DPT Geriatric Rehabilitation 3 — Questions and Answers
Question 1: A PT is evaluating sarcopenia in an 80-year-old male. Which finding is MOST consistent with this diagnosis?
- Increased fat-free mass with decreased grip strength
- Low muscle mass combined with reduced muscle strength or physical performance (Correct answer)
- Elevated BMI with preserved functional mobility
- Decreased bone mineral density with normal muscle mass
Correct answer: Low muscle mass combined with reduced muscle strength or physical performance
Sarcopenia is defined by the combination of low muscle mass with reduced muscle strength or physical performance, per the EWGSOP2 consensus criteria.
Question 2: Which type of exercise has the STRONGEST evidence for preventing bone loss and reducing fracture risk in postmenopausal women?
- Swimming
- Progressive resistance training and weight-bearing aerobic exercise (Correct answer)
- Seated stretching exercises
- Low-intensity cycling
Correct answer: Progressive resistance training and weight-bearing aerobic exercise
Progressive resistance training combined with weight-bearing aerobic exercise generates osteogenic mechanical loads that stimulate bone formation and reduce fracture risk.
Question 3: A 76-year-old woman reports urinary leakage when coughing and sneezing. Which intervention is FIRST-LINE for stress urinary incontinence in this population?
- Bladder training with scheduled voiding
- Pelvic floor muscle training (Kegel exercises) (Correct answer)
- Biofeedback electrostimulation
- Recommending incontinence pads
Correct answer: Pelvic floor muscle training (Kegel exercises)
Pelvic floor muscle training is the recommended first-line conservative treatment for stress urinary incontinence due to its high efficacy and low risk.
Question 4: Which modified fall prevention protocol is RECOMMENDED for an older adult with a recent fall AND a cardiac pacemaker?
- High-intensity interval training on a treadmill
- Supervised low-to-moderate intensity balance and strengthening exercises avoiding electromagnetic devices (Correct answer)
- Tai Chi classes in a community gym unsupervised
- Aggressive TENS application to lower extremities
Correct answer: Supervised low-to-moderate intensity balance and strengthening exercises avoiding electromagnetic devices
Low-to-moderate intensity supervised exercise is safe for pacemaker patients; high-intensity protocols and certain electrical modalities carry device-interference risks.
Question 5: In the context of geriatric rehabilitation, 'frailty' is BEST characterized by which clinical phenotype?
- Presence of three or more chronic diseases
- Unintentional weight loss, exhaustion, weakness, slow gait, and low physical activity (Correct answer)
- Age above 85 with any degree of functional decline
- Dependency in all basic activities of daily living
Correct answer: Unintentional weight loss, exhaustion, weakness, slow gait, and low physical activity
Fried's frailty phenotype defines frailty as the presence of ≥3 of five criteria: weight loss, exhaustion, weakness, slow gait, and low physical activity.
Question 6: A PT notes that an 84-year-old patient's resting heart rate is 48 bpm and does not increase appropriately with exercise. Which condition MOST likely explains this finding?
- Deconditioning
- Sick sinus syndrome (Correct answer)
- Autonomic neuropathy
- Normal aging-related chronotropic response
Correct answer: Sick sinus syndrome
Sick sinus syndrome (sinoatrial node dysfunction) causes bradycardia and chronotropic incompetence, meaning the heart rate fails to rise appropriately with exercise.
Question 7: Which assessment tool uses performance-based tasks including standing from a chair, 10-foot walk, and one-leg stance to measure physical function in older adults?
- Barthel Index
- Short Physical Performance Battery (SPPB) (Correct answer)
- Katz ADL Scale
- Functional Independence Measure (FIM)
Correct answer: Short Physical Performance Battery (SPPB)
The SPPB combines balance tests, a 4-meter gait speed test, and five chair stands to provide a composite score (0–12) of lower extremity function.
DPT Geriatric Rehabilitation 3
A PT is evaluating sarcopenia in an 80-year-old male.
Which finding is MOST consistent with this diagnosis?