(Test Bank) Therapeutic Exercise, Foundations and Techniques

Kisner, 7

Nursing

Test Bank

7th Edition

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Test Bank for Therapeutic Exercise, Foundations and Techniques, The downloadable file consists of 177 pages, and the total size of the file is 1.82 MB. Purchase now only for highly discounted price.

Author(s): Kisner

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Copyright © 2018 by F. A. Davis Company Chapter 1: Therapeutic Exercise: Foundational Concepts Multiple Choice 1. According to the definition of therapeutic exercise and the goal of designing an individualized program of therapeutic exercise, the physical therapist might develop a therapeutic exercise program in order to: A. Restore function through the elimination of body structure impairments. B. Improve function but not to remediate or reduce disability. C. Optimize overall health status, fitness, or sense of well-being. D. Remediate activity limitations but not to reduce health-related risk factors. ANS: C KEY: Book Part: Part I: General Concepts DIF: Intermediate 2. Awareness of safety measures during exercise protects the patient and the therapist. All of the following measures should be routinely taken to prevent injury to the patient and/or therapist except: A. Recommend that the patient discontinue taking any medication that might impair balance or tolerance for physical activity. B. Maintain proper body mechanics while applying manual resistance, stretching, or joint-mobilization techniques. C. Assess the physical environment for adequate space and equipment. D. Provide the necessary feedback and education for proper performance of therapeutic exercise. ANS: A KEY: Book Part: Part I: General Concepts DIF: Basic 3. Which of the following terms associated with aspects of physical function is used to describe the ability of the neuromuscular system to statically or dynamically hold proximal or distal body segments in appropriate positions using synergistic muscle action? A. Muscle strength B. Muscle power C. Coordination D. Stability Copyright © 2018 by F. A. Davis Company ANS: D KEY: Book Part: Part I: General Concepts DIF: Basic 4. Which of the following terms is synonymous with cardiopulmonary fitness and is associated with the aspects of physical function that can be modified by therapeutic exercise? A. Cardiopulmonary resistance B. Cardiopulmonary endurance C. Cardiopulmonary stability D. Cardiopulmonary strength ANS: B KEY: Book Part: Part I: General Concepts DIF: Basic 5. Each of the following is a step in the process of evidence-based practice except: A. Convert the patient problem to an answerable clinical question. B. Spend many hours gathering any and all information that might be used to answer the question. C. Integrate relevant evidence with clinical experience and expertise to make decisions about the management and care of a patient. D. Assess the outcomes of interventions based on evidence. ANS: B KEY: Book Part: Part I: General Concepts DIF: Basic 6. According to the International Classification of Functioning, Disability and Health (ICF) endorsed by the American Physical Therapy Association (APTA), a rotator cuff tear is considered a(n): A. Health condition. B. Impairment. C. Functional limitation. D. Disability. ANS: A KEY: Book Part: Part I: General Concepts DIF: Basic Copyright © 2018 by F. A. Davis Company 7. Which of the following components of the ICF model is defined by the individual’s life-style, education, and social and environmental backgrounds? A. Risk factors for health conditions B. Impairments in body function C. Participation restrictions D. Contextual factors ANS: D KEY: Book Part: Part I: General Concepts DIF: Basic 8. Ms. C is an 18-year-old who is 3 days post-ACL reconstruction. She must wear a knee immobilizer during ambulation with axillary crutches and must remain partial weight bearing on the involved side. She has limited passive and active range of motion of the operated knee. According to the ICF model of functioning and disability, her limited knee ROM is classified as a: A. Secondary impairment of body structure. B. Primary impairment of body function. C. Primary impairment of body structure. D. Secondary impairment of body function. ANS: B KEY: Book Part: Part I: General Concepts DIF: Basic 9. Ms. L is a 78-year-old who underwent surgery for internal fixation of an intertrochanteric fracture of the (L) hip 3 days ago. For the next few weeks she must remain nonweight-bearing on the operated side and has begun to use a walker for ambulation. She is able to walk for short distances around her hospital bed but is not yet able to rise from a chair to standing. According to the ICF model, the inability to stand from a sitting position is classified as a(n): A. Health condition. B. Impairment. C. Activity limitation. D. Participation restriction. ANS: C KEY: Book Part: Part I: General Concepts DIF: Basic Copyright © 2018 by F. A. Davis Company 10. Part of a preseason screening program for high school athletes includes testing the stability of the glenohumeral and scapulothoracic joints. If you identify an athlete with signs of shoulder instability but has no activity limitations or participation restrictions, you might suggest an exercise program designed to prevent or reduce the risk of injury during the season. This is an example of what type of prevention? A. Primary B. Secondary C. Tertiary D. Indirect ANS: B KEY: Book Part: Part I: General Concepts DIF: Basic 11. Which of the following is a true statement about the components of the patient management model described in the Guide to Physical Therapist Practice? A. Patient education is the one intervention that should be included for every patient throughout the entire episode of care. B. Goals and outcomes are synonymous terms. C. A primary focus of the diagnostic process performed by physical therapists is the identification of pathology. D. It is appropriate to discontinue a patient from an exercise program only when the patient has attained the goals stated in the initial plan of care. ANS: A KEY: Book Part: Part I: General Concepts DIF: Basic 12. According to the patient management model described in the Guide to Physical Therapist Practice, each of the following is a component of the examination performed by the physical therapist except: A. Selecting and performing appropriate tests and measures. B. Taking a patient’s history either verbally or from the medical record. C. Interpreting information derived from specific measurement tools to form a diagnosis and prognosis. D. Performing a systems review. ANS: C KEY: Book Part: Part I: General Concepts DIF: Basic Copyright © 2018 by F. A. Davis Company 13. As a result of supraspinatus impingement syndrome, Mrs. J is unable to lift her arm fully overhead without pain. You plan to design an exercise program consisting of both discrete and serial tasks. You do not want to include continuous tasks at this time. Which of the following should not be included? A. ROM exercises using a cloth to wipe down the wall B. Active reaching exercises to place small objects in a cabinet C. Active assisted stretching by lifting a cane overhead in supine D. Warming up on the upper extremity (UE) ergometer (UE cycling) ANS: D KEY: Book Part: Part I: General Concepts DIF: Intermediate 14. Your patient is performing pelvic tilt exercises for the first time and needs verbal and tactile cues (feedback) to perform the exercises correctly. This represents which stage of motor learning? A. Cognitive B. Contemplative C. Associative D. Autonomous ANS: A KEY: Book Part: Part I: General Concepts DIF: Basic 15. During several physical therapy sessions, a patient you have been treating for low back pain learned how to perform pelvic tilt exercises in several positions (supine, sitting, quadruped, standing). With continued practice at home, your patient is now able to perform extremity movements while maintaining a stable pelvic position. This represents which stage of motor learning? A. Cognitive B. Continuous C. Associative D. Autonomous ANS: D KEY: Book Part: Part I: General Concepts DIF: Intermediate Copyright © 2018 by F. A. Davis Company 16. You are helping a patient learn a motor skill. You set up several variations of the same task (walking on several types of surfaces). You have the patient perform one variation of the task and have him identify his own errors after the first repetition (or point out errors to him after the first repetition). Next, allow him to repeat the same variation of the task one or two more times before moving on to another variation of the task. What term best describes this type of practice? A. Blocked B. Random-blocked C. Random D. Augmented ANS: B KEY: Book Part: Part I: General Concepts DIF: Difficult 17. In which of the following stages of motor learning does augmented/extrinsic feedback have the most positive impact on acquisition of a motor skill? A. Cognitive stage B. Associative stage C. Autonomous stage D. External feedback is equally effective in any stage of motor learning. ANS: A KEY: Book Part: Part I: General Concepts DIF: Basic 18. Helping a patient acquire the ability to shift his weight from side to side in a standing position by means of manual guidance by the therapist is called: A. Summary feedback. B. Delayed feedback. C. Concurrent feedback. D. Instantaneous postresponse feedback. ANS: C KEY: Book Part: Part I: General Concepts DIF: Intermediate 19. For which of the following tasks will teaching components (parts) of the motor task be most effective? A. Swinging a golf club B. Riding a stationary bicycle Copyright © 2018 by F. A. Davis Company C. Grasping an object D. Performing a standing-pivot transfer from bed to wheelchair ANS: D KEY: Book Part: Part I: General Concepts DIF: Basic 20. Consistent with the taxonomy of motor tasks, which of the following activities is the best example of body stability in an open environment with intertrial variability without manipulation? A. Maintaining sitting balance while riding a bus from school to home B. Maintaining standing balance while on an escalator C. Maintaining balance on a sidewalk or on the grass D. Maintaining sitting balance in chairs of different heights in your family room when you are home alone ANS: A KEY: Book Part: Part I: General Concepts DIF: Difficult 21. Which of the following is not a prerequisite for motor skill acquisition and retention? A. Augmented feedback B. Understanding the task or goal C. Being able to activate the motor system D. Being able to retrieve motor memories over time ANS: A KEY: Book Part: Part I: General Concepts DIF: Intermediate 22. As a therapist, you can be relatively confident that motor learning has taken place when your patient demonstrates which of the following? A. Consecutive repetitions of a task without error during the treatment session B. Decreased need for manual guidance during the treatment sessions C. The ability to perform a slight variation of the task in a new context during the treatment session D. Increased speed demonstrated when carrying out the task ANS: C KEY: Book Part: Part I: General Concepts Copyright © 2018 by F. A. Davis Company DIF: Intermediate 23. Patient satisfaction is an important area for outcome assessment in physical therapy when following the patient management model described in the Guide to Physical Therapist Practice. There are several determinants of patient satisfaction that, if included in the gathering and analysis of data, may help clinics to improve the quality of care being provided. Each of these has been shown in the literature to be determinant of patient satisfaction except: A. Professionalism, empathy, and helpfulness of the therapist. B. Patient participation in goal setting in the plan of care. C. The chronicity of the patient’s condition (higher satisfaction with patients having chronic conditions). D. Convenience of access and flexibility for scheduling appointments. ANS: C KEY: Book Part: Part I: General Concepts DIF: Basic 24. The body systems react, adapt, and develop in response to forces and physical stresses placed on them. All of the following stresses help the body to develop and maintain a functional level of strength except: A. Gravity. B. Weight-bearing. C. Therapeutic exercise. D. Bed rest. ANS: D KEY: Book Part: Part I: General Concepts DIF: Basic Copyright © 2018 by F. A. Davis Company Chapter 2: Prevention, Health, and Wellness Multiple Choice 1. Each of the following is a prescreening question that should be addressed before participation in a health promotion program, except: A. Have you ever been diagnosed with a heart condition? B. What are your blood pressure and heart rate normally? C. Do you experience chest pain when you engage in physical activity? D. Do you ever lose your balance or lose consciousness? ANS: B KEY: Book Part: Part I: General Concepts DIF: Basic 2. An individual who perceives a threat of contracting a disease decides to follow specific health recommendations because he believes that he can prevent or reduce the risk of contracting the disease. These behaviors are aligned with what behavioral change theory or model? A. Social cognitive theory B. Health belief model C. Transtheoretical model D. Risk assessment theory ANS: B KEY: Book Part: Part I: General Concepts DIF: Intermediate 3. The goals of Healthy People 2020 are based on the nation’s vision to: A. Eliminate HIV and develop an immunization for prevention of AIDS. B. Develop a cure for the common cold. C. Promote smoking cessation, eliminate tobacco use, and pass legislation in all states banning smoking in public places. D. Foster a society in which all people live long and healthy lives. ANS: D KEY: Book Part: Part I: General Concepts DIF: Basic Copyright © 2018 by F. A. Davis Company 4. Mr. K has had chronic low back pain for several years. He has a sedentary life-style that includes office work and being a self-reported “TV junkie.” His physician suggests physical therapy for exercise and management of his pain. Even though Mr. K schedules physical therapy, initially he does not think that exercises will help his pain. He does not associate his life-style with his low back pain and therefore does not consider making changes. After his first session with the physical therapist, Mr. K realizes that changes in his life-style and adding regular exercise may help decrease his low back pain. So he decides to continue physical therapy two times a week for 1 month as suggested. Following the first physical therapy session, Mr. K shows he is in which of the following stages of change associated with the transtheoretical model of behavioral change? A. Contemplation B. Preparation C. Action D. Maintenance ANS: B KEY: Book Part: Part I: General Concepts DIF: Intermediate 5. Which of the following sequences represents the correct order for developing and implementing a health promotion program? A. Assess the need; set goals and objectives; develop the intervention; implement the program; evaluate the program. B. Develop goals and objectives for a program; assess the need; design an intervention; implement the program; evaluate the outcomes. C. Develop a broad-based intervention; set goals and objectives that could be met; assess the community’s needs; implement the program; evaluate the program’s effectiveness. D. Evaluate the goals, objectives, and effectiveness of a previously implemented program; modify or update the program based on the evaluation; assess the current needs of a community; implement the new program. ANS: A KEY: Book Part: Part I: General Concepts DIF: Basic 6. The purpose of performing pre-participation screenings and risk assessments when developing health, wellness, and fitness programs includes all of the following except: A. To provide the therapist with baseline information for monitoring the individuals’ response to program progression. B. To determine the motivational readiness of the individual to make life-style changes. Copyright © 2018 by F. A. Davis Company C. To assist the therapist in developing an appropriate level of exercise for the individuals. D. To identify if an individual should be referred to a physician prior to participation in the program. ANS: B KEY: Book Part: Part I: General Concepts DIF: Basic 7. The Perceived Wellness Survey (PWS) and the Model of Healthy Living Assessment Wheel were developed from models of wellness and various initiatives to improve the health and wellness of society as advocated by the Healthy People 2020 program. Which of the following best describes these tools? A. They are complex and require special training to administer and interpret. B. They have no clinical relevance to the role of physical therapy and are intended to be anecdotal for the public. C. If used as part of the examination and history taking during the initial visit, they could provide a baseline to establish goals and report outcomes when incorporating wellness into physical therapy practice. D. They were program assessments that were used to evaluate the success of the Healthy People 2010 program and to improve the subsequent initiative, Healthy People 2020. ANS: C KEY: Book Part: Part I: General Concepts DIF: Difficult 8. You have designed and are directing an exercise class for individuals who have been diagnosed with high blood pressure. This type of program falls within the definition of which type of prevention? A. Multifactorial prevention B. Primary prevention C. Secondary prevention D. Tertiary prevention ANS: C KEY: Book Part: Part I: General Concepts DIF: Basic 9. All of the following risk factors are common to both coronary artery disease (CAD) and osteoporosis except: A. Prolonged use of corticosteroids Copyright © 2018 by F. A. Davis Company B. Smoking C. Sedentary life-style D. Family history ANS: A KEY: Book Part: Part I: General Concepts DIF: Intermediate 10. Which of the following best describes the target audience for a program of physical activity designed for primary prevention of childhood obesity? A. A group of morbidly obese children who have been diagnosed with type 2 diabetes B. A group of mildly obese children who are identified as being “at risk” for type 2 diabetes C. A group of mildly obese children D. A group of sedentary children whose weight is within normal limits ANS: D KEY: Book Part: Part I: General Concepts DIF: Intermediate 11. Non-communicable chronic diseases are the primary cause of death and illness in the United States (US). The top four chronic conditions in the US in terms of mortality include all of the following except: A. Cardiovascular disease B. Diabetes C. Obesity D. Chronic respiratory disease ANS: C KEY: Book Part: Part I: General Concepts DIF: Basic 12. People with disabilities should be included in wellness and prevention programs, as described by Healthy People 2020’s goal of health equity and elimination of disparity. Each of the following are resources for providing health and wellness programs to people with disabilities except: A. Individual Education Plans (IEPs) for school-aged children with disabilities. B. The World Health Organization’s International Classification of Functioning, Disability and Health (ICF). C. The National Center on Health, Physical Activity and Disability (NCHPAD). D. Physical Activity Guidelines for Americans (US Department of Health & Human Services). Copyright © 2018 by F. A. Davis Company ANS: B KEY: Book Part: Part I: General Concepts DIF: Intermediate 13. Which of the following descriptions is true about mindfulness and its implications for health and wellness? A. Mindfulness encourages focus on pain, increasing the pain response, anxiety, and blood pressure. B. Mindful meditation is a spiritual exercise that should not be associated with human movement interventions. C. Mindful breathing can be easily incorporated into physical therapy exercise instructions to assist the patient to avoid holding the breath during difficult or painful activities. D. Mindfulness invites one to be in another place or time and experience peace and well-being while focusing on a past time or event. ANS: C KEY: Book Part: Part I: General Concepts DIF: Intermediate Copyright © 2018 by F. A. Davis Company Chapter 3: Range of Motion Multiple Choice 1. Which of the following is a goal of passive range of motion (PROM) exercises? A. Prevent muscle atrophy B. Enhance movement of synovial fluid for articular cartilage nutrition C. Increase joint range of motion (ROM) and muscle length D. Improve muscle performance ANS: B KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 2. Which of the following is a contraindication to PROM exercises? A. When movement of a body segment is disruptive to the healing process B. Presence of muscle weakness or paralysis C. Presence of chronically impaired circulation D. When a patient is in a coma ANS: A KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 3. All of the following can cause impaired range of motion (ROM) except: A. Early movement after surgery. B. Muscle imbalance and disuse. C. Neurological injury. D. Systemic inflammatory disease. ANS: A KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 4. Which of the following best describes ROM exercises? A. Functional excursion of a muscle Copyright © 2018 by F. A. Davis Company B. Passive or active stretching exercise beyond the available range of movement C. Active muscle insufficiency D. Passive, assisted, or active movement of a body segment through the available range of motion ANS: D KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 5. During active ROM exercises, which of the following structures is most elongated with full active extension and ulnar deviation of the wrist if the fingers remain relaxed? A. Flexor carpi ulnaris B. Flexor carpi radialis C. Flexor digitorum profundus D. Flexor digitorum superficialis ANS: B KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Difficult 6. You are treating a patient with weak hip abductors (muscle grade is 2/5). Which of the following ROM exercises is most appropriate to prevent tightness of the hip adductors and maintain the current level of strength of the hip abductors? A. Perform passive abduction of the hip with the patient positioned in the supine position B. Have the patient perform active hip abduction through the available ROM while positioned in the side-lying position C. Have the patient perform active hip abduction through the available ROM while positioned in the supine position as you support the weight of the leg D. Perform passive abduction of the hip with the patient positioned in the side-lying position ANS: C KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Difficult 7. The most effective results of continuous passive motion (CPM) can be expected: A. If the device is applied for at least 5 hours per day but its use is delayed for at least 5 days postoperatively. B. If the device is applied as early as possible after surgery for at least 4 to 8 hours per day. C. If the device is applied immediately after surgery for 1 hour, then on alternate days for 1 hour each time. Copyright © 2018 by F. A. Davis Company D. If the rate of motion is at least 5 cycles per minute, no matter how many hours per day the device is used. ANS: B KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Intermediate 8. Which of the following PROM exercises provides the most flexion of the lumbar spine? A. Single knee to chest B. Posterior pelvic tilt with the patient lying supine with hips/knees at 45°/90° C. Posterior pelvic tilt with patient lying supine D. Double knees to chest ANS: D KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Difficult 9. Mr. J underwent a repair of a torn biceps brachii 2 days ago. During PROM exercises, which combination of motions should you avoid at end range to protect (not disrupt) the healing tissue? A. Elbow extension, shoulder extension, forearm supination B. Elbow extension, shoulder flexion, forearm pronation C. Elbow extension, shoulder flexion, forearm supination D. Elbow extension, shoulder extension, forearm pronation ANS: D KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Difficult 10. Which of the following is a true statement about ROM exercises? A. Passive ROM is synonymous with stretching. B. If a joint is hypermobile, PROM exercises are contraindicated. C. Passive ROM can be carried out manually or mechanically. D. Whenever possible, active-assistive ROM should be performed in positions that eliminate the effect of gravity on the weak muscle that is actively contracting. ANS: C KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic Copyright © 2018 by F. A. Davis Company 11. During ROM of the cervical spine: A. Avoid grasping the jaw. B. Avoid extension past neutral (i.e., hyperextension). C. Perform ROM while the patient is in an upright position (seated or standing). D. Never combine flexion with rotation. ANS: A KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Intermediate 12. During your examination of a patient’s lower extremity, you have identified tightness of the gastrocnemius muscle. You are teaching a patient to perform self-ROM exercises of the ankle. In order to maintain the gastrocnemius in a relaxed position while moving the ankle into full range of dorsiflexion available, the patient should: A. Actively extend the toes. B. Keep the knee extended. C. Actively flex the toes. D. Keep the knee flexed. ANS: D KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 13. In order to maintain the web space of the hand, it is important to maintain which of the following motions of the carpometacarpal joint of the thumb? A. Adduction and flexion B. Abduction and extension C. Adduction and extension D. Abduction and flexion ANS: B KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 14. The most effective and safe way to perform passive pronation and supination of the forearm is to: A. Grasp the patient’s hand around the metacarpals and perform ROM while maintaining the elbow in extension. B. Grasp the patient’s forearm just proximal of the wrist and perform ROM while maintaining Copyright © 2018 by F. A. Davis Company the elbow in extension. C. Grasp the patient’s forearm just proximal of the wrist and perform ROM while maintaining the elbow in flexion. D. Grasp the patient’s hand around the metacarpals and perform ROM while maintaining the elbow in flexion. ANS: C KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Intermediate 15. You are treating a patient who sustained an anterior dislocation of the glenohumeral joint. When it is permissible for the patient to begin self-assisted or active ROM of the involved shoulder within pain-free ranges, which of the following exercises places the most stress on the anterior aspect of the capsule at the end range of external rotation, therefore posing the greatest risk of re-dislocating the involved shoulder? A. Wand exercises while lying in the supine position with both shoulders abducted to 90° (upper arms supported on the treatment table) and both elbows flexed to 90° B. Wand exercises while sitting in a chair or standing, both arms at the patient’s sides and elbows flexed to 90° C. Self-assisted shoulder ROM guided manually by the sound hand while lying on the sound side and the involved upper arm resting on a pillow placed alongside the chest and the elbow flexed to 90° D. Self-assisted shoulder ROM guided manually by the sound hand while the patient is lying in the supine position on a treatment table and the involved arm is at the patient’s side, resting on a pillow in slight abduction and flexion and the elbow is flexed to 90° ANS: A KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Difficult 16. When incorporating functional patterns into ROM interventions, which of the following guidelines is correct? A. PROM should always be performed in anatomical planes of motion to reinforce motor learning. B. Mechanical assistance should not be used for assisted ROM because it will reduce motor learning. C. Incorporate the functional movement into the patient’s daily activities once the pattern can be performed safely and correctly, without assistance or compensation. D. Patients with visual impairments should always perform ROM in anatomical planes, avoiding functional patterns, so that joint alignment is maintained. ANS: C Copyright © 2018 by F. A. Davis Company KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Intermediate Chapter 4: Stretching for Improved Mobility Multiple Choice 1. Which of the following is an incorrect statement about hypomobility? A. It may be associated with loss of passive or dynamic flexibility. B. It may be caused by muscle imbalance or weakness. C. It is usually associated with joint instability. D. It may occur with or without tissue trauma. ANS: C KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 2. In a patient’s medical record you see “knee flexion contracture.” What does it mean? A. The patient is unable to actively extend the knee through the full range of motion (ROM) despite full passive knee extension. B. The quadriceps muscle group is tight and limits full, passive knee flexion. C. Full, passive knee extension is not possible. D. The patient cannot actively contract the hamstrings to flex the knee. ANS: C KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 3. Which of the following descriptions of stretching procedures performed for several repetitions during a single treatment session and repeated over a series of stretching sessions represents the safest and most comfortable process to achieve soft tissue lengthening? A. In an end-range position, apply several high-intensity, rapid-velocity stretch forces. B. Slowly apply a low-load force; maintain the end-range position for an extended time period and release the stretch force slowly. C. Apply an end-range, high-load force slowly, maintain the end-range stretch for an extended time period, and release the stretch quickly. D. In an end-range position, apply several low-intensity, rapid-velocity stretch forces. ANS: B KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic Copyright © 2018 by F. A. Davis Company 4. Which of the following is categorized as an extrinsic factor contributing to limited ROM? A. Bony block B. Inflammation of soft tissue C. Paralysis D. Cast immobilization after a fracture ANS: D KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 5. To maintain gains in ROM achieved as the result of a stretching program, it is recommended to: A. Use the stretch-induced gains in ROM during functional activities as soon as able on a regular basis. B. Perform daily resistance training of the muscle group opposite the stretched muscle. C. Apply heat on a daily basis to the lengthened muscle groups. D. Perform daily resistance training of the stretched muscle. ANS: A KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 6. Which of the following terms best describes impaired extensibility of a muscle-tendon unit as the result of spasticity or rigidity from a lesion of the central nervous system? A. Myostatic contracture B. Fibrotic contracture C. Pseudomyostatic contracture D. Hypotonic contracture ANS: C KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 7. Each of the following is a contraindication to stretching adaptively shortened tissues except: A. Sharp, acute pain during ROM. B. When ROM is limited because scar tissue has reduced soft tissue extensibility. C. A bony block. Copyright © 2018 by F. A. Davis Company D. When tight (shortened) soft tissues provide functional stability of a body segment affected by paralysis. ANS: B KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 8. Which of the following is a true statement about a muscle’s response to stretch? A. The muscle spindle is the motor receptor that protects the sarcomeres when a stretch is applied. B. “Sarcomere give” is best described as a plastic change in muscle that occurs as the result of stretch force that is applied quickly. C. A quick stretch of a muscle is believed to facilitate contraction of muscle fibers by means of the Golgi tendon organ (GTO). D. The primary source of a muscle’s resistance to passive stretch is the connective tissue in and around muscle. ANS: D KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Difficult 9. To achieve maximum elongation of the long head of the biceps brachii during passive stretching: A. Extend the elbow with the forearm in pronation and then extend the shoulder. B. Flex the shoulder overhead after extending the elbow with the forearm in supination. C. Extend the elbow with the forearm in supination and then extend the shoulder. D. Flex the shoulder overhead after extending the elbow with the forearm in pronation. ANS: A KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Intermediate 10. To increase terminal knee extension, you position the patient prone so the lower leg is not supported on the treatment table. The patient relaxes while the lower leg and foot “hang” off the end of the table. The therapist adds a cuff weight around the ankle. What type of stretching procedure is being applied? A. Ballistic B. Mechanical C. Dynamic D. Cyclic Copyright © 2018 by F. A. Davis Company ANS: B KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 11. Multiple potential benefits and outcomes are speculated to result from stretching programs. Which of the following is strongly supported by evidence and research? A. Reduction in the risk of soft tissue injury by participating in a stretching warm-up routine B. Improved flexibility and increased ROM by restoring extensibility of the muscle-tendon unit with specific stretching techniques C. Reduction in muscle soreness after rigorous exercise by participating in a warm-up and cool-down stretching routine D. Enhanced physical performance (strength and endurance) in athletics when participating in pre-event (acute) stretching ANS: B KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Difficult 12. Based on the neurophysiological properties of the contractile components of muscle, a high-intensity, quick stretch of a muscle-tendon unit is believed to create phasic elevation of tension in the stretched muscle by: A. Facilitating the muscle spindle via the Ib fibers. B. Facilitating the GTO. C. Facilitating the primary (Ia) afferents, which in turn stimulate the extrafusal fibers of the muscle. D. Inhibiting the secondary (II) afferents, which in turn stimulate the extrafusal fibers of the muscle. ANS: C KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Intermediate 13. Ballistic stretching: A. Should be used with elderly patients or patients with long-standing contractures. B. Utilizes quick bouncing movements during the stretching maneuver, resulting in an increased chance for tissue trauma and muscle soreness. C. Is effective only if done concurrently with joint-mobilization techniques. D. Can be very effective because the rapid force has greater chance of reaching the plastic range, leading to tissue remodeling. Copyright © 2018 by F. A. Davis Company ANS: B KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 14. Each of the following is a true statement about self-stretching procedures except: A. A portion of body weight is often the source of the stretch force when the distal segment is fixed. B. Self-stretching is effective only when the distal segment is stabilized and the proximal segment moves. C. Proper stabilization of one segment sometimes can be achieved intrinsically (i.e., by an isometric or active muscle contraction). D. A stationary object or surface can be used to stabilize one body segment as the other segment is moved. ANS: B KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 15. During a stretching maneuver, you apply a 30-second stretch of a shortened muscle group just up to the point of tissue resistance. After this maneuver, rather than relaxing with the patient and returning the body segment to a neutral position, you move the body segment into the newly gained range to apply another stretch of the same muscle group and hold the stretch for an additional 30 seconds. What term best describes this type of stretching? A. Static B. Cyclic C. Ballistic D. Static-progressive ANS: D KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 16. You are teaching a client total-body relaxation techniques as part of a pain management program. Each of the following is an indicator of relaxation except: A. Flat facial expression. B. Lowered heart and respiratory rates. C. Decreased skin temperature in the extremities. D. Decreased muscle tension evidenced by relaxed jaw and hands. Copyright © 2018 by F. A. Davis Company ANS: C KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Basic 17. The goal of this exercise is to increase the flexibility (extensibility) of the pectoralis major muscle. You teach the patient to stand facing a corner with the shoulders abducted to 90°, elbows flexed to 90°, and hands and forearms placed on the walls. You tell the patient to relax into the stretch (by leaning into the corner) for 30 seconds; push his forearms into the walls for a count of six; then relax and lean forward toward the corner again and hold for 30 seconds. The self-stretching technique the patient is using is: A. Hold–relax (contract–relax). B. Contract–relax–contract (hold–relax–agonist contraction). C. Agonist contraction. D. Static-progressive stretching. ANS: A KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Intermediate 18. Which is the safest (for protection of the long arch of the foot) and most effective way to apply a long-duration self-stretch of the gastrocnemius-soleus muscle group? A. Stand facing a wall; lean into the wall while keeping both heels on the floor. Sustain that position for as long as possible. B. Assume a long-sitting position on the floor; loop a towel or strap under one foot (strap should be at the heads of the metatarsals) and pull on the towel or strap. C. Stand on a solid wedge (5°, 10°, or 15° angle) for an extended period of time. D. Stand on a step with your heels hanging over the edge and let your heels drop slightly below step level and maintain that position as long as tolerated. ANS: C KEY: Book Part: Part II: Applied Science of Exercise and Techniques DIF: Difficult 19. The most effective means of stretching the latissimus dorsi in order to increase flexion of the shoulder is to: A. Place the patient in a prone position; stabilize the scapula and hyperextend the shoulder. B. Place the patient in a supine position; stabilize the lateral border of the scapula as you flex the shoulder. C. Place the patient in the supine position with hips and knees flexed; stabilize the pelvis at the iliac crest and flex the shoulder.