CCEP Rehabilitation & Therapeutic Exercises 5 — Questions and Answers
Question 1: The 'Rule of Thirds' in tendon healing indicates that clinical symptoms resolve before full structural tendon repair. Approximately how long does tendon collagen remodeling continue after injury?
- 6 weeks
- 3 months
- 6-12 months (Correct answer)
- 18-24 months
Correct answer: 6-12 months
Tendon collagen remodeling continues for 6-12 months following injury, explaining why early return to sport—despite symptom resolution—risks re-injury.
Question 2: Which exercise type is CONTRAINDICATED in the early phase of rehabilitation following a total hip arthroplasty (posterior approach)?
- Supine heel slides
- Hip flexion beyond 90 degrees (Correct answer)
- Ankle pumps for DVT prevention
- Isometric gluteal sets
Correct answer: Hip flexion beyond 90 degrees
Following posterior approach THA, hip flexion beyond 90 degrees is contraindicated due to risk of posterior dislocation until soft tissue healing stabilizes the joint.
Question 3: A chiropractor uses blood flow restriction (BFR) training for a patient post-knee surgery who cannot tolerate high loads. At what percentage of limb occlusion pressure (LOP) is BFR typically applied?
- 20-30% LOP
- 40-80% LOP (Correct answer)
- 90-100% LOP
- Over 100% LOP
Correct answer: 40-80% LOP
BFR training is typically applied at 40-80% of limb occlusion pressure, allowing venous occlusion while maintaining arterial flow to create metabolic stress for hypertrophy at low loads.
Question 4: During shoulder rehabilitation, which scapular muscle is MOST responsible for upward rotation of the scapula during overhead reaching?
- Rhomboid major
- Middle trapezius
- Lower trapezius and serratus anterior (Correct answer)
- Levator scapulae
Correct answer: Lower trapezius and serratus anterior
The lower trapezius and serratus anterior work synergistically to produce scapular upward rotation, which is essential for normal glenohumeral rhythm during overhead activities.
Question 5: Which outcome measure is MOST appropriate for assessing functional limitations and disability in patients with foot and ankle conditions in an extremity chiropractic practice?
- Oswestry Disability Index (ODI)
- Foot and Ankle Ability Measure (FAAM) (Correct answer)
- Upper Extremity Functional Index (UEFI)
- QuickDASH
Correct answer: Foot and Ankle Ability Measure (FAAM)
The FAAM is a validated, region-specific outcome measure designed to assess activity limitations and participation restrictions in patients with musculoskeletal foot and ankle disorders.
Question 6: A patient with rotator cuff tendinopathy is progressing from isometric to isotonic exercises. Which isotonic exercise should be introduced FIRST?
- Overhead press with dumbbells at 90° abduction
- Side-lying external rotation with light resistance (Correct answer)
- Military press on a cable machine
- Internal rotation with tubing at end-range
Correct answer: Side-lying external rotation with light resistance
Side-lying external rotation with light resistance is introduced early in isotonic progressions because it loads the infraspinatus and teres minor in a gravity-assisted, low-demand position.
Question 7: Which of the following BEST describes the therapeutic goal of joint mobilization as a precursor to therapeutic exercise in extremity rehabilitation?
- To permanently stretch joint capsule collagen fibers
- To restore arthrokinematic motion and reduce pain, facilitating exercise participation (Correct answer)
- To replace the need for stretching and strengthening exercises
- To eliminate the need for neuromuscular re-education
Correct answer: To restore arthrokinematic motion and reduce pain, facilitating exercise participation
Joint mobilization restores normal arthrokinematic motion and reduces pain through neurophysiological and mechanical mechanisms, creating a window of opportunity for therapeutic exercise.
CCEP Rehabilitation & Therapeutic Exercises 5
The 'Rule of Thirds' in tendon healing indicates that clinical symptoms resolve before full structural tendon repair.
Approximately how long does tendon collagen remodeling continue after injury?