CHT Therapeutic Interventions 4 — Questions and Answers
Question 1: A therapist treats a patient with lateral epicondylitis using friction massage. This technique is BEST applied:
- Along the muscle belly with the elbow flexed to 90°
- Transversely across the common extensor origin with the elbow extended (Correct answer)
- Longitudinally along the extensor tendons with light pressure
- At the radiohumeral joint in circular motions
Correct answer: Transversely across the common extensor origin with the elbow extended
Transverse friction massage (Cyriax technique) is applied perpendicular to the common extensor tendon fibers at their origin to promote collagen realignment.
Question 2: Which orthosis is indicated to prevent boutonnière deformity after an acute central slip injury at the PIP joint?
- PIP joint extension splint worn continuously, leaving DIP and MCP free (Correct answer)
- Dynamic PIP flexion splint to encourage DIP extension
- Buddy strap to the adjacent finger only
- Wrist and finger immobilization splint in intrinsic-plus position
Correct answer: PIP joint extension splint worn continuously, leaving DIP and MCP free
Continuous PIP extension splinting for 6 weeks allows the central slip to heal in a lengthened position and prevents boutonnière deformity.
Question 3: A CHT applies fluidotherapy at 48°C for 20 minutes to a patient's hand. The PRIMARY therapeutic effect is:
- Deep heating of tendon and joint structures
- Superficial tissue heating with gentle mechanical stimulation aiding desensitization (Correct answer)
- Reduction of acute inflammation via vasoconstriction
- Electrical stimulation of denervated muscle
Correct answer: Superficial tissue heating with gentle mechanical stimulation aiding desensitization
Fluidotherapy provides superficial dry heat and particle agitation, making it especially useful for desensitization and gentle range-of-motion exercises in the warm medium.
Question 4: During fabrication of an anti-spasticity splint for a patient with stroke-related hand spasticity, the thumb should be positioned in:
- Full opposition and flexion to maintain web space
- Palmar abduction and extension to prevent adduction contracture (Correct answer)
- Neutral rotation adjacent to the index finger
- Tip pinch position to promote functional grip
Correct answer: Palmar abduction and extension to prevent adduction contracture
Palmar abduction and extension of the thumb maintains the first web space and counteracts the spastic adduction pattern common after stroke.
Question 5: A therapist is using low-level laser therapy (LLLT) for wound healing on a chronic hand ulcer. The appropriate application technique is:
- Contact method directly on wound tissue at 4 J/cm²
- Non-contact method above intact skin surrounding the wound (Correct answer)
- Contact method on the wound with maximum power output
- Submerged in water bath with the probe at 10 cm distance
Correct answer: Non-contact method above intact skin surrounding the wound
LLLT for wound healing is applied non-contact around the wound perimeter on intact skin to stimulate surrounding tissue without contaminating the device.
Question 6: When treating a patient with a proximal phalanx fracture that is surgically fixed, active ROM exercises typically begin:
- Immediately post-op with full composite fist
- 3–5 days post-op with gentle protected active range of motion per surgeon protocol (Correct answer)
- At 6 weeks post-op after radiographic healing confirmed
- At 12 weeks post-op when remodeling is complete
Correct answer: 3–5 days post-op with gentle protected active range of motion per surgeon protocol
Stable surgical fixation allows early protected active motion starting at 3–5 days post-op to prevent adhesions while respecting tissue healing.
Question 7: The PRIMARY goal of using a Coban self-adherent wrap on a post-traumatic swollen digit is to:
- Immobilize the digit to prevent further injury
- Apply circumferential compressive force to reduce edema (Correct answer)
- Protect a wound from contamination
- Provide proprioceptive feedback during exercise
Correct answer: Apply circumferential compressive force to reduce edema
Coban wrap provides circumferential compression that assists venous and lymphatic return to reduce edema in the digit.
CHT Therapeutic Interventions 4
A therapist treats a patient with lateral epicondylitis using friction massage.
This technique is BEST applied: