PCE PCE Cardiopulmonary and Special Populations 3 — Questions and Answers
Question 1: A physiotherapist is treating a patient with Parkinson's disease. Which exercise approach has the strongest evidence for improving gait and motor function?
- Complete rest and avoidance of physical activity
- Treadmill training with or without body weight support (Correct answer)
- Passive range of motion only by the therapist
- Breath-holding exercises to improve diaphragm strength
Correct answer: Treadmill training with or without body weight support
Treadmill training, with or without partial body weight support, has strong evidence for improving gait speed, stride length, and overall motor function in Parkinson's disease.
Question 2: During pulmonary rehabilitation, a patient with asthma reports increased dyspnea immediately after starting exercise. What is the most likely cause and initial management?
- Muscle deconditioning requiring immediate increased workload
- Exercise-induced bronchoconstriction; administer prescribed short-acting bronchodilator and reduce intensity (Correct answer)
- Cardiac arrhythmia; immediately perform CPR
- Anxiety disorder; ignore symptoms and continue at the same intensity
Correct answer: Exercise-induced bronchoconstriction; administer prescribed short-acting bronchodilator and reduce intensity
Exercise-induced bronchoconstriction commonly occurs in asthma patients; management includes reducing exercise intensity, allowing rest, and administering the prescribed short-acting bronchodilator.
Question 3: A physiotherapist is assessing muscle tone in a patient with a spinal cord injury (SCI) at T6, classified as AIS A. Spasticity below the level of injury is managed primarily to:
- Increase reflexive activity for complete motor recovery
- Prevent contractures, maintain hygiene, and improve functional positioning (Correct answer)
- Eliminate all reflexes below the injury level
- Strengthen voluntary motor control of affected muscles
Correct answer: Prevent contractures, maintain hygiene, and improve functional positioning
In complete SCI, spasticity management focuses on preventing secondary complications such as contractures, pressure injuries, and hygiene issues, and optimizing positioning for function.
Question 4: Which principle guides exercise prescription for a patient with heart failure with reduced ejection fraction (HFrEF) during Phase II cardiac rehabilitation?
- Maximize exercise intensity to rapidly improve cardiac output
- Start with low-to-moderate intensity, monitor for symptoms, and progress gradually based on tolerance (Correct answer)
- Avoid all aerobic exercise to prevent cardiac remodeling
- Exercise only on days when the patient is asymptomatic
Correct answer: Start with low-to-moderate intensity, monitor for symptoms, and progress gradually based on tolerance
Phase II cardiac rehabilitation for HFrEF uses conservative initial intensity with continuous symptom monitoring and gradual progression, guided by RPE, HR, and symptom response.
Question 5: A physiotherapist working with a patient who has multiple sclerosis (MS) should be aware that fatigue management is critical because:
- MS fatigue is always caused by deconditioning alone and resolves with high-intensity exercise
- MS-related fatigue can be exacerbated by heat and overexertion, requiring energy conservation strategies (Correct answer)
- Fatigue in MS is a psychological symptom requiring no physical intervention
- High temperatures improve nerve conduction in MS patients
Correct answer: MS-related fatigue can be exacerbated by heat and overexertion, requiring energy conservation strategies
MS fatigue is often worsened by elevated body temperature (Uhthoff's phenomenon) and overexertion; energy conservation strategies, pacing, and cool environments are essential management components.
Question 6: When treating a child with developmental coordination disorder (DCD), which intervention approach is most evidence-based according to current pediatric physiotherapy guidelines?
- Passive sensory integration techniques administered only by a therapist
- Task-oriented intervention focusing on child-specific functional goals with active participation (Correct answer)
- Avoidance of all physical activity until coordination normalizes
- Bracing all extremities to prevent compensatory movement patterns
Correct answer: Task-oriented intervention focusing on child-specific functional goals with active participation
Task-oriented approaches, such as the Cognitive Orientation to daily Occupational Performance (CO-OP), focus on child-specific functional goals and are the most evidence-supported intervention for DCD.
PCE PCE Cardiopulmonary and Special Populations 3
A physiotherapist is treating a patient with Parkinson's disease.
Which exercise approach has the strongest evidence for improving gait and motor function?