NPTE-PT Musculoskeletal System Interventions 4 — Questions and Answers
Question 1: A physical therapist is applying ultrasound over a recent scar tissue formation. Which parameter is MOST appropriate to promote tissue extensibility?
- 1 MHz, pulsed 20%, low intensity (0.5 W/cm²)
- 3 MHz, continuous, moderate intensity (1.0–1.5 W/cm²) (Correct answer)
- 1 MHz, continuous, high intensity (2.5 W/cm²)
- 3 MHz, pulsed 50%, low intensity (0.3 W/cm²)
Correct answer: 3 MHz, continuous, moderate intensity (1.0–1.5 W/cm²)
3 MHz continuous ultrasound heats superficial tissue (1–2 cm depth) most effectively, and moderate intensity in continuous mode increases collagen extensibility.
Question 2: Which exercise is considered CLOSED kinetic chain for the lower extremity?
- Seated leg extension machine
- Supine straight leg raise
- Wall squat (wall slide) (Correct answer)
- Prone hip extension
Correct answer: Wall squat (wall slide)
A wall squat is a closed kinetic chain exercise because the foot remains in contact with a fixed surface, causing simultaneous multi-joint motion under load.
Question 3: A patient with adhesive capsulitis (frozen shoulder) in the freezing phase is best managed with which intervention priority?
- Aggressive joint mobilization grades IV–V
- Pain management and gentle ROM within pain-free range (Correct answer)
- Heavy rotator cuff strengthening
- Corticosteroid injection as sole treatment
Correct answer: Pain management and gentle ROM within pain-free range
In the freezing phase, pain is the dominant symptom; management focuses on pain control and gentle pain-free ROM to avoid exacerbating the inflammatory process.
Question 4: Which grade of joint mobilization is used primarily to reduce pain with minimal tissue stretch?
- Grade I (Correct answer)
- Grade III
- Grade IV
- Grade V (manipulation)
Correct answer: Grade I
Grade I mobilizations are small-amplitude oscillations at the beginning of range used primarily for pain modulation via neurophysiological mechanisms.
Question 5: A patient recovering from a hamstring strain (grade II) is progressing to sport-specific training. Which criterion BEST indicates readiness to advance?
- Pain-free walking only
- Hamstring strength ≥90% of the uninvolved side with no pain during eccentric loading (Correct answer)
- Full passive range of motion
- Two weeks elapsed since injury
Correct answer: Hamstring strength ≥90% of the uninvolved side with no pain during eccentric loading
Return to sport requires hamstring strength symmetry (≥90%) and pain-free eccentric loading to reduce re-injury risk during high-speed running.
Question 6: Which approach is MOST evidence-based for treating non-specific chronic low back pain?
- Bed rest for 2 weeks
- Passive modalities (heat/TENS) as primary treatment
- Active exercise and cognitive-behavioral approaches (Correct answer)
- Lumbar corset use during all activities
Correct answer: Active exercise and cognitive-behavioral approaches
Current evidence strongly supports active exercise combined with cognitive-behavioral strategies for chronic low back pain over passive treatment approaches.
Question 7: A patient with de Quervain's tenosynovitis is referred for physical therapy. Which intervention is MOST appropriate initially?
- Aggressive resisted thumb strengthening
- Thumb spica splinting and activity modification (Correct answer)
- Joint manipulation of the CMC joint
- High-load tendon loading exercises
Correct answer: Thumb spica splinting and activity modification
Initial management of de Quervain's tenosynovitis includes thumb spica splinting to rest the APL and EPB tendons and activity modification to reduce irritation.
NPTE-PT Musculoskeletal System Interventions 4
A physical therapist is applying ultrasound over a recent scar tissue formation.
Which parameter is MOST appropriate to promote tissue extensibility?