throughout the muscle are activated.
C) Only motor units directly under the electrodes are activated.
D) Motor units in the deep part of the muscle near bone are not activated.
Q2) Which of the following types of ES is required for ES of denervated muscle?
A) Direct current (DC)
B) Alternating current (AC)
C) Biphasic pulsed
D) Interferential
Q3) During NMES, what pattern of recruitment of motor units will most likely occur?
A) Spatial and temporal
B) Smallest to largest
C) Largest to smallest
D) Only the largest motor units will be recruited.
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15
Chapter 14: Neuromuscular Electrical Stimulation Nmes
and Functional Electrical Stimulation Fes in Patients With
Neurological Diagnoses
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Q1) Studies have shown that FES for upper extremity function has been effective in facilitating functional use of the extremity in which of the following patient populations?
A) Those who have had a stroke
B) Those with traumatic brain injury
C) Those having a spinal cord injury
D) All of the above
Q2) Studies have shown that NMES for patients with neurological problems who have muscle weakness
A) May help increase muscle strength, especially in the stroke population
B) Shows minimal improvements in muscle strength
C) Results in significant increases in strength, especially in spinal cord injured patients
D) Shows no improvements in muscle strength
Q3) FES for dorsiflexion assist during ambulation
A) Cannot be performed on patients who have CP because of spasticity
B) Improves ankle dorsiflexion required during swing phase of gait
C) Can result in full recovery of muscle function in patients post-CVA
D) Has not been shown to be effective for dorsiflexion assist
Page 16
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Chapter 15: Therapeutic Modalities for Tissue Healing
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Sample Questions
Q1) Which of the following parameters for electrical stimulation (ES) would be recommended for tissue healing of chronic wounds?
A) Motor level direct current, negative polarity over infected wound
B) Motor level neuromuscular electrical stimulation (NMES), 50 pps, for muscle pump of muscles adjacent and distal to wound
C) Sensory level high-voltage pulsed current (HVPC), 100 pps, with negative electrode over infected wound
D) Sensory level TENS, low frequency (2 to 4 pps), positive electrode over necrotic wound bed
Q2) Which of the following is a proposed mechanical effect of intermittent pneumatic compression (IPC) that promotes wound healing?
A) Increased peak blood flow velocity
B) Decreased arterial blood pressure
C) Increased venous blood pressure
D) Decreased oxygenated blood
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Chapter 16: Alternative Modalities for Pain and Tissue
Healing
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Sample Questions
Q1) Which of the following are typical parameters used during hyperbaric oxygen therapy (HBOT)?
A) 2 to 3 atmospheres absolute (ATA) for a duration of 30 to 120 minutes
B) 5 to 10 ATA for a duration of 2 to 4 hours
C) 50 to 100 ATA for a duration of 4 to 6 hours
D) 500 to 1,000 ATA for a duration of 6 to 8 hours
Q2) Which of the following is a contraindication for ESWT?
A) Peripheral neuropathy
B) Use of blood thinner medications
C) Chronic obstructive pulmonary disease (COPD)
D) Osteoarthritis
Q3) Which of the following is a likely explanation of the physiological effects of pulsed magnetic fields?
A) Inhibition of interstitial edema and facilitation of ribonucleic acid (RNA) formation
B) Movement of ions across cell membranes and stimulation of deoxyribonucleic acid (DNA) transcription
C) Increased release of inflammatory hormones and facilitation of fibrinogenesis
D) Facilitation of nerve conduction velocity and release of endogenous substrates
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Chapter 17: Electrophysiological Testing of Nerves and Muscles
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Sample Questions
Q1) Which of the following patients will typically not benefit from a referral for ENMG testing?
A) Those with numbness and pain involving the sensory division of the peripheral nervous system
B) Those having weakness of the right arm and leg following a cerebrovascular accident (CVA)
C) Those having paresthesias in the left foot and toes involving the sensory division of the peripheral nervous system
D) Those having weakness of right hand grasp involving the motor division of the peripheral nervous system
Q2) Which of the following are primary indicators of demyelination of a nerve?
A) Positive sharp waves and decreased sensory and muscle action potentials
B) Prolonged distal latencies and slowing of nerve conduction velocity
C) Decreased amplitude and blocked nerve conduction
D) Shorter distal latencies and increased nerve conduction velocity
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