Orthopedic Rehabilitation Final
Exam Questions
Course Introduction
Orthopedic Rehabilitation is a specialized course focusing on the assessment, treatment, and management of musculoskeletal injuries and disorders. Students will learn key principles of rehabilitation, including evidence-based therapeutic exercises, manual therapy techniques, and modalities designed to restore function, alleviate pain, and promote optimal recovery following orthopedic surgery or trauma. The course covers both upper and lower extremity rehabilitation protocols and emphasizes interdisciplinary collaboration, patient education, and the development of individualized rehabilitation plans for varied populations.
Recommended Textbook
Therapeutic Modalities 4th Edition by Chad Starkey
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Chapter 1: The Injury Response Process
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Q1) Which is an accurate statement regarding the effect of modalities and the healing process?
A) Modalities attempt to provide the optimal environment for healing to occur.
B) Most modalities can speed up the healing of an injury.
C) Modality devices are primarily used to alter the body's psychological status to provide a good healing environment.
D) The stage of the healing process does not influence which modality is used.
Answer: A
Q2) According to the general adaptation syndrome,what is the correct order of the three stages of stress response?
A) Alarm,resistance,exhaustion
B) Resistance,alarm,excitement
C) Exhaustion,excitement,alarm
D) Resistance,exhaustion,excitement
Answer: A
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Chapter 2: The Physiology and Psychology of Pain
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Q1) Which scenario will result in a closing of the gate,thus inhibiting the pain signal from getting to the second-order neuron?
A) Large-diameter afferent traffic is greater than small diameter.
B) Small-diameter afferent traffic is greater than large diameter.
C) Increase speed of small-diameter afferent transmission.
D) Increase speed of large-diameter afferent transmission.
Answer: A
Q2) What substance is released by the body and reduces the perception of pain by bonding to pain receptor sites?
A) Serotonin
B) Enkephalin
C) Mast cells
D) Tract cells
Answer: B
Q3) Which statement best describes nociception?
A) Nociception must be interpreted as pain by higher brain centers.
B) Nociception is a neuropsychological process that must be interpreted as pain.
C) Nociception describes an unpleasant sensation.
D) Nociception is the neural process of encoding and processing noxious stimuli.
Answer: D
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Chapter 3: Development and Delivery of Intervention Strategies
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Q1) PICO is a mnemonic that provides structure for developing clinical questions.When developing a clinical question,what part of the mnemonic represents the therapy being considered?
A) Patient
B) Intervention
C) Comparison
D) Outcomes
Answer: B
Q2) What are the first three steps of the problem-solving approach?
A) Obtain a medical history,identify patient limitations and restrictions,and prioritize problems
B) Obtain a medical history,review the evidence,and set treatment goals
C) Identify patient limitations and restrictions,prioritize problems,and set treatment goals
D) Identify patient limitations and restrictions,set treatment goals,and review the evidence
Answer: A
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Chapter 4: Administrative Considerations
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Q1) What term best describes the tort when there is a duty to act but a failure to perform the act?
A) Malfeasance
B) Misfeasance
C) Nonfeasance
D) Malpractice
Q2) Which statements are true concerning third-party reimbursement? Select all that apply.
A) Other insurance companies use Medicare but not Medicaid standards when establishing their own guidelines.
B) Individuals rendering treatment must be state licensed to be eligible for reimbursement.
C) As long as all standards are met,a reimbursement is guaranteed by insurance companies.
D) Reimbursement requires documentation of the treatment services but not the condition being treated.
E) The rate of reimbursement is frequently based on the usual,customary,and reasonable (UCR)system.
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Chapter 5: Thermal Modalities
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Q1) Heat produces vasodilation through a combination of what mechanisms? Select all that apply.
A) Arteriole smooth muscle relaxes
B) Capillary smooth muscle relaxes
C) Release of neurotransmitters and peptides
D) Spinal level reflex
E) Cerebral cortex level reflex
Q2) Which nerves are most susceptible to cold-induced neuropathy? Select all that apply.
A) Ulnar
B) Peroneal
C) Femoral
D) Tibial
E) Radial
Q3) Every 1.8°F change in tissue temperature results in a percent change in the tissues' metabolic rate.
A) 5
B) 7
C) 13
D) 20
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Chapter 6: Clinical Application of Thermal Modalities
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Q1) According to the practical evidence,how should an ice pack be applied in order to obtain maximal intramuscular temperature decrease?
A) With an elastic wrap
B) With flexible plastic wrap
C) Without any wrap
D) With a nonflexible plastic wrap
Q2) How many layers of terry-cloth towel should be placed between the skin and moist heat pack?
A) 3
B) 6
C) 9
D) 12
Q3) What modality carries the greatest risk of frostbite?
A) Reusable cold pack
B) Plastic bag with crushed ice
C) Cold compression therapy unit
D) Chemical cold pack
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Chapter 7: Therapeutic Ultrasound
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Q1) How large of a treatment area can be effectively exposed to ultrasonic energy?
A) Slightly larger than the diameter of the sound head
B) Slightly smaller than the diameter of the sound head
C) Equivalent to the diameter of the sound head
D) Significantly larger than the diameter of the sound head
Q2) Which output frequency will penetrate deeper into the tissue?
A) 1 MHz
B) 2 MHz
C) 3 MHz
D) 1,2,and 3 MHz all penetrate the same depth
Q3) Which of the following represents a 1-MHz output frequency? Select all that apply.
A) Divergent beam
B) Maximum heating rate of 0.36°F per minute per W/cm<sup>2</sup>
C) Penetration depth of 0.8 to 3 cm
D) Maximum heating rate of 1.1°F per minute per W/cm<sup>2</sup>
E) Collimated beam
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Chapter 8: Clinical Application of Therapeutic Ultrasound
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Q1) Which coupling methods are best suited to treat an irregular area such as the talocrural joint?
A) Direct coupling and bladder technique
B) Bladder technique and immersion technique
C) Immersion technique and direct coupling
D) Direct coupling and pad technique
Q2) To ensure safe application of therapeutic ultrasound,how often should the unit be calibrated?
A) Once a year
B) Every 6 months
C) Every other year
D) Quarterly
Q3) According to the practical evidence,which of the following is one of the most common errors when applying therapeutic ultrasound?
A) Treating too small an area
B) Using too long of a treatment duration
C) Selecting the wrong output frequency
D) Selecting an output intensity that is too low
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Chapter 9: Shortwave Diathermy
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Q1) Continuous shortwave diathermy is typically limited to what conditions?
A) Chronic
B) Acute
C) Subacute
D) Postsurgical
Q2) According to the practical evidence,what is one of the most common clinical uses of shortwave diathermy?
A) Osteoarthritic knees
B) Hip flexor strain
C) Posterior thigh muscle spasm
D) Deep-vein thrombosis
Q3) Which of the following accurately represents shortwave diathermy (SWD)and not microwave diathermy MWD? Select all that apply.
A) SWD uses a magnetron that produces high-frequency electromagnetic energy.
B) Magnetic as opposed to electric fields are predominant in SWD.
C) With SWD,superficial tissues are heated more than deeper tissues.
D) The radiation created by SWD penetrates the fat layer better than MWD.
E) The effects of SWD occur at only about one-third the depth that MWD effects.
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Chapter 10: Clinical Application of Shortwave Diathermy
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Q1) Which of the following are nonthermal effects resulting from shortwave diathermy treatment? Select all that apply.
A) Improved tissue healing
B) Edema reduction
C) Lymphedema reduction
D) Increased blood flow
E) Increased cell metabolism
Q2) Which of the following contraindicate the use of shortwave diathermy? Select all that apply.
A) Cancer
B) Thrombophlebitis
C) Sinusitis
D) Hematoma
E) Muscle spasm
Q3) Which of the following heating modalities is capable of penetrating all the tissues of the body?
A) Ultrasound
B) Shortwave diathermy
C) Warm whirlpool
D) Moist heat pack
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Chapter 11: Principles of Electrical Stimulation
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Q1) The physiological effects of electrical stimulation are related to what characteristic?
A) Current density
B) Average current
C) Duty cycle
D) Ohm's law
Q2) What biological tissue is the primary resistor to therapeutic electrical flow?
A) Skin
B) Muscle
C) Adipose
D) Fascia
Q3) What type of current does high-voltage pulsed stimulation use?
A) Monophasic
B) Biphasic
C) Pulsed
D) Asymmetrical
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Chapter 12: Electrical Stimulation Techniques
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Q1) What type of electrode is able to deliver the most current at the lowest skin impedance?
A) Carbon-rubber electrodes
B) Silver electrodes
C) Self-adhesive electrodes
D) Metal electrodes
Q2) Which is an accurate statement regarding the use of motor-level stimulation to reduce swelling?
A) Motor-level stimulation has more clinical efficacy than the sensory-level stimulation.
B) If the generator does not allow for a duty cycle,a high-pulse frequency-60 to 100 pps-should be used.
C) High-voltage pulsed stimulation is the only current that can be utilized to reduce swelling via motor-level stimulation.
D) According to the practical evidence,motor-level swelling reduction is most effective during the acute inflammatory phase of injury response.
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Chapter 13: Clinical Application of Electrical Agents
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Q1) When attempting to control pain via the gate-control mechanism,what are correct high-voltage pulsed stimulation parameter settings?
A) Motor-level output intensity
B) Pulse frequency of 60 to 100 pps
C) Electrode placement distal to the spinal nerve root origin
D) 50 percent duty cycle
Q2) When preparing the patient for a pain-control technique with electrical stimulation,one should ask about caffeine intake.The effectiveness of electrical stimulation on pain control is diminished after how many milligrams of caffeine have been ingested?
A) 200
B) 150
C) 100
D) 50
Q3) What feature distinguishes microcurrent from other electrical modalities?
A) Microcurrent does not attempt to excite peripheral nerves.
B) Microcurrent only attempts to excite sensory nerves.
C) Microcurrent only attempts to excite motor nerves.
D) Microcurrent only attempts to excite nociceptive nerves.
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Page 15
Chapter 14: Intermittent Compression
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Q1) When using external compression to treat lower leg edema,pressures of ___have been shown to increase venous flow by 175 percent.
A) 35 to 55 mm Hg
B) 10 to 30 mm Hg
C) 65 to 95 mm Hg
D) 90 to 100 mm Hg
Q2) When using intermittent compression to treat lymphedema,what is the common duration of treatment?
A) 20 min
B) 10 min
C) 30 min
D) Several hours
Q3) When subacute or chronic conditions exist,what is an intermittent or sequential compression unit best used for? Select all that apply.
A) Reducing edema
B) Preventing edema
C) Decreasing ecchymosis
D) Preventing ecchymosis
E) Increasing lymphatic return
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Page 16
Chapter 15: Continuous Passive Motion
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Q1) Which are considered contraindications to the use of continual passive motion?
Select all that apply.
A) Unstable fracture
B) Uncontrolled infection
C) After joint debridement
D) After osteochondral repair
E) Tendon laceration
Q2) Which of the following is not a benefit realized through the use of continuous passive motion?
A) Increased strength
B) Decreased apprehension to joint movement after surgery
C) Restoration of range of motion
D) Decreased functional shortening of muscle
Q3) Which of the following are indications to treat with continuous passive motion?
Select all that apply.
A) After joint arthroplasty
B) Joint contracture
C) Thrombophlebitis
D) After meniscectomy
E) Spastic paralysis
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Chapter 16: Cervical and Lumbar Traction
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Q1) When treating the cervical spine,you should question the patient about sensation in what region(s)of the spine?
A) Cervical
B) Thoracic
C) Lumbar
D) Cervical,thoracic,and lumbar
Q2) What type of traction is best suited for treating degenerative disk disease of the cervical spine?
A) Sustained traction with a flexion angle
B) Sustained traction with an extension angle
C) Intermittent traction with a flexion angle
D) Intermittent traction with an extension angle
Q3) When examining the evidence,the effect of what traction variables is clearly understood?
A) Patient position and angle of pull
B) Amount of tension and duration of treatment
C) Amount of tension and angle of pull
D) Duration of treatment and patient position
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Chapter 17: Therapeutic Massage
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Q1) When performing ischemic compression,the amount of pressure applied should be determined by the patient's tolerance.On a scale of 1 to 10,what level should not be exceeded?
A) 7 or 8
B) 10
C) 8 or 9
D) 6 or 7
Q2) Which form of massage is described as a stroking of the skin?
A) Effleurage
B) Petrissage
C) Friction massage
D) Myofascial release
Q3) Which basic massage stroke is typically applied to increase blood flow and provide systemic invigoration of tissues?
A) Neuromuscular stroke
B) Tapotement
C) Vibration
D) Active assisted
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Chapter 18: Electromyographic Biofeedback
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Q1) According to the practical evidence,when is it most beneficial to incorporate electromyographic biofeedback in a neuromuscular rehabilitation?
A) Early on
B) Middle of the program
C) Toward the end of the program
D) Timing of application does not alter the benefits of biofeedback.
Q2) Which of the following modalities does not deliver energy to the body?
A) Ice pack
B) Moist heat pack
C) Ultrasound
D) Electromyographic biofeedback
Q3) Measurements from one biofeedback unit can be reliably compared to another brand of biofeedback unit.
A)True
B)False
Q4) Placement of treatment electrodes from one treatment to another will affect the reliability of a biofeedback measurement.
A)True
B)False
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Chapter 19: Low-Level Laser Therapy
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Q1) Current evidence suggests that the biophysical benefits of laser are related to what?
A) Photomechanical or photothermal effects
B) Photochemical or photothermal effects
C) Photomechanical or photochemical effects
D) Photomechanical,photochemical,and photothermal effects
Q2) Which type of therapeutic laser produces a wavelength of 488 nm and a blue light band?
A) Helium-neon
B) Gallium aluminum arsenide
C) Argon
D) Gallium-arsenide
Q3) In general,low-pulse frequencies are used to promote tissue healing when applying laser therapy.
A)True
B)False
Q4) Longer laser wavelengths penetrate deeper into tissues than shorter wavelengths.
A)True
B)False
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