CNS CNS Neurorehabilitation and Recovery 2 — Questions and Answers
Question 1: Which gait deviation is most commonly seen in patients with foot drop following peroneal nerve injury?
- Trendelenburg gait
- Steppage gait (Correct answer)
- Scissor gait
- Antalgic gait
Correct answer: Steppage gait
Steppage gait occurs when the patient excessively flexes the hip and knee to lift a dropped foot off the ground during the swing phase.
Question 2: During spasticity management in a CNS patient, which intervention is considered FIRST-LINE before procedural options?
- Intrathecal baclofen pump
- Botulinum toxin injection
- Stretching, positioning, and oral antispasticity agents (Correct answer)
- Selective dorsal rhizotomy
Correct answer: Stretching, positioning, and oral antispasticity agents
Conservative management including stretching, positioning, and oral medications such as baclofen or tizanidine should precede more invasive interventions.
Question 3: A patient recovering from spinal cord injury at C5 asks about realistic functional goals. Which expectation is MOST appropriate for a complete C5 injury?
- Independent ambulation with AFOs
- Independent manual wheelchair propulsion on all surfaces
- Ability to feed self with adaptive equipment and drive a power wheelchair (Correct answer)
- Full upper extremity function with wrist extension
Correct answer: Ability to feed self with adaptive equipment and drive a power wheelchair
C5 SCI typically preserves shoulder abduction and elbow flexion, allowing self-feeding with adaptive equipment and power wheelchair use.
Question 4: Which neurological complication is associated with inappropriate calcium deposits forming around joints after spinal cord injury or traumatic brain injury?
- Reflex sympathetic dystrophy
- Heterotopic ossification (Correct answer)
- Charcot arthropathy
- Osteoporosis
Correct answer: Heterotopic ossification
Heterotopic ossification is the formation of bone in soft tissues around joints and is a known complication of SCI and TBI that limits joint range of motion.
Question 5: A CNS specialist notes that a patient with Parkinson's disease has improved walking speed when visual cues (lines on the floor) are used. This technique exploits which mechanism?
- Cerebellar compensation via visual feedback
- External cueing to bypass defective basal ganglia timing (Correct answer)
- Corticospinal tract override of spinal CPGs
- Proprioceptive substitution for dopaminergic loss
Correct answer: External cueing to bypass defective basal ganglia timing
External rhythmic or visual cues bypass the defective internal timing circuitry of the basal ganglia, enabling more regular stride initiation.
Question 6: Which assessment tool is specifically designed to measure participation and quality of life outcomes in adults with neurological conditions in the US?
- Wechsler Adult Intelligence Scale
- PROMIS Neuro-QoL (Correct answer)
- Unified Parkinson's Disease Rating Scale
- NIH Stroke Scale
Correct answer: PROMIS Neuro-QoL
Neuro-QoL (Quality of Life in Neurological Disorders) is a PROMIS-based measurement system validated for assessing health-related quality of life across neurological conditions.
CNS CNS Neurorehabilitation and Recovery 2
Which gait deviation is most commonly seen in patients with foot drop following peroneal nerve injury?