Deck 37: Functional Activity Intervention in Upright Mobility

Question 1

You are providing physical therapy for a young patient with multiple sclerosis who is having difficulty performing dual tasks.She wants to be able to walk while using her smart phone.You plan to use Gentile's taxonomy to progress the activities.What progression will you use to increase the level of challenge as her dual task control improves?

A)Walking indoors while holding a phone to her ear;walking indoors while talking on the phone;walking outdoors while texting
B)Standing indoors while watching TV;standing indoors while operating the TV remote;walking indoors while talking on the phone
C)Sitting on a Physioball while talking on the phone;standing on an inflated disc reading a text;walking in the therapy gym while reading a text
D)Sitting on a stool with wheels while talking on the phone;standing in a crowed area while texting;walking while talking on the phone

Answer 1

A

Question 2

Mr.Meyer is an 81 year-old man who walks with a very slow gait velocity.Given his slow velocity what changes to normal gait do you expect to see during observational gait analysis?

A)A change in the out-of-phase relationship of the lower extremities
B)Difficulty with foot clearance during swing limb advancement
C)Reduced amplitude of arm swing
D)Less time spent in single limb support

Answer 2

C

Question 3

In single limb support (SLS) postural control is maintained by:

A)An extensor moment at the hip,knee,and ankle
B)By activation of the plantar flexors acting to control tibial advancement
C)By hip muscles acting to control the head,arms,and trunk (HAT)
D)By coactivation of the quadriceps and hamstrings acting to stabilize the knee

Answer 3

A

Question 4

Physical therapists often incorporate adjunctive strategies such as manual guidance into a patient's intervention program.What must a therapist keep in mind when using adjunctive strategies with a patient who is practicing upright mobility tasks?

A)Adjunctive strategies make movement easier for the patient so they should be used frequently and throughout the patient's episode of care.
B)The patient may not be able to perform the task once adjunctive strategies are withdrawn.
C)By limiting movement errors adjunctive strategies will enable the patient to learn the task more quickly.
D)The use of adjunctive strategies promotes the retention and transfer of upright mobility skills.

Question 5

You are providing outpatient physical therapy for a patient with right hemiplegia.The patient's goal is to more effectively meet the challenges of community mobility by increasing her ability to negate obstacles.Which of the following activities will enable the patient to best meet her goals?

A)Ambulation using the Locomat
B)Body weight supported treadmill training (BWSTT) with 30% body weight-support (BWS)
C)Progressively challenging the patient's locomotor adaptation
D)Constraint-induced movement therapy

Question 6

You are working with Mrs.Z,a patient with right-sided hemiplegia.She is showing improvement in ambulating on level surfaces in a quite area of the physical therapy gym.Given this,you plan to progress her ambulation program using Gentile's taxonomy.Which of the following would be the BEST choice for progressing Mrs.Z's plan of care?

A)Adding a manual and cognitive dual task to ambulation on level surfaces.
B)Taking Mrs.Z to the hospital cafeteria during lunchtime so she can practice ambulation in an open environment.
C)Varying the surface conditions so Mrs.Z can practice gait adaptations.
D)Squatting to pick up objects from the floor.

Question 7

You are preparing to examine a 64 year-old man with a neurological disorder who is seeking physical therapy for the first time after receiving his diagnosis.He reports problems with balance and gait.You want to do a thorough assessment of his mobility status to establish a baseline level of function.Given this,you plan to include tests/measures across the three International Classification of Functioning,Disability and Health-2 (ICF-2) domains.Which set of tests/measures will you select?

A)Sensory testing,coordination testing,Functional Gait Assessment (FGA)
B)Mini-Mental State Exam,HiMAT,FGA
C)FGA,Rivermead Mobility Index
D)FGA,manual muscle testing (MMT),Activities Specific Balance Confidence Scale (ABC)

Question 8

Patients with neurological disorders incur a range of primary and secondary impairments that affect upright mobility.Mrs.Jones is a 43 year-old woman who was diagnosed with multiple sclerosis 10 years ago.She wants to resume physical therapy to address an increase in falls.Based on your examination findings you hypothesize that her falling is due more to secondary impairments than primary impairments.All of the following are secondary impairments that contribute to fall risk EXCEPT:

A)Limitations in lower extremity range of motion
B)Depression
C)Deconditioning
D)Hypertonicity

Question 9

Your patient is a college student who incurred a traumatic brain injury in a motor vehicle accident.He is being seen for physical therapy in an inpatient rehabilitation facility.To optimize the patient's outcome you know he must:

A)Actively practice tasks meaningful to him,frequently throughout the day
B)Perform multiple repetitions of hamstring and heel cord stretching exercises
C)Practice walking the length of the therapy gym at least three times per treatment session
D)Actively practice tasks you decide are meaningful,frequently throughout the day

Question 10

You are examining a 7 year-old child with the spastic diplegic form of cerebral palsy (CP).You know that children with CP can demonstrate major gait deviations.You also know that the gait of typically developing children is not fully mature until about age 7 years.Which of the following gait parameters seen in typically developing young children would be considered a significant gait deviation in this 7 year-old patient?

A)Single limb stance time of 38%
B)Step length of 20 cm
C)Cadence of 140 steps/min
D)Walking velocity of 120cm/sec