NPTE-PT Equipment and Therapeutic Modalities 3 — Questions and Answers
Question 1: A physical therapist is using neuromuscular electrical stimulation (NMES) to facilitate quadriceps re-education after ACL reconstruction. Which parameter is MOST important for minimizing patient discomfort while achieving muscle contraction?
- High pulse duration (300–500 µs) with low frequency (Correct answer)
- Short pulse duration (50–100 µs) with high frequency
- Long on/off ratio (1:1)
- High amplitude with short ramp time
Correct answer: High pulse duration (300–500 µs) with low frequency
Longer pulse durations effectively recruit motor neurons at lower amplitudes, improving comfort while achieving the desired contraction.
Question 2: Which assistive device requires the GREATEST amount of upper extremity strength and coordination to use safely?
- Standard walker
- Axillary crutches (Correct answer)
- Lofstrand (forearm) crutches
- Hemi-walker
Correct answer: Axillary crutches
Axillary crutches require significant upper extremity strength, trunk stability, and coordination for safe swing-through gait patterns.
Question 3: A patient with a spinal cord injury at T6 is being fitted for a wheelchair. Which feature is MOST critical to prevent autonomic dysreflexia?
- Solid seat insert for pressure distribution (Correct answer)
- Adjustable footrests to relieve hamstring tightness
- Anti-tip wheels for safety on ramps
- Removable armrests for lateral transfers
Correct answer: Solid seat insert for pressure distribution
Proper pressure distribution with a solid seat insert prevents pressure injuries, which are a common trigger for autonomic dysreflexia in high thoracic SCI.
Question 4: When is whirlpool hydrotherapy MOST appropriate?
- Management of wounds with necrotic tissue requiring debridement (Correct answer)
- Acute ankle sprain within the first 24 hours
- Venous insufficiency ulcers with dependent edema
- Burns covering more than 20% body surface area
Correct answer: Management of wounds with necrotic tissue requiring debridement
Whirlpool's agitation aids mechanical debridement of necrotic tissue, making it appropriate for wounds requiring wound bed preparation.
Question 5: A therapist applies pulsed ultrasound (20% duty cycle) to a subacute injury. What is the PRIMARY physiological effect intended?
- Thermal heating to increase tissue extensibility
- Mechanical (non-thermal) effects to promote tissue healing (Correct answer)
- Increased nerve conduction velocity
- Vasoconstriction to reduce inflammation
Correct answer: Mechanical (non-thermal) effects to promote tissue healing
Low duty cycle pulsed ultrasound minimizes heat accumulation and produces non-thermal mechanical effects like acoustic streaming that promote healing.
Question 6: Which wheelchair propulsion pattern is associated with the LOWEST risk of developing carpal tunnel syndrome in manual wheelchair users?
- Arc pattern (pushing forward and allowing hand to drop naturally)
- Semi-circular pattern (hand returns below the pushrim) (Correct answer)
- Choppy or high-cadence short strokes
- Reverse semi-circular pattern with wrist extension
Correct answer: Semi-circular pattern (hand returns below the pushrim)
The semi-circular (SCIM) propulsion pattern minimizes repetitive wrist extension and reduces cumulative stress on the carpal tunnel.
Question 7: A patient ambulating with a standard cane reports the cane is causing shoulder elevation. The MOST likely cause is:
- Cane is too short
- Cane is too long (Correct answer)
- Patient is using the wrong hand
- Cane handle is incorrect type
Correct answer: Cane is too long
A cane that is too long forces the shoulder to elevate to keep the elbow at the appropriate 20–30° flexion angle during use.
NPTE-PT Equipment and Therapeutic Modalities 3
A physical therapist is using neuromuscular electrical stimulation (NMES) to facilitate quadriceps re-education after ACL reconstruction.
Which parameter is MOST important for minimizing patient discomfort while achieving muscle contraction?