Patient Management Flashcards

A patient with ALS demonstrates dysphagia and reduced respiratory reserve. Which team member should the PT PRIMARILY coordinate with regarding positioning to optimize both swallowing and breathing?

Answer: Speech-language pathologist and respiratory therapist

In ALS, swallowing safety (SLP domain) and respiratory muscle weakness (RT domain) both influence optimal postural positioning, requiring coordinated collaboration between these two specialists.

Which gait parameter is MOST sensitive to detecting early balance impairment in patients with Parkinson's disease?

Answer: Step width variability

Increased step width variability reflects anticipatory postural control deficits and is among the earliest and most sensitive gait markers for balance impairment in Parkinson's disease.

A patient with C6 ASIA B SCI is being educated on skin integrity. What is the MINIMUM recommended frequency for pressure relief when seated in a wheelchair?

Answer: Every 15–30 minutes

Current SCI clinical guidelines recommend weight shifts or pressure relief maneuvers every 15–30 minutes while seated to prevent ischemic tissue damage.

During gait analysis of a patient with foot drop from peroneal nerve palsy, which compensatory strategy is MOST commonly observed?

Answer: Hip hiking and circumduction

Hip hiking with circumduction is the classic compensatory gait deviation for foot drop, allowing toe clearance during swing phase in the absence of dorsiflexion.

A PT is treating a patient with vestibular neuritis. Which intervention approach is MOST appropriate in the acute phase (first 3 days)?

Answer: Bed rest with vestibular suppressants and gradual mobilization

In the acute phase of vestibular neuritis, bed rest with vestibular suppressants followed by gradual mobilization as tolerated is recommended; aggressive rehabilitation is contraindicated until the acute inflammatory phase subsides.

When measuring spasticity in a patient with multiple sclerosis, which scale quantifies resistance to passive movement across a velocity spectrum?

Answer: Tardieu Scale

The Tardieu Scale assesses spasticity at both slow and fast velocities, capturing the velocity-dependent nature of spastic resistance that the Modified Ashworth Scale cannot distinguish.

A post-stroke patient exhibits pusher syndrome (ipsilateral pushing). Which intervention strategy is MOST evidence-supported for this condition?

Answer: Visual and verbal feedback about true vertical orientation during weight transfer

Pusher syndrome is driven by a misperception of body vertical; evidence supports using visual references (mirrors, plumb lines) and verbal feedback during upright tasks to recalibrate vertical perception.