PCE Practice and Application 2 — Questions and Answers
Question 1: A patient with lateral epicondylitis reports pain with resisted wrist extension. Which intervention is most appropriate in the acute phase?
- Progressive resistive wrist extension exercises
- Relative rest and activity modification (Correct answer)
- Aggressive deep tissue massage to the extensor tendons
- Immediate return to full activity
Correct answer: Relative rest and activity modification
In acute lateral epicondylitis, relative rest and activity modification reduce mechanical load and allow tissue healing.
Question 2: During gait analysis, a patient demonstrates excessive trunk lateral flexion toward the stance limb. Which muscle weakness is most likely responsible?
- Gluteus maximus
- Gluteus medius (Correct answer)
- Hip adductors
- Tensor fasciae latae
Correct answer: Gluteus medius
Weakness of the gluteus medius causes a Trendelenburg gait pattern, where the trunk shifts over the weakened hip to maintain balance.
Question 3: A therapist applies ultrasound at 3 MHz frequency to a superficial tendon. What depth of penetration is primarily targeted?
- 5–10 cm
- Up to 5 cm
- Up to 2 cm (Correct answer)
- 10–15 cm
Correct answer: Up to 2 cm
3 MHz ultrasound penetrates to approximately 1–2 cm depth and is best suited for superficial tissues.
Question 4: A patient with T6 complete spinal cord injury is learning wheelchair propulsion. Which functional ability would be expected?
- Independent ambulation with bilateral KAFOs
- Full independence in manual wheelchair on level surfaces (Correct answer)
- Dependence on a power wheelchair for all mobility
- Independent transfers but dependent for wheelchair propulsion
Correct answer: Full independence in manual wheelchair on level surfaces
A person with T6 complete SCI has intact upper extremity function and can achieve full independence in manual wheelchair propulsion on level surfaces.
Question 5: Which outcome measure is most appropriate for assessing functional balance in community-dwelling older adults?
- Glasgow Coma Scale
- Berg Balance Scale (Correct answer)
- Rancho Los Amigos Scale
- Modified Ashworth Scale
Correct answer: Berg Balance Scale
The Berg Balance Scale is a validated 14-item tool used to assess static and dynamic balance in older adults.
Question 6: A patient presents with a positive Phalen's test and nocturnal hand paresthesias in the thumb, index, and middle fingers. Which structure is most likely compressed?
- Radial nerve at the spiral groove
- Ulnar nerve at Guyon's canal
- Median nerve at the carpal tunnel (Correct answer)
- Brachial plexus at the thoracic outlet
Correct answer: Median nerve at the carpal tunnel
Carpal tunnel syndrome involves median nerve compression and produces Phalen's sign positivity with paresthesias in the median nerve distribution.
Question 7: A physiotherapist is treating a patient post-ACL reconstruction. At 12 weeks post-op, which criterion is most important before initiating running?
- No pain with daily activities
- Full passive knee ROM
- Quadriceps strength ≥80% of the contralateral limb (Correct answer)
- Normal knee effusion
Correct answer: Quadriceps strength ≥80% of the contralateral limb
Limb symmetry index of ≥80% quadriceps strength is a key criterion before progressing to running after ACL reconstruction.
PCE Practice and Application 2
A patient with lateral epicondylitis reports pain with resisted wrist extension.
Which intervention is most appropriate in the acute phase?