NCS Patient Management 2 — Questions and Answers
Question 1: A patient with Parkinson's disease demonstrates freezing of gait when approaching a doorway. Which cueing strategy is MOST evidence-based for immediate gait initiation?
- Verbal counting cadence
- Rhythmic auditory stimulation with a metronome
- Visual transverse line cues on the floor (Correct answer)
- Tactile cues on the hip
Correct answer: Visual transverse line cues on the floor
Transverse visual floor cues (lines or stripes) are the most evidence-supported strategy specifically for triggering gait initiation and overcoming freezing episodes at thresholds.
Question 2: During the Berg Balance Scale, a patient can pick up a shoe from the floor but requires two attempts and loses balance momentarily. What score should be recorded for that item?
- 0
- 1
- 2 (Correct answer)
- 3
Correct answer: 2
A score of 2 is assigned when the patient is able to pick up the item but requires supervision due to loss of balance or instability during the task.
Question 3: A neurological patient has a goal to ascend stairs independently. Which clinical finding would MOST indicate readiness to progress to unassisted stair training?
- Ability to perform 10 consecutive sit-to-stands in under 30 seconds
- Single-limb stance on the affected leg for at least 5 seconds (Correct answer)
- Hip flexion strength of 3/5 on MMT
- Functional reach of 6 inches
Correct answer: Single-limb stance on the affected leg for at least 5 seconds
Single-limb stance of at least 5 seconds indicates the weight-bearing control and balance necessary for safe stair negotiation with alternating step pattern.
Question 4: A patient post-stroke has global aphasia. When setting goals with this patient, which approach BEST supports patient-centered care?
- Setting goals based solely on family input
- Using low-tech AAC boards with symbols and yes/no responses (Correct answer)
- Deferring all goal-setting to the interdisciplinary team
- Conducting standardized written preference surveys
Correct answer: Using low-tech AAC boards with symbols and yes/no responses
Low-tech AAC (augmentative and alternative communication) tools such as picture or symbol boards allow patients with global aphasia to express preferences and participate meaningfully in goal-setting.
Question 5: Which outcome measure is MOST appropriate for tracking community ambulation capacity in a patient recovering from traumatic brain injury?
- Timed Up and Go (TUG)
- 6-Minute Walk Test (6MWT) (Correct answer)
- Dynamic Gait Index (DGI)
- 10-Meter Walk Test (10MWT)
Correct answer: 6-Minute Walk Test (6MWT)
The 6MWT measures walking endurance over a functional distance, directly reflecting the cardiovascular and neuromuscular demands of community-level ambulation.
Question 6: A PT is treating a patient with multiple sclerosis who reports significantly worse fatigue after the last two therapy sessions. Which modification is MOST appropriate?
- Discontinue aerobic training entirely
- Schedule therapy in the afternoon to allow morning rest
- Reduce session intensity and incorporate planned rest periods (Correct answer)
- Refer immediately to neurology for medication adjustment
Correct answer: Reduce session intensity and incorporate planned rest periods
For MS-related fatigue exacerbated by therapy, reducing intensity and incorporating structured rest breaks within sessions is the first-line clinical modification to manage Uhthoff's phenomenon and energy conservation.
Question 7: A patient with C5 ASIA A spinal cord injury wants to independently drive a power wheelchair. Which component is the MOST critical for this goal?
- Intact wrist extension strength
- Adequate head control and neck motor function (Correct answer)
- Functional hand grip
- Elbow flexion strength of 4/5
Correct answer: Adequate head control and neck motor function
A patient with C5 ASIA A injury lacks voluntary hand and wrist control, so head-array or chin-drive controls relying on head control are the primary access method for independent power wheelchair operation.
NCS Patient Management 2
A patient with Parkinson's disease demonstrates freezing of gait when approaching a doorway.
Which cueing strategy is MOST evidence-based for immediate gait initiation?