Patient Management Flashcards

A patient with amyotrophic lateral sclerosis (ALS) is transitioning from ambulatory to non-ambulatory status. Which functional goal is MOST appropriate at this stage?

Answer: Safe power wheelchair mobility and transfer training with caregiver education

As ALS patients transition to non-ambulatory status, goals shift to maximizing independence in power mobility and ensuring safe transfers with trained caregivers, reflecting realistic functional priorities.

Which clinical measure has the STRONGEST evidence for predicting future fall risk in community-dwelling older adults with neurological conditions?

Answer: Timed Up and Go (TUG) test taking longer than 12 seconds

A TUG time greater than 12 seconds has robust validation data across neurological and older adult populations as a threshold predictive of increased fall risk in community settings.

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

Answer: Lower extremity function recovers before upper extremity

In central cord syndrome, the corticospinal tract fibers serving the lower extremities are anatomically more peripheral than those serving the upper extremities, so lower extremity recovery typically precedes upper extremity recovery.

A PT is developing a home exercise program for a patient with mild TBI and persistent post-concussion symptoms. Which activity is MOST appropriate to include initially?

Answer: Sub-symptom-threshold aerobic exercise

Sub-symptom-threshold aerobic exercise is the evidence-based approach for post-concussion syndrome, maintaining activity below the intensity that provokes symptoms while promoting recovery.

A patient with Huntington's disease begins to exhibit significant chorea affecting seated balance. Which seating modification is the HIGHEST priority?

Answer: Providing lateral trunk supports and anti-thrust seat positioning

Lateral trunk supports and an anti-thrust seat configuration provide postural containment to counteract involuntary choreiform movements that destabilize seated posture.

Which principle of neuroplasticity BEST supports incorporating task-specific training in high repetitions during stroke rehabilitation?

Answer: Specificity principle combined with repetition-dependent plasticity

The specificity principle ensures training gains transfer to the practiced task, while repetition-dependent plasticity demonstrates that synaptic strengthening and cortical map reorganization require large numbers of repetitions.

A neurological PT receives a referral for a patient with new diplopia, ataxia, and dysarthria. Which condition should be prioritized in the differential and screened for BEFORE initiating vestibular rehabilitation?

Answer: Vertebrobasilar insufficiency or posterior fossa pathology

The triad of diplopia, ataxia, and dysarthria suggests posterior fossa or brainstem pathology, including vertebrobasilar insufficiency or stroke, which must be ruled out before any vestibular or movement-based intervention.