MES Musculoskeletal Conditions & Special Populations 1 — Questions and Answers
Question 1: Which movement pattern is MOST important to avoid for a client in the early recovery phase after total hip arthroplasty (posterior approach)?
- Hip abduction
- Hip extension
- Hip flexion beyond 90° combined with internal rotation and adduction (Correct answer)
- Ankle dorsiflexion
Correct answer: Hip flexion beyond 90° combined with internal rotation and adduction
The classic posterior approach hip dislocation triad is flexion >90°, adduction past midline, and internal rotation, which must be avoided post-surgery.
Question 2: Which resistance training strategy is most appropriate for a client with active rheumatoid arthritis during a flare?
- High-load eccentric training
- Isometric exercises at comfortable angles (Correct answer)
- Maximum-effort plyometrics
- Heavy free-weight compound lifts
Correct answer: Isometric exercises at comfortable angles
Isometric contractions allow muscle activation without joint movement, minimizing stress on inflamed joints during an RA flare.
Question 3: A client with multiple sclerosis (MS) should be counseled to avoid which environmental factor that commonly worsens symptoms?
- Cold weather
- Low humidity
- Excessive heat (Correct answer)
- Low-altitude exercise
Correct answer: Excessive heat
Uhthoff's phenomenon describes the temporary worsening of MS symptoms with body temperature increase, making heat management critical.
Question 4: Which special population requires absolute avoidance of the Valsalva maneuver during resistance training?
- Trained athletes
- Clients with known intracranial aneurysm or recent stroke (Correct answer)
- Clients with well-controlled hypertension
- Sedentary but healthy older adults
Correct answer: Clients with known intracranial aneurysm or recent stroke
The Valsalva maneuver sharply raises intracranial and intrathoracic pressure, creating extreme danger for those with intracranial aneurysm or recent stroke.
Question 5: For a client with fibromyalgia, which exercise approach is most supported by evidence?
- Complete bed rest during pain episodes
- Low-to-moderate intensity aerobic exercise progressed gradually (Correct answer)
- High-intensity resistance training from the start
- Stretching only, no aerobic exercise
Correct answer: Low-to-moderate intensity aerobic exercise progressed gradually
Gradual low-to-moderate aerobic exercise is the most evidence-based intervention for reducing fibromyalgia pain and fatigue.
Question 6: Which condition is characterized by inflammation of tendons at their bony insertion points and is common in clients with ankylosing spondylitis?
- Synovitis
- Enthesitis (Correct answer)
- Bursitis
- Epicondylitis
Correct answer: Enthesitis
Enthesitis, inflammation at tendon or ligament insertion sites on bone, is a hallmark of ankylosing spondylitis and other spondyloarthropathies.
MES Musculoskeletal Conditions & Special Populations 1
Which movement pattern is MOST important to avoid for a client in the early recovery phase after total hip arthroplasty (posterior approach)?