CCAT Patient Assessment & Treatment Planning 4 — Questions and Answers
Question 1: Which physical finding on palpation of a muscle belly most specifically indicates an active myofascial trigger point?
- General muscle warmth throughout the belly
- A discrete taut band with a hypersensitive nodule eliciting a local twitch response (Correct answer)
- Diffuse swelling over the entire muscle
- Crepitus during muscle contraction
Correct answer: A discrete taut band with a hypersensitive nodule eliciting a local twitch response
An active myofascial trigger point is defined by a palpable taut band within a muscle containing a hypersensitive nodule that, when compressed, produces a local twitch response and referred pain.
Question 2: A golden retriever is referred for rehabilitation 10 days after unilateral elbow arthroscopy. Which assessment component should be DEFERRED until the surgical site is fully healed?
- Gait analysis on a non-slip surface
- Contralateral limb strength assessment
- Full passive ROM with overpressure of the surgical elbow (Correct answer)
- Neurological examination
Correct answer: Full passive ROM with overpressure of the surgical elbow
Applying overpressure at end-range ROM to a recently arthroscoped joint risks disrupting the healing portal sites and joint capsule; this is deferred until adequate healing has occurred.
Question 3: When setting SMART goals for a canine rehabilitation patient, what does the 'T' stand for and why is it important?
- Therapeutic — ensures goals are clinically relevant
- Time-bound — establishes a deadline to reassess progress (Correct answer)
- Targeted — focuses on the most affected body region
- Traceable — allows comparison to population norms
Correct answer: Time-bound — establishes a deadline to reassess progress
Time-bound goals include a specific timeframe for achievement, which allows therapists to reassess progress, adjust plans, and communicate realistic expectations to owners.
Question 4: A therapist observes a dog consistently shifting weight away from the left pelvic limb when standing still. Which objective tool best quantifies this finding for baseline documentation?
- Visual analog scale completed by the owner
- Stance analysis platform (pressure-sensitive mat) (Correct answer)
- Manual muscle testing grade
- Flexion-extension goniometry
Correct answer: Stance analysis platform (pressure-sensitive mat)
A pressure-sensitive stance analysis platform objectively measures weight distribution across all four limbs, quantifying asymmetry that is otherwise estimated subjectively.
Question 5: Which of the following is a contraindication to performing passive range of motion exercises in a rehabilitation patient?
- Muscle atrophy secondary to disuse
- Periarticular joint fibrosis
- Unstabilized fracture at or near the joint (Correct answer)
- Mild joint effusion without pain
Correct answer: Unstabilized fracture at or near the joint
Passive ROM is contraindicated over unstabilized fractures because movement can cause fragment displacement, pain, and additional tissue damage.
Question 6: A therapist reassesses a dog 4 weeks into a rehabilitation program and finds no improvement in hindlimb proprioception. The MOST appropriate next step is to:
- Discharge the patient as a non-responder
- Double the frequency of all therapeutic exercises immediately
- Communicate findings to the supervising veterinarian and discuss plan modification (Correct answer)
- Continue the same protocol for another 4 weeks without changes
Correct answer: Communicate findings to the supervising veterinarian and discuss plan modification
Lack of progress warrants communication with the supervising veterinarian to rule out new or worsening pathology and to collaboratively modify the treatment plan.
Question 7: Which body condition score (BCS) system is most widely used in clinical veterinary rehabilitation for small animals, and what is its scale?
- Modified Ashworth Scale: 0–4
- Purina BCS: 1–9 (Correct answer)
- Merck BCS: 1–5
- World Small Animal Veterinary Association BCS: 1–7
Correct answer: Purina BCS: 1–9
The 9-point Purina Body Condition Score system is the most widely adopted scale in veterinary practice, with 1 being emaciated and 9 being obese; 4-5 is ideal.
CCAT Patient Assessment & Treatment Planning 4
Which physical finding on palpation of a muscle belly most specifically indicates an active myofascial trigger point?