OTA Physical Rehabilitation 3 — Questions and Answers
Question 1: A patient is using a transcutaneous electrical nerve stimulation (TENS) unit for pain management. Which electrode placement pattern uses the gate control theory of pain?
- Placing electrodes over trigger points only
- Placing electrodes proximal and distal to the pain site at sensory intensity (Correct answer)
- Placing electrodes at acupuncture points at high intensity
- Placing electrodes over the contralateral limb
Correct answer: Placing electrodes proximal and distal to the pain site at sensory intensity
Conventional TENS uses sensory-level stimulation with electrodes placed around the painful area to activate large-diameter Aβ fibers and 'close the gate' to pain signals.
Question 2: An OTA is working with a patient post-total knee arthroplasty (TKA). Which precaution is MOST important during early rehabilitation?
- Avoid any knee flexion beyond 45°
- Follow weight-bearing status prescribed by the surgeon (Correct answer)
- Avoid all strengthening exercises for 6 weeks
- Keep the knee in full extension at all times
Correct answer: Follow weight-bearing status prescribed by the surgeon
Following the surgeon's prescribed weight-bearing status is the most critical precaution after TKA to protect the implant during osseointegration.
Question 3: During intervention for a patient with Parkinson's disease, which strategy has the MOST evidence for improving gait?
- Visual or auditory rhythmic cues (Correct answer)
- Passive stretching only
- Avoiding any dual-task activities
- High-speed treadmill training exclusively
Correct answer: Visual or auditory rhythmic cues
Rhythmic auditory stimulation and visual cues (such as lines on the floor) have strong evidence for improving stride length and gait in Parkinson's disease.
Question 4: A patient with a T4 complete SCI needs to perform a pressure relief while seated in a manual wheelchair. Which method is MOST appropriate?
- Lateral weight shifts
- Forward trunk lean
- Push-up pressure relief off the armrests (Correct answer)
- Wheelchair tilt-in-space with caregiver assistance
Correct answer: Push-up pressure relief off the armrests
Patients with T4 SCI have sufficient upper extremity strength to perform push-up pressure reliefs using the armrests, which is the most independent and effective method.
Question 5: An OTA is applying ultrasound over scar tissue to improve extensibility. Which parameter is MOST appropriate?
- Pulsed ultrasound at 3 MHz, 0.5 W/cm²
- Continuous ultrasound at 1 MHz, 1.5 W/cm² (Correct answer)
- Pulsed ultrasound at 1 MHz, 3.0 W/cm²
- Continuous ultrasound at 3 MHz, 2.5 W/cm²
Correct answer: Continuous ultrasound at 1 MHz, 1.5 W/cm²
Continuous ultrasound at 1 MHz penetrates deeper tissue and produces thermal effects that increase collagen extensibility, making it most appropriate for deep scar tissue treatment.
Question 6: Which functional mobility outcome is MOST appropriate for a patient with moderate TBI who is at Rancho Los Amigos Level V?
- Independent community ambulation with no cues
- Supervised mobility with minimal verbal cuing for safety (Correct answer)
- Dependent positioning in wheelchair only
- Independent driving with adaptive equipment
Correct answer: Supervised mobility with minimal verbal cuing for safety
Rancho Level V (Confused, Inappropriate) patients require supervision and minimal cuing because they show inconsistent responses and safety judgment deficits.
Question 7: A patient reports sharp pain at the lateral epicondyle with resisted wrist extension. The OTA should FIRST:
- Increase resistance to strengthen the wrist extensors
- Discontinue the resistive exercise and report to the supervising OT (Correct answer)
- Apply ice and continue the exercise at lower resistance
- Recommend the patient rest at home without further treatment
Correct answer: Discontinue the resistive exercise and report to the supervising OT
When a patient reports sharp pain during an exercise, the OTA should immediately discontinue the activity and report the finding to the supervising OT for reassessment.
OTA Physical Rehabilitation 3
A patient is using a transcutaneous electrical nerve stimulation (TENS) unit for pain management.
Which electrode placement pattern uses the gate control theory of pain?