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1. You have been treating Anna, age 10, for 5 treatments in relation to her diagnosis of Cerebral Palsy. During the next treatment session Anna’s mother tells you that Anna’s doctor wants to begin casting her LE’s secondary to spasticity. As a PT, what are your concerns concerning this patient and advice you may provide to Anna’s mother in relation to the casting?
a. The casting may decrease her muscular reserve and the development of muscular tasks may be delayed.
b. It may affect her self-esteem due to the negative cosmesis issues that may occur as a result of the casting.
c. The casting may limit her ADL performance and participation in school physical activities.
d. All of the above |
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2. Joe is a 35 year old male with a diagnosis of Cerebral Palsy since childhood. During your examination today, Joe states that he has not walked independently for the past 3 years. Which of the following is NOT a contributing factor for his decline in independence during ambulation?
a. Joe feels overburdened and stressed due to his increased effort and more fatigue during walking.
b. Joe has fear of falling due to postural instability.
c. Joe has increased joint pain which increases during ambulation.
d. Joe enjoys being dependent on someone else including having someone push him around in a w/c. |
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| d. Joe enjoys being dependent on someone else including having someone push him around in a w/c. |
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3. Sally is a 45 year old female diagnosed with Cerebral Palsy. During one of your treatment sessions, she informs you of her concern relating to employment issues concerning her diagnosis of CP. What are some things that you would tell her to consider?
a. She will need to consider transportation issues, physical demands of the job, and her current level of functioning.
b. Women diagnosed with CP have a more difficult time then men finding employment.
c. She should be concerned with being denied employment directly related to her disability, since the Equal Employment Opportunity law does not apply to adults with CP.
d. She will have no concerns finding employment, as there are vast amounts of jobs available. |
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| a. She will need to consider transportation issues, physical demands of the job, and her current level of functioning. |
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1. A 5 y/o child comes into your clinic with Developmental Coordination Disorder, you decide to treat him with Sensory Integration because:
A. It is cheaper than other therapies
B. It is more effective than other therapies
C. A and B
D. None of the above |
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2. An 8 year old girl presents with poor motor coordination at school. She has a poor score on the Movement ABC and has undergone treatment from her physical therapist. Which of these treatments would have been the best option for this girl?
A. Sensory Integration, a non-cognitive movement-based therapy
B. Le Bon Depart, an individualized, rhythm-based therapy
C. Regular play and movement games at home, such as building forts and baking cookies
D. None of the above |
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| B. Le Bon Depart, an individualized, rhythm-based therapy |
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3. Which of the following characteristics limits the effectiveness of sensory integration therapy in children?
A. Epilepsy
B. Low score on the Double Tactile Stimulation Test
C. Behavior problems
D. Child has parent on single-parent government benefit program
E. All of the above |
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1. You have been seeing Jake, a 6 year old boy, who has spastic cerebral palsy for three weeks and you are seeing some progression in his gait patterns but you would like him to be walking a little bit faster and with better stride length. What would be the best protocol that should be used in order to get some positive gains in Jake’s walking speed and stride length?
a. Self weight supported treadmill walking with speed of treadmill set at his pace.
b. Body weight supported treadmill training set at a speed that challenges Jake with duration of 6 times per week for two weeks.
c. Body weight supported treadmill training set at a speed that is challenging to Jake with duration of 1-2 times per week for 12 weeks.
d. Body weight supported treadmill training set 0.5 mph |
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| b. Body weight supported treadmill training set at a speed that challenges Jake with duration of 6 times per week for two weeks. |
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You have been treating John an 8 year old child with CP using Body weight supported treadmill training at your clinic. He has been seen 4 times per week for the last month. Witch of the following outcomes would not be expected regarding his progress.
a. Increased stride length during gait
b. Increased fatigue resistance during gait
c. Increased gait speed
d. Increased SL balance time |
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| d. Increased SL balance time |
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You are treating a Huey, a 7 year old child, for Cerebral Palsy. One of your main goals for treatment is to get Huey to have better balance. Would non-weight bearing treadmill training be an appropriate intervention?
a. True
b. False |
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1. Botox injections into gastrocnemius and adductor muscles have better results for decreasing tone and improving gait parameters than injecting the adductor muscles alone.
a. True
b. False |
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2. Which of the following is FALSE about botolinum toxin A in the treatment of CP?
a. It is painless to administer.
b. Its effects can be localized to a single muscle.
c. It effectively decreases spasticity.
d. The majority of patients have some kind of adverse effects. |
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Definition
| d. The majority of patients have some kind of adverse effects. |
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3. Which of the following is NOT true regarding the use of Botox A for children with spastic CP?
a. It is recommended as an adjunct treatment with physical therapy and orthotics.
b. It is recommended as a replacement therapy to physical therapy.***
c. It has been shown to increase gross motor function even 18 months post-injection when combined with physical therapy.
d. It has been shown to decrease muscle tone at both 3 and 18 months post-injection. |
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| b. It is recommended as a replacement therapy to physical therapy |
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4. If you were a physician treating your patient with spastic CP, which of the following conservative interventions would be supported by the literature?
a. Send them home with written instructions on how the parents can stretch the child at home on their own.
b. Recommend surgical tissue lengthening procedures to whichever muscle group contributes most to their functional limitations (e.g. hip adductors, hamstrings, hip flexors, or gastrocs).
c. Prescribe this patient a motorized wheelchair since they will not be ambulatory.
d. Recommend botox injections in conjunction with casting, and physical therapy for stretching and gait training. |
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Definition
| d. Recommend botox injections in conjunction with casting, and physical therapy for stretching and gait training. |
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1. You are seeing a 9-year-old boy with spastic diplegia cerebral palsy for physical therapy. His mother informs you that he had a baclofen pump implanted 2 weeks ago. The mother asks you when she can expect her son to show optimal motor function. You tell her:
a) Immediately
b) Approximately one year from now
c) Once his Gross Motor Function Measure (GMFM) score shows a 10% increase
d) Your son will not show any improvement in motor function |
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| b) Approximately one year from now |
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2. A 3 year old female is coming to your clinic with diagnosis of diplegic cerebral palsy. The order is to eval and treat spasticity and strength deficits in the lower extremities. The physician wants to implant an intrathecal baclophen pump in three months. The mother has some information about baclofen but wants to know what some of the risks and complications may be. Which of the following are possible complications of an intrathecal baclofen pump?
a) Somnolence
b) Pump/Catheter malfunction
c) Infection
d) All of the above |
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3. Spencer, a 1st grader at the local elementary school, underwent surgery for implantation of an intrathecal baclofen pump for his cerebral palsy. Which of the following is the most important outcome for young Spencer following this procedure?
a) Hip adductor strength improvement from 2/5 to 3/5
b) Modified Ashworth Scale improvement
c) Ease of transfers for caregiver
d) Increase in hip ROM |
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| c) Ease of transfers for caregivers |
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Parents of Charlie, an eight month-old infant with a medical diagnosis of Down syndrome, decide to initiate physical therapy for their son in hopes of preventing motor developmental delays. They are most concerned with Charlie’s ability to learn how to ambulate properly and as soon as possible in order to keep up with his age-matched peers at day care. What evidence-based intervention is most appropriate to implement and teach Charlie’s parents?
a. PNF exercises utilizing SR and SRH in the D2 flexion/extension pattern
b. Treadmill training to facilitate stepping pattern
c. Place light weights around Charlie’s ankles to increase strength in LEs during random movement
d. Nothing, because the pathology of Down syndrome will not allow him to ambulate any sooner |
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| b. Treadmill training to facilitate stepping pattern |
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e) You have been seeing Taylor who is 3 years old and has been diagnosed with Down Syndrome. Taylor demonstrates difficulties with many motor tasks, such as reaching into a jar or grasping a ball secondary to generalized hypotonia. When completing these activities Taylor is more likely to adopt a motor plan of co-contraction allowing for safety rather than efficiency of movements. Which of the following methods of practice will improve her performance by improving motor synergies?
a. Blocked practice
b. Variable practice
c. Constant practice
d. Serial practice |
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f) Today you will be completing an initial evaluation of Chloe a 5 y/o child with a referral for impaired coordination as well as issues with motor planning secondary to Down Syndrome. Individuals with Down Syndrome have several cognitive deficits. What will be the best technique for you to utilize when trying to communicate with this child today?
a. Use of verbal cueing for instruction
b. Asking the patient to recall directions so that you know they understand what you ask of them
c. Visual imitation
d. Written handouts and directions |
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You are treating Sally during her physical therapy session, and noticed that she has difficulty finding the right words to say but is still able to maintain a conversation with you. What level of classification of mental retardation does Sally fall into?
A. Moderate
B. Mild
C. Profound
D. Severe |
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We are seeing Carlos in physical therapy. Prior to treating him we conduct a chart review and see that he has a diagnosis of moderate mental retardation. How can we facilitate our physical therapy session?
A. Break down tasks into smaller steps.
B. Use Verbal Instructions.
C. Repeat the Instructions 1 time.
D. Use a loud and controlling voice. |
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| a. break down tasks into smaller steps |
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You have been working with Molly, who has a moderate classification of mental retardation. She will be discharged in 2 days. She is going back to a group home setting where she is in charge of taking out the garbage. What should you focus on in physical therapy?
A. ROM for upper extremities.
B. Quad strengthening for heavy trash bags.
C. Inhibiting her Olfactory senses.
D. Going up and down steps while carrying a heavy object, similar to what she must do at home. |
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Definition
| D. Going up and down steps while carrying a heavy object, similar to what she must do at home. |
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