NCS Intervention Techniques 5

Question 1

When training stair negotiation in a patient with right hemiplegia post-stroke, what is the standard instruction for ascending stairs?

Accepted Answer

Lead with the left (unaffected) leg going up, bearing weight through it on the higher step

Answer

The mnemonic 'up with the good, down with the bad' reflects that the unaffected leg leads ascending so it bears weight on the higher step, protecting the weaker limb.

Question 2

A patient with Friedreich's ataxia has progressive sensory ataxia affecting gait and balance. Which rehabilitation approach has the most evidence for functional improvement?

Accepted Answer

Task-specific balance training with progressive reduction of base of support and manipulation of sensory conditions

Answer

Task-specific balance training with progressive sensory challenges is the most evidence-supported approach for ataxia, improving postural strategies and functional independence.

Question 3

For a patient post-stroke with foot drop and significant mediolateral ankle instability, which AFO design provides the GREATEST mediolateral control?

Accepted Answer

Solid ankle AFO with trimlines extending anterior to the malleoli bilaterally

Answer

A solid ankle AFO with trimlines anterior to the malleoli encapsulates the hindfoot rigidly and provides maximum mediolateral stability compared to more flexible designs.

Question 4

A patient recovering from Guillain-Barré syndrome (5 months post-onset, now 3+/5 strength) reports profound fatigue after therapy. What is the MOST important fatigue management principle in GBS rehabilitation?

Accepted Answer

Pacing activities to balance rest with exercise and strictly avoid overwork weakness

Answer

Overwork weakness is a well-documented risk in GBS; pacing activity and preventing excessive fatigue is the cornerstone of safe rehabilitation to protect recovering peripheral nerves.

Question 5

A patient with right-sided hemiplegia is being fitted with a standard single-point cane. How should the cane be used?

Accepted Answer

Left (unaffected) hand; advance cane simultaneously with the right (affected) leg

Answer

The cane is held in the unaffected hand and advanced with the affected leg to reduce load on the weak hip and provide a widened base of support during affected-limb stance.

(NCS) Neurologic Clinical Specialist Practice Test

(NCS) Neurologic Clinical Specialist Practice Test

NCS Intervention Techniques 5