Sports Rehabilitation
Midterm Exam
Course Introduction
Sports Rehabilitation is a comprehensive course that examines the principles and practices involved in the management and recovery of sports-related injuries. The course covers the assessment of common musculoskeletal injuries, the development and implementation of rehabilitation programs, and the integration of therapeutic exercises and modalities. Students learn strategies for injury prevention, recovery, and safe return to sport, as well as considerations for working with athletes of different ages and skill levels. Additionally, this course addresses the psychological aspects of rehabilitation, interdisciplinary collaboration, and evidence-based approaches to optimize athlete health and performance.
Recommended Textbook
Therapeutic Exercise Foundations and Techniques 6th Edition by Carolyn Kisner
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Chapter 1: Therapeutic Exercise: Foundational Concepts
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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) In the ICF model of functioning and disability endorsed by the APTA,a rotator cuff tear is considered a(n):
A) Health condition.
B) Impairment.
C) Functional limitation.
D) Disability.
Answer: A
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3
Chapter 2: Prevention, health, and Wellness
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Q1) Mr.K has had chronic low back pain for several years.He lives a sedentary lifestyle that includes office work and being a self-reported "TV junkie." His physician suggests physical therapy for exercise and management of his pain.Even though Mr.K schedules physical therapy,initially he does not think that exercises will help his pain.He does not associate his lifestyle with his low back pain and therefore does not consider making changes.After his first session with the physical therapist,Mr.K realizes that changes in his lifestyle and regular exercise may help decrease his low back pain.So he decides to continue physical therapy two times a week for 1 month as suggested.Following the first physical therapy session,Mr.K shows he is in which of the following stages of change associated with the transtheoretical model of behavioral change?
A) Contemplation
B) Preparation
C) Action
D) Maintenance Answer: B
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Chapter 3: Range of Motion
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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 positions offers the greatest protection of control of the upper extremity when performing self-assisted shoulder flexion AAROM using a dowel rod?
A) Side-lying
B) Supine
C) Sitting
D) Standing
Answer: B
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Chapter 4: Stretching for Impaired Mobility
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Q1) 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.
Q2) The type of stretching technique that utilizes a high-speed,high-intensity,and short-duration stretch force is called a:
A) Ballistic stretch.
B) Static stretch.
C) Cyclic stretch.
D) Mechanical stretch.
Q3) Your patient develops a contracture as the result of hypertonicity after a traumatic brain injury.This type of hip contracture is called a(n):
A) Arthrogenic contracture.
B) Pseudomyostatic contracture.
C) Fibrotic contracture.
D) Myostatic contracture.
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Page 6
Chapter 5: Peripheral Joint Mobilizationmanipulation
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Q1) Which of the following describes an inappropriate procedure for safe and effective application of joint-mobilization techniques?
A) Combine a grade III distraction with a grade III sustained glide
B) Initiate joint mobilization procedures with the joint in the resting position of the joint
C) Combine a grade I distraction with a grade III sustained glide
D) Stabilize one of the articulating bones while applying the mobilization force close to the joint
Q2) Which of the following is a false statement about joint arthrokinematics?
A) The more congruent the joint surfaces,the more rolling of one joint surface on the other occurs.
B) In normal ovoid joints,rolling and sliding both occur.
C) If a moving joint surface is convex,sliding of that surface is opposite that of its swinging bone.
D) Movement of the head of the radius against the capitulum during pronation/supination is called spin.
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Chapter 6: Resistance Exercise for Impaired Muscle
Performance
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Q1) In addition to an isokinetic dynamometer,which of the following types of resistance equipment can be used safely and effectively to improve muscle strength at fast velocities of limb movement?
A) Free weights
B) Variable resistance equipment made up of a weight-cable and cam system
C) Variable resistance equipment that employs pneumatic or hydraulic resistance
D) Simple weight-pulley system
Q2) A patient has mild joint swelling and pain during active ROM,but resisted tests of the muscles that cross the swollen joints do not cause pain.Your goal is to maintain or possibly increase strength through the available ROM.The most appropriate choice of exercise is:
A) Setting exercises at the end of the ROM.
B) High-velocity isokinetic exercise.
C) Multiple-angle isometric exercise against resistance.
D) Eccentric/concentric,closed-chain exercise against body weight throughout the ROM.
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8
Chapter 7: Principles of Aerobic Exercise
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Q1) Which of the following is true regarding aerobic exercise training (aerobic conditioning)?
A) Dependent on sufficient intensity,time,and frequency of exercise
B) Measured by muscular endurance
C) Produces significant crossover effects for various physical activities
D) Requires 6 weeks for evidence of improvement
Q2) Principles of stress testing include each of the following except:
A) The workload initially used in the test is low compared to an individual's anticipated aerobic threshold.
B) To increase the workload during treadmill testing,the speed and/or incline are increased.
C) Each successive workload level is maintained for no more than 1 minute.
D) Testing is terminated at the onset of symptoms,or definable abnormalities are noted on the electrocardiogram (ECG).
Q3) Fitness level is based on which of the following?
A) Ability of a muscle to work repeatedly
B) Distance that body weight is moved in 1 minute
C) Energy expenditure during a bout of physical work
D) Number of large muscles used during exercise
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Page 9
Chapter 8: Exercise for Impaired Balance
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Q1) While testing a patient's balance,you have the patient perform a series of activities,starting with those that require a low level of balance control and progressing to more difficult tasks.Of the following,the task that requires the greatest amount of balance control is:
A) Catching and throwing a ball while sitting.
B) Raising the opposite arm and leg while in the quadruped position.
C) Walking with one foot placed in front of the other.
D) While standing,balancing on one leg for 10 seconds.
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 center of gravity (COG)in most adult humans is located slightly:
A) Posterior to the L2 vertebra.
B) Posterior to the S2 vertebra.
C) Anterior to the L2 vertebra.
D) Anterior to the S2 vertebra.
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Page 10
Chapter 9: Aquatic Exercise
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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) Which of the following is true of pools used for aquatic therapy?
A) Ventilation is not necessary for installation of a self-contained,individual pool in your clinic.
B) Therapeutic pools should not have a depth that exceeds 6 feet because of safety requirements in case of a medical emergency.
C) One disadvantage of a self-contained individual pool is the inability to incorporate a treadmill.
D) Built-in filtration systems are available in both therapeutic pools and self-contained pools.
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Chapter 10: Soft Tissue Injury,repair,and Management
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Q1) Overuse syndromes occur:
A) As the result of repetitive,submaximal stress of a muscle or tendon.
B) As the result of a severe blow to a muscle.
C) As a result of prolonged immobilization.
D) Only if there is impaired circulation to soft tissue.
Q2) 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.
Q3) To treat soft tissue lesions,such as supraspinatus tendonitis or lateral epicondylitis,effectively the long-term objective should be to:
A) Reduce the pain.
B) Have the patient stop doing the activity that causes the problem.
C) Maintain functional ROM.
D) Create a strong,mobile scar.
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12
Chapter 11: Joint,connective Tissue,and Bone Disorders and Management
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Q1) Your 80-year-old patient fractured his distal radius and ulna 6 weeks ago.He wore a cast during this period,extending from the mid-humerus to,but not including,the MCP joints.His cast was removed yesterday because of evidence of clinical union,and he has been cleared to begin exercise.ROM is limited (wrist flexion and extension,thumb flexion,forearm supination,and elbow extension).Which type of exercise is contraindicated at this time?
A) Grade II distraction of the humeroulnar joint
B) Active ROM of all limited joints
C) Passive stretching to increase wrist,forearm,and elbow ROM
D) Grade III joint mobilization (gliding technique)to increase flexion of the thumb
Q2) Each of the following signs or symptoms is a characteristic of rheumatoid arthritis except:
A) Inflammatory synovitis.
B) Recurring periods of active disease (flare)followed by remission.
C) Usually asymmetrical joint involvement.
D) Fatigue,general malaise,and possibly fever.
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Chapter 12: Surgical Interventions and Postoperative Management
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Q1) Active range of motion is not possible at a joint that has undergone:
A) Arthrodesis.
B) Arthroplasty.
C) Synovectomy.
D) Osteotomy.
Q2) Synovectomy,when used,typically is indicated for:
A) Long-standing osteoarthritis.
B) Tear of a joint capsule as the result of trauma.
C) Rheumatoid arthritis.
D) Postimmobilization arthritis.
Q3) When arthroplasty involves first debriding and then resurfacing a joint by placing a foreign material-such as fascia,metal,or a silicone spacer-between the articulating surfaces of a joint,it is called a(n):
A) Abrasion arthroplasty.
B) Interposition arthroplasty.
C) Excision arthroplasty.
D) Hemireplacement arthroplasty.
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Page 14
Chapter 13: Peripheral Nerve Disorders and Management
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Q1) Nonoperative management of carpal tunnel syndrome emphasizes:
A) Vigorous stretching to gain mobility of the structures in the carpal tunnel.
B) Activity modification and joint,nerve,and tendon mobilization.
C) Strengthening exercises,especially to the muscles of the thenar eminence.
D) Immobilization.
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.
Q3) Following nerve injury,motor retraining exercises:
A) Begin as soon as signs of voluntary muscle action are detected.
B) Begin as soon as the patient tolerates electrical stimulation.
C) Are used to desensitize the areas of hypersensitivity.
D) Cannot be used until the chronic phase of healing in order to avoid further trauma to the nerve.
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Chapter 14: The Spine: Structure, function, and Posture
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Q1) Motion at a functional unit of the spine is defined by what is occurring with the:
A) Anterior portion of the body of the superior vertebrae.
B) Anterior portion of the body of the inferior vertebrae.
C) Spinous process of the superior vertebrae.
D) Spinous process of the inferior vertebrae.
Q2) The anterior pillar of the spine:
A) Consists of the vertebral bodies and the vertebral arches.
B) Includes the sternum and the 12 pairs of ribs.
C) Is the weight-bearing portion of the spinal column.
D) Provides the gliding mechanism for movement.
Q3) Your patient complains of cervical pain and headaches.You notice that she has a forward head and round back posture.The complaints could be derived from all of the following except:
A) Impingement on the neurovascular bundle from anterior scalene muscle tightness.
B) Increased tension in the muscles of mastication.
C) Irritation of the facet joints in the upper cervical spine.
D) Impingement of the suboccipital nerves.
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Page 16
Chapter 15: The Spine: Management Guidelines
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Q1) A serious complication of rheumatoid arthritis in the spine is:
A) Subluxation due to ligamentous necrosis.
B) Joint effusion.
C) Synovial hypertrophy.
D) Pain.
Q2) Your patient has nerve root symptoms and has been diagnosed as having degenerative joint disease of the spine.The approach for treating the cause of the symptoms should be:
A) Heat and massage.
B) Interventions that temporarily increase the size of the intervertebral foramina.
C) Intermittent setting exercises with the extensor muscles in the shortened position.
D) Relaxation exercises,including head rolls and conscious tension-release techniques.
Q3) The vertebral arteries:
A) Are protected in positions of extreme cervical extension.
B) Cause tension headaches when they are occluded.
C) Are compromised with severe TMJ dysfunction.
D) Enter the transverse foramen of C6 bilaterally in their course to C1.
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Chapter 16: The Spine: Exercise and Manipulation
Interventions
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Q1) Manipulation to increase thoracic spinal rotation requires clear communication in the medical record describing the treatment outcome for the segment.When using the V-spread contact,one finger is placed on the superior transverse process and the second finger is placed on the contralateral inferior transverse process.The rule of the lower finger describes the direction of rotation as:
A) Rotation of the segment occurs in the direction of the finger on the side of the inferior transverse process.
B) Rotation of the segment occurs in the direction of the finger on the side of the superior transverse process.
C) There is no rotation with the V-spread because the lower finger equally counteracts the force through the superior finger,creating an anterior glide.
D) A distraction occurs with the V-spread as the lower finger creates movement inferiorly through the lever arm of the transverse process as the force is applied.
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18
Chapter 17: The Shoulder and Shoulder Girdle
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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) Your patient exhibits a forward head posture and excessive thoracic kyphosis.Considering the muscles that typically are weak with this faulty posture,which of the following muscles of the shoulder girdle are most important to strengthen using the exercise program you are developing for this patient?
A) Pectoralis minor and levator scapulae
B) Serratus anterior and levator scapulae
C) Upper and lower trapezius and serratus anterior
D) Upper and lower trapezius and pectoralis minor
Q3) Results of numerous outcome studies have demonstrated that the most predictable outcome after shoulder arthroplasty is:
A) Increased active shoulder ROM.
B) Increased shoulder-joint stability.
C) Pain relief.
D) Improved function of the rotator cuff mechanism.
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Page 19
Chapter 18: The Elbow and Forearm Complex
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Q1) Which of the following is true about myositis ossificans (heterotopic bone formation)in the elbow region?
A) The muscle most often affected in the elbow region is the biceps brachii.
B) It is distinguished from traumatic arthritis of the humeroulnar joint in that passive extension is more limited than flexion.
C) After the acute inflammatory period,heterotopic bone is laid down within muscle fibers and within the joint.
D) Before the bony mass in the muscle has matured,the muscle should be stretched and massaged regularly to prevent a contracture.
Q2) Which of the following is true about total elbow arthroplasty (TEA)?
A) A semiconstrained,linked prosthesis allows flexion and extension of the elbow but not varus,valgus,or rotational motions.
B) The typical method of fixation of the implants is all-cementless (all-biological)fixation.
C) The surgical approach most often used leaves the triceps tendon intact.
D) One of the more common,long-term complications after TEA is joint instability,particularly with unlinked implants or if the patient previously underwent excision of the radial head.
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Chapter 19: The Wrist and Hand
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Q1) Which of the following is true about regimens that employ customized splinting and early controlled motion after flexor tendon repair in zones I,II,or III?
A) May involve the use of a dorsal tenodesis splint that allows full active extension of the wrist and MCP joints
B) May involve the use of a dynamic dorsal blocking splint with elastic bands attached,providing full passive extension of the fingers and allowing limited active flexion of the fingers
C) May involve the use of a dynamic dorsal blocking splint with elastic bands attached,allowing limited active finger extension and providing passive finger flexion
D) May involve the use of a volar tenodesis splint that allows full ROM of the wrist while maintaining the fingers in full extension
Q2) 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.
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21
Chapter 20: The Hip
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Q1) Which of the following is a correct statement about arthrodesis of the hip?
A) It is the surgery of choice for the elderly (greater than 75 years old)patient with an intertrochanteric fracture.
B) It is commonly performed arthroscopically in young,active individuals.
C) It is the procedure of choice for treating severe OA that affects both the acetabular and femoral components of the hip.
D) It is considered a salvage procedure when revision arthroplasty is not an option.
Q2) In an elderly patient,which of the following types of hip fracture is managed most often with hemireplacement of the hip (hemiarthroplasty)?
A) Noncomminuted intertrochanteric fracture
B) Displaced subcapital (intracapsular)fracture
C) Unstable subtrochanteric fracture
D) Hemiarthroplasty is equally indicated for intracapsular and extracapsular fractures
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22
Chapter 21: The Knee
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Q1) A patient with a history of recurrent dislocation of the patella underwent a surgical procedure for realignment of the extensor mechanism.Considering the position of immobilization postoperatively,you would expect to find each of the following impairments when it is permissible to begin exercises except:
A) Lack of full or almost full passive knee extension.
B) Quadriceps lag.
C) Lack of full knee flexion.
D) Weakness of the quadriceps and hamstrings.
Q2) 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.
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Chapter 22: The Ankle and Foot
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Q1) Your patient has a diagnosis of rheumatoid arthritis and is developing a capsular pattern in the foot and ankle.Which joint-mobilization technique could perpetuate or worsen the impairment/deformity typically associated with RA of the foot and ankle?
A) Stabilize the mortise and glide the talus in an anterior direction
B) Stabilize the calcaneus and glide the cuboid in a plantar direction
C) Stabilize the talus and glide the navicular in a dorsal direction
D) Stabilize the talus and glide the calcaneus in a lateral direction
Q2) A 40-year-old teacher who has been referred to you has experienced pain along the plantar aspect of the heel for more than 6 months.It is most noticeable when getting out of bed in the morning,upon standing after sitting for longer than 1 hour,and after playing racquetball.During walking,pain is most noticeable at the terminal stance/preswing phase of gait.The mostly likely disorder causing these symptoms is:
A) Plantar fasciitis.
B) Calcaneal bursitis.
C) Achilles tendinitis.
D) Posterior tibialis tendinitis.
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Chapter 23: Advanced Functional Training
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Q1) 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
Q2) Which of the following accurately describes a method to progress the challenge of balance exercises?
A) Narrow to wide base of support
B) Standing activities to sitting activities
C) Open environment to closed environment
D) Low-magnitude to high-magnitude perturbations
Q3) Which of the following describes a proper progression of positions to increase balance and postural stability?
A) Standing to tall kneeling
B) Unilateral stance to tandem stance
C) Half-kneeling to sitting without foot support
D) Reaching activities in bilateral stance to unilateral stance
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25
Chapter 24: Womens Health: Obstetrics and Pelvic Floor
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Q1) Which of the following statements adequately represents aerobic exercise guidelines for a woman during an uncomplicated pregnancy?
A) Continue exercise at levels prior to pregnancy with the understanding that a lower intensity of exercise results in the same level of exertion.
B) Limit exercise to three times a week at a target heart rate during exercise based on a conventional age-based calculation.
C) Women who have not been exercising prior to pregnancy should wait for 3 months after delivery to begin an exercise program.
D) If a woman has exercised prior to pregnancy,all types of exercise can be continued throughout pregnancy,including those with ballistic,end-range movements and rapid changes of direction.
Q2) Which of the following is true about sacroiliac (SI)joint pain experienced during pregnancy?
A) Pain often radiates from the buttock region,distally to the foot.
B) Asymmetrical lower extremity weight-bearing activities aggravate the pain.
C) Resting on a soft support surface typically alleviates the pain.
D) Hypomobility of the SI joint typically is evident.
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Chapter 25: Management of Lymphatic Disorders
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Q1) Intervention goals for lymphedema include all of the following except:
A) Educating the patient in techniques for self-management.
B) Reducing the risk of infection.
C) Softening of fibrotic tissue.
D) Resolving the lymphedema and returning the lymphatic system to a normal state.
Q2) Which of the following is the least advisable means of preventing limitations of the glenohumeral joint and improving shoulder range of motion (ROM)after mastectomy?
A) Self-assisted ROM of the involved upper extremity
B) Wand exercises
C) Pendulum exercises
D) Wall-climbing exercises with the involved upper extremity
Q3) Which of the following factors associated with breast cancer surgery and adjuvant therapy is least likely to contribute to impaired shoulder mobility?
A) Incisional pain
B) Chemotherapy
C) Fibrosis of tissues in the axillary area as the result of radiation therapy
D) Increased thoracic kyphosis related to incisional pain or age
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