OCS Rehabilitation & Therapeutic Interventions 3 — Questions and Answers
Question 1: A 45-year-old with adhesive capsulitis is in the freezing phase. Which intervention is most appropriate?
- Pain-free ROM and modalities for pain control (Correct answer)
- Aggressive joint mobilizations grade IV+
- Immediate strengthening of the rotator cuff
- Resistive exercises through full range
Correct answer: Pain-free ROM and modalities for pain control
During the freezing phase of adhesive capsulitis, pain management and maintaining available ROM through gentle, pain-free exercise is the priority to avoid aggravating the inflammatory process.
Question 2: Which proprioceptive exercise progression is most appropriate for a patient in early ACL reconstruction rehabilitation (weeks 2–6)?
- Single-leg balance on a foam pad with eyes open, progressing to eyes closed (Correct answer)
- Lateral plyometric hops between cones
- Full-speed cutting drills on a field
- Single-leg squats at 90 degrees knee flexion
Correct answer: Single-leg balance on a foam pad with eyes open, progressing to eyes closed
Early proprioceptive training after ACL reconstruction begins with low-demand balance challenges such as single-leg stance on unstable surfaces, progressed by removing visual input.
Question 3: Maitland Grade II joint mobilizations are best described as:
- Large-amplitude oscillations that do not reach end range (Correct answer)
- Small-amplitude oscillations at end range
- High-velocity thrusts through resistance
- Sustained end-range stretching
Correct answer: Large-amplitude oscillations that do not reach end range
Maitland Grade II mobilizations are large-amplitude oscillations performed within the mid-range of joint motion, primarily used for pain modulation.
Question 4: A patient with lateral epicondylalgia demonstrates wrist extensor weakness. Which exercise is most evidence-supported for this condition?
- Eccentric wrist extension with a dumbbell (Correct answer)
- Passive wrist flexion stretching only
- Hot pack application to the lateral elbow
- Ultrasound phonophoresis with cortisone
Correct answer: Eccentric wrist extension with a dumbbell
Eccentric wrist extension exercises load the common extensor tendon and have strong evidence for reducing pain and improving strength in lateral epicondylalgia.
Question 5: Which clinical finding best indicates that a patient's lumbar stabilization exercise program should progress from Stage I (supine) to Stage II (quadruped)?
- Ability to maintain neutral spine during lower extremity loading in supine (Correct answer)
- Pain-free passive range of motion in all directions
- Normal hamstring flexibility bilaterally
- Negative straight leg raise test
Correct answer: Ability to maintain neutral spine during lower extremity loading in supine
Progression to Stage II quadruped exercises is warranted when the patient demonstrates the ability to maintain a neutral lumbar spine under limb loading in the supine position.
Question 6: Which intervention is the FIRST priority for a patient presenting with acute compartment syndrome following a tibial fracture?
- Immediate surgical fasciotomy referral (Correct answer)
- Elevation of the limb above heart level
- Application of ice and compression
- Aggressive active range of motion exercise
Correct answer: Immediate surgical fasciotomy referral
Acute compartment syndrome is a surgical emergency; immediate referral for fasciotomy is required to decompress the compartment and prevent neurovascular damage.
Question 7: A therapist uses iontophoresis with dexamethasone for a patient with plantar fasciitis. Which electrode should carry the dexamethasone?
- Negative electrode (cathode), as dexamethasone is negatively charged (Correct answer)
- Positive electrode (anode), as dexamethasone is positively charged
- Either electrode based on skin condition
- The dispersive electrode regardless of charge
Correct answer: Negative electrode (cathode), as dexamethasone is negatively charged
Dexamethasone is a negatively charged ion and is therefore driven into the tissue from the negative electrode (cathode) during iontophoresis.
OCS Rehabilitation & Therapeutic Interventions 3
A 45-year-old with adhesive capsulitis is in the freezing phase.
Which intervention is most appropriate?