DPT Neurological Rehabilitation 5

Question 1

A patient post-stroke demonstrates synergistic movement patterns in the upper extremity. During the Fugl-Meyer assessment, elbow flexion occurs automatically when the patient attempts shoulder abduction. Which stage of Brunnstrom recovery BEST describes this?

Accepted Answer

Stage 3 — spasticity at peak with full flexion synergy

Answer

Brunnstrom Stage 3 is characterized by peak spasticity and the ability to voluntarily produce limb synergies in their entirety, with strong coupling of synergy components.

Question 2

Which clinical test BEST differentiates a central cause from a peripheral cause of vertigo?

Accepted Answer

Head Impulse Test (HIT) — a normal HIT with vertigo suggests a central etiology

Answer

A normal head impulse test (no corrective saccade) in a patient with acute vertigo and nystagmus is a red flag for central pathology, as peripheral lesions typically produce a catch-up saccade.

Question 3

A patient with incomplete cervical SCI demonstrates central cord syndrome. Which functional recovery pattern is MOST expected?

Accepted Answer

Lower extremities recover before upper extremities, with hand function recovering last

Answer

In central cord syndrome, the cervical tracts are more centrally located; leg function (peripheral fibers) typically recovers first, while arm and hand function (central fibers) recover later or incompletely.

Question 4

Which sensory retraining technique is MOST appropriate for a patient with hypersensitivity (allodynia) following peripheral nerve repair?

Accepted Answer

Desensitization using graded textures from least to most stimulating

Answer

Desensitization using graded textures progressively habituates the nervous system to stimuli that were previously perceived as painful, reducing allodynia after nerve repair.

Question 5

A DPT is working with a patient post-TBI who demonstrates impaired dual-task performance. Which approach BEST addresses this deficit during functional training?

Accepted Answer

Progressively add cognitive tasks (e.g., counting backwards) during motor activities

Answer

Dual-task training that progressively combines motor and cognitive demands reflects real-world requirements and has evidence for improving performance in both domains after TBI.

(DPT) Board Certified Doctor of Physical Therapy Practice Test

(DPT) Board Certified Doctor of Physical Therapy Practice Test

DPT Neurological Rehabilitation 5