Deck 14: Locomotor Training

Question 1

What is one of the benefits of using a modified plantigrade position as a lead-up activity to gait?

A)It requires close to full weightbearing,hip and knee extension,with ankle dorsiflexion.
B)It encourages upper extremity weightbearing in a position used with assistive devices.
C)It is a position with a large base of support and a relatively low center of mass.
D)It facilitates sit-to-stand transitional movement and increases knee extensor strength.

Answer 1

A

Question 2

During gait in the parallel bars what should the therapist instruct the patient to do with the upper extremities?

A)Pull yourself forward with your arms.
B)Place your arms on my shoulders for balance.
C)Push down on the parallel bars as you step.
D)Touch the bars only with your fingertips.

Answer 2

C

Question 3

As preparation for standing and gait activities,the therapist has determined the patient needs to participate in a stability exercise to increase hip and trunk stability and strength while decreasing the base of support and raising the center of mass from the supine position.The patient has significant extensor spasticity of the lower extremities.What would be an appropriate mat activity to use with this patient?

A)Sit-to-stand with resistance
B)Sitting weight shifts while reaching
C)Stabilizing reversals in quadruped
D)Resisted bridging

Answer 3

C

Question 4

The therapist is having the patient perform weight-shifting activities in half-kneeling.What would be the goal of this activity?

A)Facilitation of anterior weight shift during sit-to-stand
B)Facilitation of weight shifting with hip extension
C)Facilitation of stability in the position of half-kneeling
D)Facilitation of weightbearing through the anterior foot

Question 5

What type of activity would it be if the therapist works with the patient to achieve and maintain independent sitting on the mat?

A)Mobility
B)Stability
C)Dynamic stability
D)Skill

Question 6

The patient requires maximal assist to transition to standing from the wheelchair.What would be an appropriate activity to facilitate improvement in hip and knee extensor strength while allowing the patient greater independence during this transition?

A)Practice of sit-to-stand from a higher surface progressing to lower surfaces
B)Weight shifting activities with reaching in short sitting on the mat
C)Incorporation of standing on one foot to mimic the stance phase of gait
D)Resisted bridging with the patient supine on the mat table

Question 7

The therapist notes that the patient has difficulty transferring weight forward over the feet to transition from sitting to standing.What might be an intervention strategy to facilitate this weight transfer?

A)Encourage the patient to use the upper extremities to push off from the chair.
B)Have the patient explore limits of stability with shifting weight side to side.
C)Facilitate standing-to-sitting transition with manual contacts on the hips.
D)Have the patient clasp the hands together and then reach forward toward a target.

Question 8

The patient is able to maintain a sitting position on the mat with upper extremity support without challenges to limits of stability.What would be an appropriate next progression for this patient?

A)Sitting push-ups
B)Reaching for a ball in sitting
C)Sitting on a therapy ball
D)Resisted upper extremity exercises

Question 9

The patient has been successfully participating in resisted walking activities during therapy gym.What would be an appropriate progression of activities?

A)Approximation during stance
B)Diagonal weight shifts
C)Unresisted backwards walking
D)Side-stepping with manual cues

Question 10

The therapist's goal is to increase stability in standing.Which activity would be best to facilitate accomplishment of this goal?

A)Weight shifting in standing testing the patient's limits of stability
B)Weight shifting with the patient in a standing stride position
C)In standing provide alternating isometric resistance to the trunk
D)Use of rhythmic stabilization with the patient in short sitting

Question 11

As preparation for standing and gait activities,the patient needs to increase hip extensor strength and become accustomed to bearing weight through the feet in a position that has a large base of support and a low center of mass.What would be an appropriate activity to use with this patient?

A)Bridging
B)Sit-to-stand
C)Sitting weight shifts
D)Half kneeling

Question 12

What is the correct sequence of preparatory exercises for gait?

A)Stability → Mobility → Dynamic stability → Skill
B)Mobility → Stability → Dynamic stability → Skill
C)Mobility → Stability → Skill → Dynamic stability
D)Mobility → Dynamic stability → Stability → Skill

Question 13

The therapist's goal is to increase dynamic stability in standing.Which activity would be best to facilitate accomplishment of this goal?

A)In standing,alternately placing one foot on a step
B)Facilitation of trunk and pelvic stability during locomotion
C)In standing,provide alternating isometric resistance to the trunk
D)Use of rhythmic stabilization with the patient in short sitting

Question 14

A concern when assisting a patient into standing for the first time is orthostatic hypotension.What are the symptoms a patient will demonstrate if experiencing orthostatic hypotension?

A)Pain in the lower extremities
B)Confusion or disorientation
C)Elevated blood pressure
D)Nausea or lightheadedness

Question 15

What type of activity would it be if the therapist works with the patient on locomotion?

A)Mobility
B)Stability
C)Dynamic stability
D)Skill

Question 16

The therapist's goal is to facilitate weightbearing through the hips while inhibiting the spasticity in the patient's quadriceps.What activity will meet this goal?

A)Facilitation of sit-to-stand
B)Facilitation of stand-to-sit
C)Reaching activities in kneeling
D)Reaching activities in sitting

Question 17

What is the proper technique for teaching a patient to rise from the wheelchair to standing in the parallel bars?

A)Have the patient reach forward and place the hands on the therapist's shoulders.
B)Have the patient scoot forward and push up with the hands on the armrests of the chair.
C)Have the patient hold onto the parallel bars and pull up into standing.
D)Have the patient cross the arms across the chest while the therapist pulls on the guarding belt.

Question 18

What type of activity would it be if the therapist works with the patient to achieve a supine position on the mat?

A)Mobility
B)Stability
C)Dynamic stability
D)Skill

Question 19

What type of activity would it be if the therapist works with the patient on weight-shifting activities in standing?

A)Mobility
B)Stability
C)Dynamic stability
D)Skill

Question 20

The patient is planning to go to the mall and walk once inside rather than using the wheelchair.The patient is independent with gait in the home setting.What types of training activities might be important in preparation for this outing?

A)Walking over grassy terrain
B)Stepping on and off an escalator
C)Walking on level surfaces
D)Walking in and out of doors

Question 21

When instructing a patient with weakness of the right lower extremity to use a cane,in which hand would the cane be placed?

A)The right hand
B)The left hand
C)It doesn't matter

Question 22

What is the correct progression for advancing the cane during ambulation?

A)The cane and the uninvolved extremity advance together.
B)The cane and the involved extremity advance together.
C)The uninvolved extremity is moved forward then the cane.
D)The involved extremity is moved forward then the cane.

Question 23

What would be the appropriate gait sequence for using axillary crutches for an individual who is partial weightbearing?

A)The crutches are advanced together and then both legs together.
B)The crutches are advanced together and then the uninvolved leg.
C)The crutches are advanced together and then the involved leg.
D)The uninvolved leg is advanced and then the crutches are moved.

Question 24

What is one of the benefits of locomotor training using body weight support and a treadmill?

A)It facilitates upper extremity motions during gait.
B)It allow the therapist to initiate gait training earlier.
C)It allows the therapist to break down the gait cycle.
D)It encourages full weightbearing on the lower extremities.

Question 25

What is the correct position to guard a patient who is descending the stairs?

A)The therapist is positioned anterior and lateral to the patient on the involved side.
B)The therapist is positioned anterior and lateral to the patient on the uninvolved side.
C)The therapist is positioned posterior and lateral to the patient on the involved side.
D)The therapist is positioned posterior and lateral to the patient on the uninvolved side.

Question 26

What is the correct position to guard a patient who is ascending the stairs?

A)The therapist is positioned anterior and lateral to the patient on the involved side.
B)The therapist is positioned anterior and lateral to the patient on the uninvolved side.
C)The therapist is positioned posterior and lateral to the patient on the involved side.
D)The therapist is positioned posterior and lateral to the patient on the uninvolved side.

Question 27

What is the reason for having the patient use a cane in the hand opposite the affected extremity?

A)It widens the base of support.
B)It lowers the center of mass.
C)It allows for partial weightbearing.
D)It depends on the patient's diagnosis.

Question 28

How does the therapist measure the correct height for a cane or walker?

A)The handle should be the height of the iliac crest.
B)The handle should be the height of the ASIS.
C)The patient's elbow should be flexed to approximately 30º.
D)The patient's elbow should be flexed to approximately 90º.

Question 29

Why would a therapist choose to prescribe a walker for ambulation over a quad cane?

A)The walker is best for a patient who doesn't need a great deal of additional stability.
B)The walker works well for negotiating stairs and small spaces in the home.
C)The walker provides the patient with the greatest number of options for gait sequence.
D)The walker provides the widest base of support and most anterior and lateral stability.

Question 30

What would be the correct position for the therapist to guard the patient during gait training with a standard walker?

A)The therapist is standing on the patient's weaker side; one hand is on the guarding belt and the other just anterior to the patient's shoulder.
B)The therapist is standing on the patient's stronger side; one hand is on the guarding belt and the other just anterior to the patient's shoulder.
C)The therapist is standing in front of the patient; one hand is on the guarding belt and the other just anterior to the patient's shoulder.
D)The therapist is standing behind the patient; one hand is on the guarding belt and the other just anterior to the patient's shoulder.

Question 31

How does the therapist measure the correct height for axillary crutches?

A)In supine the therapist should measure the distance from the head of the humerus to the lateral malleoli and subtract 6 in.
B)In supine the therapist should measure the distance from the axilla to the lateral border of the heel and subtract 6 in.
C)In standing there should be about four finger widths beneath the axilla with the crutches approximately 2 in.lateral and anterior to the foot.
D)In standing there should be approximately 2 in.below the axilla with the crutches approximately 2 in.lateral and 6 in.anterior to the foot.