OTR Therapeutic Interventions & Techniques 4 — Questions and Answers
Question 1: Which splinting position is recommended for a patient at risk for intrinsic-minus deformity of the hand?
- Wrist neutral, MCP extension, IP flexion
- Wrist extension, MCP flexion, IP extension (intrinsic-plus position) (Correct answer)
- Wrist flexion, all digits in full extension
- Thumb opposition with all fingers extended
Correct answer: Wrist extension, MCP flexion, IP extension (intrinsic-plus position)
The intrinsic-plus (safe) position maintains MCP flexion and IP extension to preserve collateral ligament length and prevent deformity.
Question 2: An OTR is implementing cognitive rehabilitation with a TBI patient using errorless learning. What is the core feature of this technique?
- Allowing the patient to make errors and self-correct for deeper learning
- Structuring the environment so the patient succeeds without making errors during acquisition (Correct answer)
- Using trial-and-error to test memory consolidation
- Providing no feedback so the patient develops internal error monitoring
Correct answer: Structuring the environment so the patient succeeds without making errors during acquisition
Errorless learning prevents incorrect responses during skill acquisition because people with memory impairments cannot easily suppress erroneous responses they have practiced.
Question 3: When fabricating a dorsal blocking splint after flexor tendon repair (Zone II), what position should be maintained?
- Wrist extension 30°, MCPs in extension, IPs in extension
- Wrist flexion 20-30°, MCPs flexion 60-70°, IPs in full extension (Correct answer)
- Wrist neutral, all joints at 0°
- Wrist flexion 45°, all digits fully flexed
Correct answer: Wrist flexion 20-30°, MCPs flexion 60-70°, IPs in full extension
A dorsal blocking splint for Zone II flexor tendon repairs maintains wrist and MCP flexion while allowing IP extension to protect the repair under reduced tension.
Question 4: Which intervention strategy is BEST aligned with the Recovery Model for a patient with serious mental illness?
- Focusing treatment solely on symptom reduction
- Supporting the client's self-determined goals and meaningful roles despite ongoing symptoms (Correct answer)
- Providing structured activity to prevent relapse
- Prioritizing medication adherence above occupational participation
Correct answer: Supporting the client's self-determined goals and meaningful roles despite ongoing symptoms
The Recovery Model emphasizes hope, self-determination, and meaningful community participation regardless of symptom status.
Question 5: A patient with Parkinson's disease is having difficulty initiating gait. Which cueing strategy is MOST evidence-based?
- Verbal reminders to 'think about walking'
- Rhythmic auditory stimulation (e.g., metronome or music) to initiate and regulate gait (Correct answer)
- Ankle weights to increase proprioceptive feedback
- Reducing distractions in the environment only
Correct answer: Rhythmic auditory stimulation (e.g., metronome or music) to initiate and regulate gait
Rhythmic auditory stimulation bypasses defective basal ganglia timing circuits and has strong evidence for improving gait initiation in Parkinson's disease.
Question 6: In hand therapy, which test is used specifically to evaluate two-point discrimination and tactile spatial acuity?
- Semmes-Weinstein monofilament test
- Disk-Criminator or static/moving two-point discrimination test (Correct answer)
- Purdue Pegboard Test
- Grip dynamometry
Correct answer: Disk-Criminator or static/moving two-point discrimination test
Static and moving two-point discrimination tests measure the minimum distance at which a patient can distinguish two simultaneous points of contact on the skin.
Question 7: An OTR is treating a child with developmental coordination disorder (DCD). Which intervention approach has the strongest evidence base?
- Sensory integration therapy focusing on vestibular input
- Task-oriented approach using motor learning principles and practice of functional tasks (Correct answer)
- Neurodevelopmental treatment to normalize tone
- Passive stretching and strengthening programs
Correct answer: Task-oriented approach using motor learning principles and practice of functional tasks
Task-oriented approaches using ecological and motor learning principles have the most evidence for improving motor performance in children with DCD.
OTR Therapeutic Interventions & Techniques 4
Which splinting position is recommended for a patient at risk for intrinsic-minus deformity of the hand?