DPT Neurological Rehabilitation 2 — Questions and Answers
Question 1: A patient with Parkinson's disease demonstrates festinating gait. Which intervention BEST addresses this motor pattern?
- Rhythmic auditory stimulation using a metronome (Correct answer)
- Strengthening of hip flexors with resistance bands
- Passive stretching of the Achilles tendon
- Balance training on an unstable foam surface
Correct answer: Rhythmic auditory stimulation using a metronome
Rhythmic auditory stimulation provides external temporal cues that help override the disrupted internal timing mechanisms causing festination in Parkinson's disease.
Question 2: Which outcome measure is MOST appropriate for assessing upper extremity function after stroke in a patient with moderate spasticity?
- Fugl-Meyer Assessment Upper Extremity (Correct answer)
- DASH (Disabilities of the Arm, Shoulder and Hand)
- Box and Block Test
- Grip strength dynamometry
Correct answer: Fugl-Meyer Assessment Upper Extremity
The Fugl-Meyer Assessment Upper Extremity is specifically designed to measure post-stroke motor impairment and synergy patterns, making it most appropriate for this population.
Question 3: A patient with C5 ASIA A spinal cord injury wants to perform pressure relief independently. Which technique is MOST realistic for this level?
- Lateral weight shift using head-hips relationship (Correct answer)
- Standard push-up pressure relief from wheelchair
- Forward lean pressure relief independently
- Standing pivot transfer for full pressure relief
Correct answer: Lateral weight shift using head-hips relationship
At C5 ASIA A, patients lack wrist extension and hand function needed for push-ups, but can perform lateral weight shifts using the head-hips relationship with shoulder musculature.
Question 4: During assessment of a patient with cerebellar ataxia, which finding is MOST characteristic of dysmetria?
- Overshoot and correction during finger-to-nose testing (Correct answer)
- Cogwheel rigidity during passive elbow movement
- Resting tremor that diminishes with intentional movement
- Spastic catch at end range of passive motion
Correct answer: Overshoot and correction during finger-to-nose testing
Dysmetria is characterized by errors in movement endpoint accuracy, typically seen as overshoot (past-pointing) followed by corrective oscillations during the finger-to-nose test.
Question 5: Which neuroplasticity principle supports the use of high-repetition, task-specific practice in neurological rehabilitation?
- Use it or lose it — synaptic connections strengthen with repeated activation (Correct answer)
- Massed practice is always superior to distributed practice
- Cortical maps are fixed after the critical developmental period
- Motor learning only occurs during the acute phase post-injury
Correct answer: Use it or lose it — synaptic connections strengthen with repeated activation
High-repetition task-specific practice drives synaptic strengthening through long-term potentiation, supporting the neuroplasticity principle that repeated use reinforces neural pathways.
Question 6: A patient post-TBI demonstrates difficulty following two-step commands but can follow simple one-step instructions. At which Rancho Los Amigos level is this patient MOST likely functioning?
- Level IV — Confused/Agitated
- Level III — Localized Response
- Level VI — Confused/Appropriate (Correct answer)
- Level VII — Automatic/Appropriate
Correct answer: Level VI — Confused/Appropriate
Rancho Level VI (Confused/Appropriate) is characterized by following simple commands consistently but having difficulty with complex or two-step directions.
Question 7: Which gait deviation is MOST commonly observed in patients with foot drop following a common peroneal nerve injury?
- Steppage gait with exaggerated hip and knee flexion (Correct answer)
- Trendelenburg gait with contralateral pelvic drop
- Antalgic gait with shortened stance phase
- Scissor gait with hip adductor hypertonicity
Correct answer: Steppage gait with exaggerated hip and knee flexion
Peroneal nerve injury causes dorsiflexion weakness, leading to steppage gait where the patient exaggerates hip and knee flexion to clear the foot during swing phase.
DPT Neurological Rehabilitation 2
A patient with Parkinson's disease demonstrates festinating gait.
Which intervention BEST addresses this motor pattern?