NCS Intervention Techniques 4

Question 1

Constraint-induced movement therapy (CIMT) is MOST appropriate for which patient?

Accepted Answer

A patient with at least 10° active wrist extension and 10° active finger extension in the affected hand

Answer

A patient with 0/5 strength in the affected hand and no active finger movement 2 weeks post-stroke

Answer

A patient in the hyperacute phase (<2 weeks) post-stroke with significant edema and shoulder pain

Answer

A patient with bilateral upper extremity involvement from bilateral hemispheric strokes

Question 2

Mirror therapy for upper extremity rehabilitation post-stroke is hypothesized to improve motor function primarily through which mechanism?

Accepted Answer

Activation of mirror neuron systems and promotion of motor cortex reorganization

Answer

Direct strengthening of paretic muscles via visual biofeedback of effort level

Answer

Reduction of spasticity through visual inhibition of stretch reflex pathways

Answer

Improvement of proprioceptive accuracy in the affected limb through visual substitution

Question 3

When incorporating motor imagery as an adjunct to physical therapy post-stroke, what is the optimal way to use it?

Accepted Answer

In conjunction with physical practice sessions to amplify cortical activation and motor learning

Answer

Only during the chronic phase when motor recovery has reached a plateau

Answer

As a complete replacement for physical practice in patients who are easily fatigued

Answer

With eyes closed only, since visual input interferes with accurate internal movement representation

Question 4

A patient with MS is participating in an aerobic exercise program. Which principle is MOST critical to prevent Uhthoff's phenomenon?

Accepted Answer

Monitoring core body temperature and employing pre-cooling or cooling strategies to prevent overheating

Answer

Limiting all exercise sessions to a maximum of 15 minutes regardless of intensity

Answer

Avoiding all aerobic exercise due to the risk of symptom exacerbation

Answer

Scheduling exercise exclusively in the morning when ambient and body temperatures are lowest

Question 5

During harness-supported treadmill locomotor training for a patient with incomplete SCI, what is the PRIMARY role of manual leg trainers?

Accepted Answer

To facilitate appropriate swing and stance phase kinematics to optimize sensory input to spinal locomotor networks

Answer

To provide passive range of motion to maintain joint flexibility during stepping

Answer

To support body weight to reduce loading stress on articular cartilage

Answer

To prevent falls by physically holding the patient's legs throughout the gait cycle

Question 6

A patient with Parkinson's disease experiences significant motor 'off' periods in the morning before medications take effect. When should the physical therapist schedule the most demanding exercise sessions?

Accepted Answer

During medication 'on' periods when dopaminergic drive maximizes motor performance

Answer

During 'off' periods to challenge motor adaptation under worst-case conditions

Answer

At a fixed time each day regardless of medication timing for behavioral consistency

Answer

In the late evening after all daily medication doses have been administered

Question 7

A patient with incomplete cervical SCI (ASIA C, C6 level) is learning manual wheelchair propulsion. What is the most appropriate training approach to build propulsion endurance?

Accepted Answer

Interval training on an arm ergometer at 60–70% heart rate reserve

Answer

Upper extremity progressive resistance training with biceps curls and shoulder press

Answer

Passive shoulder stretching to maintain ROM required for propulsion mechanics

Answer

NMES to the triceps during propulsion to supplement push-phase force