Orthopedic Rehabilitation Final
Exam
Course Introduction
Orthopedic Rehabilitation is a specialized course focused on the principles and practices involved in the restoration of function and mobility in individuals with musculoskeletal disorders or injuries. The course covers assessment techniques, treatment planning, and evidence-based therapeutic interventions for orthopedic conditions affecting the bones, joints, ligaments, and muscles. Students will learn to design and implement rehabilitation programs tailored to various orthopedic diagnoses, emphasizing pain management, strengthening, flexibility, and functional retraining. The curriculum also includes patient education, prevention of further injury, and interdisciplinary collaboration, preparing students for effective clinical practice in rehabilitation settings.
Recommended Textbook
Therapeutic Exercise Foundations and Techniques 6th Edition by Carolyn Kisner
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25 Chapters
448 Verified Questions
448 Flashcards
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Chapter 1: Therapeutic Exercise: Foundational Concepts
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Sample Questions
Q1) Helping a patient acquire the ability to shift his weight from side to side in a standing position by means of manual guidance by the therapist is called:
A) Summary feedback.
B) Delayed feedback.
C) Concurrent feedback.
D) Instantaneous postresponse feedback.
Answer: C
Q2) During several physical therapy sessions,a patient you have been treating for low back pain learned how to perform pelvic tilt exercises in several positions (supine,sitting,quadruped,standing).With continued practice at home,your patient is now able to perform extremity movements while maintaining a stable pelvic position.This represents which stage of motor learning?
A) Cognitive
B) Continuous
C) Associative
D) Autonomous
Answer: D
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3
Chapter 2: Prevention, health, and Wellness
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Sample Questions
Q1) The purpose of performing pre-participation screenings and risk assessments when developing health,wellness,and fitness programs includes all of the following except:
A) To provide the therapist with baseline information for monitoring the individuals' response to program progression
B) To determine the motivational readiness of the individual to make lifestyle changes
C) To assist the therapist in developing an appropriate level of exercise for the individuals
D) To identify if an individual should be referred to a physician prior to participation in the program
Answer: B
Q2) All of the following risk factors are common to both coronary artery disease (CAD)and osteoporosis except:
A) Prolonged use of corticosteroids
B) Smoking
C) Sedentary lifestyle
D) Family history
Answer: A
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Chapter 3: Range of Motion
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Sample Questions
Q1) You've been doing AROM for the left hip abductors and you wish to progress your patient to work this muscle group against gravity.Which of the following positions would you place him in?
A) Supine
B) Prone
C) Left side-lying
D) Right side-lying
Answer: D
Q2) Which of the following is not a benefit of using CPM?
A) Increased synovial fluid lubrication of the joint
B) Prevents development of adhesions
C) Long-term functional gains
D) Enhancing incisional healing
Answer: C
Q3) Interventions to improve impaired mobility include all of the following except:
A) Range of motion exercises.
B) Joint-mobilization exercises.
C) Proprioceptive exercises.
D) Stretching exercises.
Answer: C
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Chapter 4: Stretching for Impaired Mobility
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Sample Questions
Q1) While instructing a patient to fully elongate the latissimus dorsi muscle,you would have her place the limb in which position?
A) Shoulder flexion,abduction,and external rotation
B) Shoulder extension,abduction,and internal rotation
C) Shoulder extension,adduction,and internal rotation
D) Shoulder flexion,adduction,and external rotation
Q2) A person who has been on extended bed rest has a hip contracture that places the hip in a position of external rotation.You note in your documentation that your patient has a:
A) Hip flexion contracture.
B) Hip adduction contracture.
C) Hip internal rotation contracture.
D) Hip external rotation contracture.
Q3) The ability of soft tissue to assume a new and greater length after a stretch force is removed is called:
A) Plasticity.
B) Viscoelasticity.
C) Elasticity.
D) Tissue memory.
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Page 6
Chapter 5: Peripheral Joint Mobilizationmanipulation
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Sample Questions
Q1) Mobilizations to increase extension of the wrist include all the following except:
A) Stabilize the trapezium-trapezoid unit and volar-glide the scaphoid.
B) Stabilize the lunate and volar-glide the capitate.
C) Stabilize the radius and volar-glide the lunate.
D) Stabilize the scaphoid and volar-glide the radius.
Q2) A posterior glide of the head of the femur on the surface of the acetabulum increases which of the following hip motions?
A) Flexion and external rotation
B) Extension and external rotation
C) Extension and internal rotation
D) Flexion and internal rotation
Q3) A long-axis distraction of the humerus provides which direction of gliding?
A) Anterior
B) Inferior
C) Posterior
D) Superior
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Chapter 6: Resistance Exercise for Impaired Muscle
Performance
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Q1) You are having a patient perform manual resistance exercise of the lower extremity using a PNF diagonal pattern.In which of the following lower extremity patterns is ankle dorsiflexion coupled with eversion resisted?
A) DS1U1B11S1U1B0flexion
B) DS1U1B11S1U1B0extension
C) DS1U1B12S1U1B0flexion
D) DS1U1B12S1U1B0extension
Q2) You have a patient assume a prone-lying position and prop symmetrically on his forearms.You apply manual resistance in several directions at the shoulder girdles as you ask the patient to hold (maintain)the symmetrical position.This technique is known as:
A) Agonist-contraction.
B) Rhythmic stabilization.
C) Recurrent facilitation.
D) Repeated contractions.
Q3) Each of the following is characteristic of delayed-onset muscle soreness except:
A) Tends to peak 48 to 72 hours after the conclusion of high-intensity exercise.
B) Increased soreness during passive lengthening of the involved muscle groups.
C) Occurs more frequently after eccentric exercise than isometric exercise.
Page 8
D) Is believed to be caused by postexercise muscle spasm.
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Chapter 7: Principles of Aerobic Exercise
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Sample Questions
Q1) Which of the following is a true statement about an exercise program that is carefully planned?
A) It can slow the decrease in functional capacity of the elderly individual.
B) The cooldown period is intended to encourage rapid return of blood to the extremities.
C) A program of continuous training is the most effective way to improve aerobic conditioning.
D) Venous return is reduced during the warm-up period as blood flow is shifted centrally from the periphery.
Q2) Four methods of training are known to challenge the aerobic system.Which method of training is characterized by a period of exercise followed by a brief period of relief?
A) Continuous
B) Interval
C) Circuit
D) Circuit-interval
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9
Chapter 8: Exercise for Impaired Balance
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Sample Questions
Q1) An 82-year-old woman is referred to physical therapy with a history of two falls in the past month.The patient lives alone and relies on her daughter for transportation.The best choice of an exercise program for this person is:
A) Otago Exercise Program.
B) Nitz and Choy Circuit Exercise Program.
C) Tai Chi Exercise Program.
D) Group Balance Exercise Program by Means and colleagues.
Q2) To improve a patient's dynamic postural control using visual and vestibular inputs,the most appropriate activity for the patient to perform is:
A) Standing on a foam surface with feet apart and eyes open.
B) Marching in place on a firm surface with the eyes open.
C) Walking with a narrowed base of support on foam with eyes open.
D) Walking with a narrowed base of support on a firm surface with eyes closed.
Q3) The vestibular system provides which of the following types of sensory information for balance control?
A) Muscle tension and length
B) Joint movement and position
C) Position of the head and body with respect to inertial forces
D) Position of the head relative to the environment
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Page 10
Chapter 9: Aquatic Exercise
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Sample Questions
Q1) In an aquatic environment,manual resistance exercises of the extremities typically involve which type of muscle contractions?
A) Eccentric,closed-chain (distal segment fixed)
B) Concentric,closed-chain (distal segment fixed)
C) Isometric
D) Concentric,open-chain (distal segment moving)
Q2) The difficulty of exercises can be controlled with the depth of immersion and the body's physiological response to hydrostatic pressure.According to Barbosa and colleagues,which of the following best describes a proper progression of a patient's exercise program in order to increase physiological demands?
A) Land exercises to aquatic chest depth to hip depth
B) Aquatic hip depth to neck depth to land exercises
C) Alternate land exercises with aquatic chest depth exercises
D) Aquatic chest depth to hip depth to land exercises
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Chapter 10: Soft Tissue Injury,repair,and Management
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Sample Questions
Q1) During the repair process following tissue injury,the newly developing collagen fibrils are:
A) Ready to withstand normal stresses by 3 weeks.
B) Slow to be deposited.
C) Laid down in alignment exactly replicating the fibers that were damaged.
D) Thin and unorganized.
Q2) Pain that occurs during the chronic stage of soft tissue healing is best relieved by:
A) Stretching and strengthening the healing tissues.
B) Applying cold.
C) Applying heat and massage.
D) Resting.
Q3) During your evaluation,you identify signs of chronic inflammation of a muscle group.Each of the following techniques is tissue-specific for this condition at this time except:
A) Cross-fiber massage.
B) Grade II joint mobilization.
C) ROM within the limits of pain.
D) Muscle setting in pain-free positions.
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Chapter 11: Joint,connective Tissue,and Bone Disorders and Management
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Sample Questions
Q1) The articular cartilage of a synovial joint is most susceptible to damage from stress:
A) During low-impact,low- to moderate-intensity resistance exercise performed on a regular basis.
B) During early weight-bearing exercises after soft tissue surgery.
C) During passive stretching procedures.
D) Immediately following a period of prolonged joint immobilization.
Q2) A 43-year-old patient with a diagnosis of fibromyalgia (FM)has been referred to you for an exercise program.As you take her history,she tells you that she rarely exercises.Which of the following types of exercise have been shown to be most appropriate at the beginning of an exercise program for patients with FM?
A) Circuit weight training at 60% to 70% of maximum for each exercise at five or six stations
B) Stretching program of trunk and large muscles of the extremities
C) Aerobic exercise started at a low intensity that is adjusted based on the individual's response
D) Relaxation and meditation exercises
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13
Chapter 12: Surgical Interventions and Postoperative Management
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Sample Questions
Q1) Which of the following is a true statement about a DVT?
A) It may occur in the greater saphenous veins.
B) It is most common in the deep arterial system of the calf muscles.
C) It usually resolves without complication if the patient is active.
D) It may result in a pulmonary embolism if undetected.
Q2) Ambulation should begin in the early postoperative phase in order to:
A) Reduce the risk of a pulmonary embolism after a diagnosis of DVT is confirmed.
B) Reduce the risk of a DVT after surgery.
C) Provide an alternative circulatory activity for those who do not want to wear compression stockings.
D) Reduce the risk of a diagnosed embolism traveling to the lungs.
Q3) Which of the following soft tissue repairs are most commonly immobilized in a relative position of tension (elongation)postsurgically?
A) Tendon Z lengthening and ligament tears
B) Muscle fasciotomy and tendon realignments
C) All repairs of muscles and tendons
D) Muscle and ligament complete ruptures
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Page 14
Chapter 13: Peripheral Nerve Disorders and Management
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Sample Questions
Q1) To effectively treat complex regional pain syndrome type I (reflex sympathetic dystrophy),a physical therapist:
A) Performs a sympathetic block prior to any manual or exercise interventions.
B) Utilizes an approach that manages the physical symptoms of pain,edema,stiffness,and muscle changes.
C) Bombards the autonomic nervous system with stimuli using desensitization techniques.
D) Avoids the "no pain,no gain" philosophy and encourages the patient to minimize activity if it causes discomfort.
Q2) Your patient injured her ulnar nerve falling up some steps and catching herself on the medial side of her hand 2 days ago.She currently has constant tingling and decreased sensation to pressure and touch in the little finger and ulnar half of the ring finger.Your intervention during the first week of treatment will be all of the following except:
A) Protect the nerve by immobilizing the wrist in a splint.
B) Teach active ROM to wrist and fingers.
C) Emphasize the importance of resistive exercises to prevent muscle atrophy.
D) Inform the patient about ways to protect the hand from further injury.
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Chapter 14: The Spine: Structure, function, and Posture
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Sample Questions
Q1) The difference between a lordotic posture and a slouched posture is:
A) Only the lordotic posture has lumbar lordosis.
B) Flexion in the upper lumbar and lower thoracic spine with the slouched posture.
C) Extension of the pelvis on the femurs with the lordotic posture.
D) There is no difference;both affect the pelvis and lumbar spine the same way.
Q2) Your patient has a forward head posture.On testing (supine-lying),she cannot isolate capital flexion to lift her head when you ask her to flex her neck.Passively you can move the head about 5S1U1P1\(\circ\)S1S1P0 into capital flexion and then feel tissue resistance.Based on these supine tests,what muscles are tight and what muscles are weak?
A) Tight suboccipital muscles and weak longus capitis and longus colli muscles
B) Tight erector spinae and weak sternocleidomastoid muscles
C) Tight splenius capitis and splenius cervicis muscles and weak multifidus muscles
D) Tight erector spinae and weak suprahyoid and infrahyoid muscles
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16
Chapter 15: The Spine: Management Guidelines
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Sample Questions
Q1) All resistive flexion and extension activities and exercises are contraindicated when there is an acute disk lesion because:
A) They cause increased pain.
B) They cause swelling of the nucleus against pain-sensitive structures.
C) They increase the intradiscal pressure.
D) Resisted extension is all right-but not flexion because it increases the bulge.
Q2) All of these are reasons to assess the thoracic spine during evaluation of patients who present with cervical spine dysfunction except:
A) The thoracic spine becomes unstable with pain and soft tissue dysfunction in the cervical spine.
B) The thoracic spine is prone to hypomobility.
C) There are common muscle attachments between the cervical and thoracic areas.
D) Joint manipulation performed along with high-velocity thrust of the thoracic spine often improves outcomes in patients with cervical complaints.
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Chapter 16: The Spine: Exercise and Manipulation
Interventions
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Sample Questions
Q1) Positional traction is used to:
A) Allow the patient to relax the musculature and therefore get greater separation of the vertebrae.
B) Isolate a passive distraction stretch to a specific facet.
C) Substitute for mechanical traction when a traction unit is not available.
D) Apply traction when the therapist is not strong enough to apply a sufficient amount of manual traction.
Q2) Anterior-posterior pelvic tilt exercises are used:
A) To strengthen the abdominal muscles.
B) To strengthen the back extensor muscles.
C) To train the transversus abdominis.
D) To perform ROM to the lumbar spine.
Q3) The first step in training a patient with spinal stabilization techniques should be:
A) Performing posterior pelvic tilt followed by alternating arm and leg motions.
B) Developing muscular endurance prior to strength.
C) Teaching awareness of safe spinal motions and functional position.
D) Developing control of extremity motions while in the functional position.
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Page 18
Chapter 17: The Shoulder and Shoulder Girdle
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Sample Questions
Q1) For effective shoulder function,each of the following is necessary except:
A) Appropriate movement and stability of the scapula.
B) Greater mobility in the external rotators than the internal rotators.
C) A balance in strength of the external and internal rotators.
D) Thoracic extension and axial extension of the cervical spine.
Q2) Which of the following is a true statement about glenohumeral arthroplasty?
A) Hemiarthroplasty is most often performed using an arthroscopic approach.
B) The primary indication for glenohumeral arthroplasty is limited mobility of the shoulder.
C) A reverse total shoulder arthroplasty (rTSA)is an appropriate design for a patient with marked instability of the glenohumeral joint and a rotator cuff that is not repairable.
D) For adequate exposure of the joint during surgery,the muscle that routinely must be released (and reattached prior to closure)is the anterior deltoid.
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19
Chapter 18: The Elbow and Forearm Complex
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Sample Questions
Q1) Your patient,a 19-year-old college student,sustained a nondisplaced fracture of the distal humerus,which was managed by closed reduction and 6 weeks of immobilization in a cast.Yesterday the cast was removed and the patient is to begin exercises to improve ROM and strength of the elbow.Your examination reveals significant limitation of elbow flexion/extension and forearm pronation/supination as well as reduced joint play at the elbow.The patient describes her elbow as feeling "very stiff," but pain occurs only when overpressure is applied at the end of the available ranges.One of the goals in this patient's treatment plan is to increase elbow ROM.Which of the following techniques should you begin with to increase ROM?
A) Cross-fiber massage of the tendons inserting at the elbow
B) Joint-mobilization techniques to stretch the restricted joints (grade III sustained glide or grade IV oscillation techniques)after evaluating the reactivity of the elbow joints with grade II sustained glides
C) Manual passive stretching to lengthen muscles that cross the elbow
D) Passive ROM within pain-free ranges
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Chapter 19: The Wrist and Hand
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Sample Questions
Q1) Prerequisites for successful PIP arthroplasty include all of the following except:
A) Adequate bone stock.
B) No history of chronic synovitis.
C) Intact neurovascular system.
D) Functioning flexor/extensor mechanism.
Q2) Each of the following is true about the use of early controlled motion after tendon repair in the hand and forearm except:
A) When ROM exercises are initiated,they are performed within a protected range to minimize the risk of excessive stress on the repair site and gapping of the repaired tendon ends.
B) It has been shown to increase the tensile strength of the scar at the repair site more effectively than the use of prolonged immobilization after a surgical repair.
C) It is thought to improve synovial fluid diffusion,thereby improving tendon nutrition and promoting tendon healing.
D) It is used more often after extensor tendon repair than after flexor tendon repair.
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Chapter 20: The Hip
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Sample Questions
Q1) Which of the following signs and symptoms in the hip region and/or lower extremity is most consistent with the finding associated with trochanteric bursitis?
A) Pain along the lateral aspect of the hip joint and possibly along the lateral thigh and knee to the insertion of the iliotibial band;pain typically worsens during long periods of asymmetrical standing with more weight shifted to the involved side
B) Pain that becomes evident during extended periods of sitting,with most pain experienced in the buttock region over the ischial tuberosities
C) Groin and anterior thigh pain that becomes evident or is aggravated during activities that require repetitive hip flexion
D) Groin pain at rest that increases with weight bearing coupled with a positive Trendelenburg sign and pain with hip abduction
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Chapter 21: The Knee
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Sample Questions
Q1) A quadriceps lag may be described as:
A) Patient has full active knee extension but exhibits increased time to peak torque when knee extensors are evaluated on an isokinetic dynamometer.
B) Patient has full passive knee flexion but limited passive knee extension.
C) Patient cannot actively extend the knee to full extension even though there is full passive knee extension.
D) Another term for knee extension contracture.
Q2) The primary value of a patient performing quadriceps setting exercises when the knee is immobilized in a long leg cast for an extended period of time is to:
A) Strengthen the quadriceps muscle.
B) Maintain mobility of the patella.
C) Stretch the anterior portion of the knee capsule.
D) Prevent a knee extension contracture.
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Chapter 22: The Ankle and Foot
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Q1) Your uncle called you last night after playing three games in a softball tournament yesterday.He indicated that late in the third game while trying to stretch a double into a triple,he felt a sudden,sharp pain in his calf,which significantly interfered with his ability to continue running.He is able to move his foot "up and down," but both motions are painful.He is also able to walk if he "takes it slow." From the information your uncle gave you and the fact that he is a 42-year-old weekend warrior,your preliminary hypothesis is that your uncle may have sustained a(n):
A) Fracture of the tibia.
B) Achilles tendon rupture.
C) Plantaris rupture.
D) Syndesmosis injury.
Q2) Which of the following special tests may be used to confirm or rule out a rupture of the Achilles tendon during a physical examination of a patient?
A) Thompson test
B) Anterior drawer of the ankle
C) Talar tilt test
D) Test for Homan's sign
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Page 24
Chapter 23: Advanced Functional Training
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Q1) Healing of tissues and readiness to tolerate increased intensity of exercises with more resistance requires adjusting other parameters for safety and effectiveness.Which of the following describes a proper adjustment for a treatment session in which the resistance of the activity was increased for the first time?
A) Decrease repetitions
B) Increase speed
C) Position the resistance more distally
D) Reduce the rest time between repetitions
Q2) The phase of a plyometric activity during which the muscle reverses its action from deceleration to acceleration of the load is called the:
A) Stretch phase
B) Amortization phase
C) Concentric Phase
D) Eccentric Phase
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Chapter 24: Womens Health: Obstetrics and Pelvic Floor
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Q1) When exercising during pregnancy,each of the following is a reason to discontinue exercise and contact a physician before resuming exercise except:
A) Pubic pain.
B) Irregular heart rhythm.
C) Vaginal bleeding.
D) Uterine contractions that persist after cessation of exercise.
Q2) Which of the following is true about testing for a diastasis recti?
A) The fingertips are placed vertically at the midline of the abdomen (parallel along the linea alba)at the level of the umbilicus to assess the size of the separation.
B) Place the heel of your hand across the abdomen and apply light compression at the level of the umbilicus and have the patient cough.
C) The test is performed with the patient in a hook-lying position and having her perform an abdominal contraction by lifting her head,shoulders,and trunk off the support surface.
D) The fingertips are placed horizontally at the midline of the abdomen (perpendicular to the linea alba)at the level of the umbilicus to assess the size of the separation.
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Chapter 25: Management of Lymphatic Disorders
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Q1) The purpose of the lymphatic system is to:
A) Collect and transport fluid from the lungs to the venous system.
B) Collect and transport fluid from the interstitial spaces to the venous system.
C) Collect and transport fluid from the interstitial spaces to the kidneys.
D) Collect and transport fluid from the interstitial spaces to the blood capillaries.
Q2) Signs and symptoms of chronic venous insufficiency can include any of the following except:
A) Venous distention in the affected limb.
B) Dependent peripheral edema.
C) Brownish pigmentation of the affected limb.
D) Severe pain with the limb in an elevated position.
Q3) Which of the following describes severity of lymphedema from least to most severe?
A) Pitting,brawny,weeping
B) Brawny,pitting,weeping
C) Weeping,brawny,pitting
D) Pitting,weeping,brawny
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