DPT Orthopedic & Musculoskeletal Therapy 5 — Questions and Answers
Question 1: Which manual therapy technique uses a high-velocity, low-amplitude thrust to restore joint mobility?
- Grade III joint mobilization
- Manipulation (Correct answer)
- Sustained natural apophyseal glide (SNAG)
- Muscle energy technique
Correct answer: Manipulation
Manipulation is defined by a high-velocity, low-amplitude thrust delivered at end range to restore joint mobility and reduce pain via neurophysiological mechanisms.
Question 2: A patient presents with medial knee pain, joint line tenderness, and a positive McMurray test with a thud on external rotation. What structure is injured?
- Lateral meniscus
- Medial collateral ligament
- Medial meniscus (Correct answer)
- Posterior cruciate ligament
Correct answer: Medial meniscus
McMurray's test with external tibial rotation and valgus stress targets the medial meniscus; a palpable click or thud at the medial joint line indicates a medial meniscal tear.
Question 3: In grading manual muscle testing, which grade indicates active movement against gravity but NOT against any additional resistance?
- Grade 2
- Grade 3 (Correct answer)
- Grade 4
- Grade 5
Correct answer: Grade 3
Grade 3 (Fair) in manual muscle testing denotes active full range of motion against gravity but inability to tolerate any additional resistance.
Question 4: Which of the following is the MOST appropriate initial intervention for acute CRPS (Complex Regional Pain Syndrome) Type I of the upper extremity?
- Aggressive joint mobilization and strengthening
- Graded motor imagery and desensitization (Correct answer)
- Complete immobilization and splinting
- High-intensity electrical stimulation
Correct answer: Graded motor imagery and desensitization
Graded motor imagery and desensitization are first-line PT interventions for CRPS, targeting central sensitization without provoking pain flares.
Question 5: The Q-angle is measured between the quadriceps line of pull and the patellar tendon. An elevated Q-angle increases risk of:
- Medial patellar subluxation
- Lateral patellar subluxation and patellofemoral pain (Correct answer)
- Posterior patellar impingement
- Patellar tendon rupture
Correct answer: Lateral patellar subluxation and patellofemoral pain
An increased Q-angle creates a lateral pull vector on the patella, predisposing to lateral patellar subluxation and patellofemoral pain syndrome.
Question 6: Which test assesses the integrity of the transverse ligament of the atlas at the C1-C2 articulation?
- Vertebral artery test
- Sharp-Purser test (Correct answer)
- Alar ligament stress test
- Spurling's test
Correct answer: Sharp-Purser test
The Sharp-Purser test assesses transverse ligament integrity by applying a posterior force to the forehead while stabilizing C2; excessive translation indicates laxity.
Question 7: A patient recovering from total knee arthroplasty at 6 weeks post-op has 85° of knee flexion. Which intervention is MOST appropriate to improve ROM at this stage?
- Continuous passive motion machine only
- Aggressive manipulation under anesthesia
- Progressive active-assisted range of motion and joint mobilization (Correct answer)
- Complete rest to allow further healing
Correct answer: Progressive active-assisted range of motion and joint mobilization
At 6 weeks post-TKA, progressive active-assisted ROM combined with Grade III/IV joint mobilization is appropriate to improve flexion before scar tissue matures.
DPT Orthopedic & Musculoskeletal Therapy 5
Which manual therapy technique uses a high-velocity, low-amplitude thrust to restore joint mobility?