DPT Geriatric Rehabilitation 2 — Questions and Answers
Question 1: An 82-year-old woman with osteoporosis sustains a vertebral compression fracture at T12. Which activity should be AVOIDED during early rehabilitation?
- Aquatic therapy in a warm pool
- Spinal flexion exercises (Correct answer)
- Isometric trunk stabilization
- Standing balance training
Correct answer: Spinal flexion exercises
Spinal flexion exercises increase compressive forces on anterior vertebral bodies and are contraindicated with osteoporotic vertebral fractures.
Question 2: Which outcome measure is MOST appropriate for assessing functional mobility and fall risk in a community-dwelling older adult?
- Berg Balance Scale
- Timed Up and Go (TUG) Test (Correct answer)
- Functional Reach Test
- Dynamic Gait Index
Correct answer: Timed Up and Go (TUG) Test
The TUG test is widely validated for predicting fall risk in community-dwelling older adults, with scores ≥12 seconds indicating increased risk.
Question 3: A 78-year-old male post-hip replacement demonstrates Trendelenburg gait. Which muscle group is the PRIMARY target for strengthening?
- Hip flexors
- Hip abductors (Correct answer)
- Hip external rotators
- Quadriceps
Correct answer: Hip abductors
Trendelenburg gait results from weakness of the hip abductors (primarily gluteus medius), causing the pelvis to drop on the contralateral side during stance.
Question 4: Which pharmacological class of medications is MOST associated with orthostatic hypotension and fall risk in older adults?
- NSAIDs
- Antihypertensives (Correct answer)
- Proton pump inhibitors
- Statins
Correct answer: Antihypertensives
Antihypertensives, especially alpha-blockers and diuretics, commonly cause orthostatic hypotension by blunting the normal compensatory vasoconstriction upon standing.
Question 5: A PT is treating a 90-year-old with moderate dementia in a skilled nursing facility. Which communication strategy is MOST effective?
- Provide complex multi-step verbal instructions
- Use short simple sentences with visual cues and demonstration (Correct answer)
- Rely solely on written home exercise programs
- Speak to the caregiver exclusively to avoid confusing the patient
Correct answer: Use short simple sentences with visual cues and demonstration
Short simple sentences combined with visual cues and demonstration leverage preserved procedural memory and improve comprehension in patients with dementia.
Question 6: Which gait parameter is MOST predictive of future fall risk in older adults according to the literature?
- Stride length
- Cadence
- Gait speed (Correct answer)
- Step width
Correct answer: Gait speed
Gait speed is the single strongest predictor of falls, hospitalization, and mortality in older adults, with <0.8 m/s indicating high risk.
Question 7: An older adult presents with decreased proprioception, widened base of support, and bilateral ankle weakness. Which balance system is MOST impaired?
- Visual system
- Vestibular system
- Somatosensory system (Correct answer)
- Central nervous system integration
Correct answer: Somatosensory system
Decreased proprioception and ankle weakness indicate somatosensory system dysfunction, which is the primary sensory input for balance on stable surfaces.
DPT Geriatric Rehabilitation 2
An 82-year-old woman with osteoporosis sustains a vertebral compression fracture at T12.
Which activity should be AVOIDED during early rehabilitation?