CCEP Rehabilitation & Therapeutic Exercises 4 — Questions and Answers
Question 1: Which functional movement screen (FMS) pattern, when scored as a '0', requires the rehabilitation program to STOP and address the movement asymmetry before progressing?
- Deep squat scoring 1
- Hurdle step scoring 2 asymmetrically
- Any movement with pain (scoring 0) (Correct answer)
- Rotary stability scoring 1 bilaterally
Correct answer: Any movement with pain (scoring 0)
A score of '0' on any FMS pattern indicates the presence of pain during the movement, which must be addressed before any performance training is initiated.
Question 2: A patient with chronic Achilles tendinopathy begins an eccentric heel drop program. What weekly progression is MOST evidence-based?
- Increase repetitions from 15 to 30 per set each week
- Maintain 3x15 reps and progressively add external load using a weighted vest or backpack (Correct answer)
- Decrease sets and increase explosive plyometric volume
- Switch to concentric-only loading after 2 weeks
Correct answer: Maintain 3x15 reps and progressively add external load using a weighted vest or backpack
The Alfredson eccentric heel drop protocol progresses by maintaining 3x15 repetitions and systematically adding external load once the exercise becomes pain-free.
Question 3: During therapeutic exercise for wrist rehabilitation following a distal radius fracture, which exercise is appropriate at the earliest stage of post-immobilization recovery?
- Weighted wrist curls with 5 lb dumbbell
- Active-assisted range of motion with the unaffected hand (Correct answer)
- Plyometric ball toss against a rebounder
- Power grip squeezing with maximum effort
Correct answer: Active-assisted range of motion with the unaffected hand
Active-assisted ROM exercises using the contralateral hand are appropriate early post-immobilization to restore joint mobility without excessive loading on healing bone.
Question 4: Which neuromuscular electrical stimulation (NMES) parameter is MOST responsible for determining the strength of muscle contraction?
- Pulse frequency (Hz)
- Pulse duration (microseconds)
- Amplitude (mA) (Correct answer)
- Waveform shape
Correct answer: Amplitude (mA)
Amplitude (current intensity in milliamps) is the primary parameter controlling the strength of muscle contraction by determining how many motor units are recruited.
Question 5: A CCEP practitioner prescribes plyometric training for ACL reconstruction rehabilitation. Which criteria must be met before initiating plyometrics?
- Minimum 3 months post-surgery regardless of functional status
- Limb symmetry index ≥85% on strength testing and full pain-free ROM (Correct answer)
- Patient can perform 10 consecutive single-leg squats at any depth
- Surgical clearance from the operating physician only
Correct answer: Limb symmetry index ≥85% on strength testing and full pain-free ROM
A limb symmetry index of ≥85% on quadriceps and hamstring strength testing, combined with full pain-free ROM, are standard criteria before initiating ACL plyometric progression.
Question 6: Which type of muscle contraction produces the GREATEST muscle force at any given activation level?
- Concentric
- Isometric
- Eccentric (Correct answer)
- Isokinetic concentric
Correct answer: Eccentric
Eccentric contractions produce greater force than isometric or concentric contractions at any given activation level due to titin's elastic contribution and cross-bridge mechanics.
Question 7: A patient with a Grade I medial collateral ligament (MCL) sprain of the knee should begin which exercise modality FIRST?
- Aggressive resistance training with leg press machine
- Active ROM exercises and isometric quadriceps sets (Correct answer)
- Single-leg plyometric jump training
- Closed kinetic chain squatting below 90 degrees immediately
Correct answer: Active ROM exercises and isometric quadriceps sets
Grade I MCL sprains begin rehabilitation with active ROM exercises and isometric quadriceps sets to maintain muscle activation and joint nutrition without stressing the healing ligament.
CCEP Rehabilitation & Therapeutic Exercises 4
Which functional movement screen (FMS) pattern, when scored as a '0', requires the rehabilitation program to STOP and address the movement asymmetry before progressing?