Neuromuscular System Interventions Flashcards

A patient with stroke has difficulty initiating voluntary movement. Which PNF technique is MOST appropriate to address this impairment?

Answer: Rhythmic initiation

Rhythmic initiation progresses from passive to active assistive to active movement, teaching the motor pattern to patients who cannot initiate movement voluntarily.

Which motor learning feedback schedule produces the BEST long-term retention of a motor skill in neurological rehabilitation?

Answer: Faded feedback with reduced frequency over time

Faded feedback (reducing frequency over time) promotes retention because it prevents dependency and forces the patient to self-evaluate, consistent with the guidance hypothesis.

Neuromuscular electrical stimulation (NMES) produces its strongest therapeutic effect in which patient population?

Answer: Upper motor neuron lesion with intact peripheral nerve and some volitional control

NMES requires an intact lower motor neuron (peripheral nerve) and is most effective when combined with voluntary effort, making it ideal for upper motor neuron lesions.

During motor skill acquisition, random practice of multiple tasks is preferred over blocked practice because of which effect?

Answer: Contextual interference from random practice enhances long-term retention and transfer

The contextual interference effect demonstrates that the cognitive effort required during random practice leads to superior retention and transfer compared to blocked practice.

Surface EMG biofeedback is used with a post-stroke patient. What is the PRIMARY therapeutic goal?

Answer: Provide real-time sensory information to facilitate volitional muscle activation

EMG biofeedback gives patients visual or auditory representation of muscle activity, helping them learn to volitionally activate muscles that they may not be able to sense or control.

Which duty cycle parameter in NMES is MOST directly adjusted to manage muscle fatigue during functional electrical stimulation training?

Answer: On-to-off time ratio

The duty cycle (on:off ratio) determines how long the muscle is actively contracting versus resting; longer off times reduce fatigue during repetitive NMES-assisted movement.

A therapist uses PNF rhythmic stabilization at the shoulder for a patient with rotator cuff weakness post-neurological injury. What is the PRIMARY physiological mechanism?

Answer: Facilitating co-contraction of agonist and antagonist muscles via alternating isometric resistance

Rhythmic stabilization uses alternating isometric resistance to both agonist and antagonist, promoting dynamic joint stability through simultaneous co-contraction.

A patient with unilateral vestibular hypofunction is prescribed gaze stabilization exercises. What is the PRIMARY mechanism of these exercises?

Answer: Promoting adaptation of the vestibulo-ocular reflex (VOR)

Gaze stabilization exercises (head moving while eyes stay fixed on a target) drive VOR adaptation so the brain recalibrates the reflex to compensate for vestibular hypofunction.

The Epley canalith repositioning maneuver is the first-line treatment for which condition?

Answer: Posterior canal BPPV causing brief positional vertigo

The Epley maneuver uses gravity and head positioning to move displaced otoconia from the posterior semicircular canal back into the utricle, resolving posterior canal BPPV.

During treadmill training with body weight support (BWS) for a patient with incomplete SCI, which variable should be PROGRESSIVELY reduced as the patient improves?

Answer: Percentage of body weight supported

BWS is systematically decreased (often starting at 30–40% support) as the patient gains strength and motor control, progressively loading the lower extremities toward full weight-bearing.

A patient with Parkinson's disease benefits from rhythmic auditory stimulation (RAS) during gait training. What is the PRIMARY mechanism?

Answer: External auditory rhythm substitutes for impaired internal timing from basal ganglia dysfunction

Parkinson's disease impairs internal rhythm generation in the basal ganglia; an external metronome or musical beat provides a substitute timing signal that the motor system can lock onto.

Which intervention has the STRONGEST evidence for producing long-term functional improvement in patients with upper motor neuron spasticity?

Answer: Task-specific training emphasizing active movement

Task-specific training drives neuroplasticity and functional carry-over; while stretching and modalities can temporarily reduce tone, active task practice produces the most durable functional gains.

What is the OPTIMAL period to initiate neuromuscular re-education following peripheral nerve repair surgery?

Answer: When early clinical or EMG signs of reinnervation appear, typically 3 or more months post-repair

Re-education begins when reinnervation is detected (early voluntary signals or EMG activity) so the patient can practice facilitating the newly reconnected motor units before full recovery.

When positioning a patient with SCI who has lower extremity flexor spasticity at night, which position BEST counteracts the spastic pattern?

Answer: Hip extension, knee extension, and ankle in neutral with a splint

Anti-spasticity positioning places joints in the opposite direction of the dominant spastic pattern; prolonged positioning in extension counteracts lower extremity flexor spasms.

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

Answer: Chronic stroke with at least 10° of active wrist extension in the paretic limb

CIMT eligibility requires sufficient residual motor function (typically ≥10° wrist extension and ≥10° finger extension) to perform mass practice; complete hemiplegia does not meet this threshold.

The Bobath (NDT) approach primarily aims to achieve which therapeutic outcome?

Answer: Inhibition of abnormal tone and facilitation of normal movement patterns through handling

NDT focuses on normalizing postural tone and facilitating typical movement patterns through therapist handling, key points of control, and preparation of the neuromuscular system.

Current evidence MOST strongly supports which intervention for improving upper extremity function in chronic stroke?

Answer: High-intensity, task-specific repetitive practice

Systematic reviews consistently show that high-dose, task-specific, repetitive practice drives cortical reorganization and produces the greatest functional gains in chronic stroke rehabilitation.

A patient with cerebellar ataxia and coordination deficits is treated with Frenkel's exercises. What is the PRIMARY mechanism of this approach?

Answer: Visual compensation and cognitive attention to substitute for impaired cerebellar error correction

Frenkel's exercises use careful visual attention and slow, graded movement to teach patients to substitute visual and cognitive feedback for lost cerebellar coordination.

Mirror therapy for upper extremity rehabilitation after stroke is thought to work through which PRIMARY mechanism?

Answer: Activating mirror neurons and creating an illusion of paretic limb movement to drive neuroplasticity

Mirror therapy creates a visual illusion of bilateral movement; this activates mirror neuron systems and premotor cortex of the affected hemisphere, promoting cortical reorganization.

Which outcome measure is MOST appropriate for assessing balance and fall risk across a broad range of neurological diagnoses?

Answer: Berg Balance Scale (BBS)

The Berg Balance Scale assesses static and dynamic balance through 14 functional tasks and has strong validity and reliability as a fall-risk predictor in neurological populations.