CCSP Rehabilitation & Therapeutic Exercise 3 — Questions and Answers
Question 1: A distance runner presents with patellofemoral pain. Which hip strengthening focus shows the best evidence for reducing anterior knee pain?
- Hip flexor strengthening
- Hip abductor and external rotator strengthening (Correct answer)
- Hip adductor strengthening
- Hip extensor isotonic strengthening only
Correct answer: Hip abductor and external rotator strengthening
Strengthening hip abductors and external rotators reduces dynamic valgus and patellofemoral contact stress, improving anterior knee pain in runners.
Question 2: Which type of muscle contraction produces the greatest force per unit cross-sectional area?
- Concentric
- Isometric
- Eccentric (Correct answer)
- Isotonic
Correct answer: Eccentric
Eccentric contractions generate the greatest force per cross-sectional area due to passive titin contribution and cross-bridge mechanics.
Question 3: Aquatic therapy is introduced in early ACL rehabilitation primarily because:
- Buoyancy reduces joint compressive loads (Correct answer)
- Water increases muscle fiber recruitment
- Hydrostatic pressure accelerates ligament healing
- Resistance is eliminated in all planes
Correct answer: Buoyancy reduces joint compressive loads
Buoyancy offloads body weight, reducing tibiofemoral compressive forces and allowing early weight-bearing exercise before full weight-bearing tolerance.
Question 4: In the Cyriax model of selective tissue tension, which finding indicates a contractile tissue lesion?
- Pain on passive stretch only
- Pain and/or weakness on resisted isometric testing (Correct answer)
- Full pain-free passive range of motion
- Capsular pattern of restriction
Correct answer: Pain and/or weakness on resisted isometric testing
Cyriax defined contractile lesions (muscle, tendon, attachment) by pain and/or weakness during resisted isometric testing with passive motion unaffected.
Question 5: Which closed kinetic chain exercise is most appropriate for early tibial stress fracture return-to-run progression?
- Deep squat with barbell
- Single-leg hop for distance
- Double-leg mini squat progressing to step-ups (Correct answer)
- Plyometric bounding
Correct answer: Double-leg mini squat progressing to step-ups
A graded progression from double-leg mini squats to step-ups incrementally loads the tibia without the high-impact forces of jumping or running.
Question 6: The Rate of Perceived Exertion (RPE) scale value of 13–14 corresponds approximately to what percentage of maximal heart rate?
- 50–60%
- 70–80% (Correct answer)
- 85–90%
- 95–100%
Correct answer: 70–80%
RPE 13–14 ('somewhat hard') corresponds to approximately 70–80% of maximal heart rate, representing moderate-to-vigorous aerobic intensity.
Question 7: A baseball pitcher undergoing interval throwing program is cleared to throw at 60 feet without pain. Which parameter should be increased FIRST in the next session?
- Throwing velocity
- Number of throws
- Throwing distance (Correct answer)
- Throw type (fastball to curveball)
Correct answer: Throwing distance
Interval throwing programs progress distance before intensity; increasing distance elongates the force-attenuation arc before adding velocity stress.
CCSP Rehabilitation & Therapeutic Exercise 3
A distance runner presents with patellofemoral pain.
Which hip strengthening focus shows the best evidence for reducing anterior knee pain?