DPT Therapeutic Interventions & Techniques 5 — Questions and Answers
Question 1: During eccentric muscle training, which physiological advantage makes it superior to concentric training for tendon rehabilitation?
- Greater metabolic cost per repetition
- Higher mechanical tension promoting collagen synthesis in the tendon (Correct answer)
- Greater motor unit recruitment at lower loads
- Reduced delayed-onset muscle soreness (DOMS)
Correct answer: Higher mechanical tension promoting collagen synthesis in the tendon
Eccentric loading generates higher tensile forces within the tendon, which stimulates tenocytes to produce collagen and remodel the tendon's structural integrity.
Question 2: A therapist applies continuous ultrasound at 1 MHz with 1.5 W/cm² for 8 minutes over scar tissue. The PRIMARY therapeutic goal of these parameters is:
- Pain relief via thermal analgesia
- Tissue heating to increase extensibility and promote remodeling (Correct answer)
- Cavitation for breaking down calcifications
- Non-thermal stimulation of cell membranes
Correct answer: Tissue heating to increase extensibility and promote remodeling
Continuous ultrasound at these parameters produces significant thermal effects, elevating tissue temperature to improve collagen extensibility and promote remodeling of scar tissue.
Question 3: Which manual therapy intervention is BEST supported by evidence for reducing pain and improving function in patients with hip osteoarthritis?
- High-velocity lumbar manipulation
- Long-axis distraction and anterior-posterior glides of the hip (Correct answer)
- Sacroiliac joint manipulation
- Patellofemoral joint mobilization
Correct answer: Long-axis distraction and anterior-posterior glides of the hip
Long-axis distraction and AP glides of the hip directly address intra-articular restrictions and capsular tightness, which is well-supported in clinical guidelines for hip OA.
Question 4: A patient with hemiplegia is being treated using the Bobath (NDT) approach. The concept of 'key points of control' refers to:
- Joints where spasticity is highest
- Proximal body segments used to influence distal tone and movement patterns (Correct answer)
- External supports like orthotics applied at key joints
- Pain points targeted during soft tissue mobilization
Correct answer: Proximal body segments used to influence distal tone and movement patterns
NDT key points of control are proximal body regions (e.g., shoulder girdle, pelvis) through which the therapist can modulate tone and facilitate normal movement distally.
Question 5: Which parameter adjustment would INCREASE the depth of tissue heating when using shortwave diathermy?
- Switching from inductive coil to capacitive plate electrodes placed farther apart
- Decreasing treatment duration
- Increasing pad separation in capacitive application (Correct answer)
- Using a lower frequency carrier wave
Correct answer: Increasing pad separation in capacitive application
In capacitive shortwave diathermy, increasing electrode separation concentrates the electric field in deeper tissues relative to subcutaneous fat, improving depth of heating.
Question 6: A therapist is treating a patient post-ACL reconstruction using blood flow restriction (BFR) training. What is the primary rationale for using BFR at low loads (20–30% 1RM)?
- To prevent cardiovascular overload
- To accumulate metabolic byproducts that stimulate high-threshold motor unit recruitment and hypertrophy (Correct answer)
- To reduce joint compressive forces to zero
- To increase local oxygen delivery to the muscle
Correct answer: To accumulate metabolic byproducts that stimulate high-threshold motor unit recruitment and hypertrophy
BFR occludes venous return, causing metabolite accumulation (lactate, H+) that fatigues low-threshold units and recruits high-threshold fibers, producing hypertrophy at loads safe for healing tissue.
Question 7: Which therapeutic positioning strategy is MOST effective for preventing hip flexion contracture in a patient following transfemoral (above-knee) amputation?
- Elevating the residual limb on a pillow at night
- Prone lying for at least 30 minutes twice daily (Correct answer)
- Seated positioning with the hip at 90 degrees
- Side-lying on the amputated side
Correct answer: Prone lying for at least 30 minutes twice daily
Prone lying extends the residual limb hip fully, counteracting the hip flexion forces from prolonged sitting and preventing contracture that would compromise prosthetic alignment.
DPT Therapeutic Interventions & Techniques 5
During eccentric muscle training, which physiological advantage makes it superior to concentric training for tendon rehabilitation?