OTA Physical Rehabilitation 5 — Questions and Answers
Question 1: An OTA is treating a patient with complex regional pain syndrome (CRPS) Type I in the right hand. Which early intervention approach has the MOST evidence?
- Complete immobilization of the affected limb
- Graded motor imagery and desensitization techniques (Correct answer)
- High-intensity resistive exercises
- Avoidance of all tactile stimulation
Correct answer: Graded motor imagery and desensitization techniques
Graded motor imagery and progressive desensitization are evidence-based approaches for CRPS that address central sensitization and gradually restore normal sensory processing.
Question 2: A patient with a femoral neck fracture repaired with hemiarthroplasty is given posterior hip precautions. Which bed position violates these precautions?
- Supine with hip in neutral rotation
- Side-lying on the non-operated side with a pillow between knees
- Supine with the hip flexed past 90° by elevating the head of the bed too high (Correct answer)
- Supine with legs in slight abduction
Correct answer: Supine with the hip flexed past 90° by elevating the head of the bed too high
Elevating the head of the bed past the allowed angle can create hip flexion beyond 90°, violating posterior hip precautions and risking dislocation.
Question 3: Which MMT grade indicates the patient can move the limb through full ROM against gravity but cannot tolerate any additional resistance?
- Grade 2 (Poor)
- Grade 3 (Fair) (Correct answer)
- Grade 4 (Good)
- Grade 5 (Normal)
Correct answer: Grade 3 (Fair)
MMT Grade 3 (Fair) means the patient achieves full ROM against gravity only, with no ability to resist additional manual resistance.
Question 4: An OTA is designing a strengthening program for a patient post-ACL reconstruction at 8 weeks. Which exercise is MOST appropriate at this stage?
- Open kinetic chain knee extension at full range
- Closed kinetic chain mini-squats within a pain-free range (Correct answer)
- Full depth open kinetic chain leg press at maximum resistance
- Aggressive plyometric jumping drills
Correct answer: Closed kinetic chain mini-squats within a pain-free range
At 8 weeks post-ACL reconstruction, closed kinetic chain exercises like mini-squats reduce anterior tibial shear forces and are safer and more functional than open kinetic chain knee extension.
Question 5: A patient with peripheral neuropathy from diabetes mellitus is receiving foot care education. Which instruction is MOST critical for preventing complications?
- Soak feet in hot water daily to improve circulation
- Inspect feet daily for cuts, blisters, or color changes (Correct answer)
- Walk barefoot indoors to improve tactile feedback
- Trim toenails in a curved shape following the toe contour
Correct answer: Inspect feet daily for cuts, blisters, or color changes
Daily foot inspection is the most critical preventive measure because peripheral neuropathy reduces the ability to detect injury, allowing small wounds to progress to serious complications.
Question 6: When measuring a patient for a standard wheelchair, which measurement MOST directly determines the appropriate seat width?
- Hip width plus 2 inches (Correct answer)
- Shoulder width
- Chest circumference divided by 2
- Thigh length from hip to knee
Correct answer: Hip width plus 2 inches
Standard wheelchair seat width is the patient's widest hip or thigh measurement plus 2 inches (approximately 1 inch on each side) to allow comfortable seating without excessive lateral movement.
Question 7: An OTA is providing therapeutic exercise for a patient with frozen shoulder (adhesive capsulitis) in the early inflammatory phase. Which intervention is MOST appropriate?
- Aggressive stretching to break up adhesions immediately
- Pendulum exercises and gentle active-assisted ROM within pain-free limits (Correct answer)
- Resistive shoulder strengthening with weights
- Joint mobilization at end-range in all directions
Correct answer: Pendulum exercises and gentle active-assisted ROM within pain-free limits
During the inflammatory phase of adhesive capsulitis, gentle pendulum exercises and pain-free active-assisted ROM prevent further stiffness without aggravating inflammation.
OTA Physical Rehabilitation 5
An OTA is treating a patient with complex regional pain syndrome (CRPS) Type I in the right hand.
Which early intervention approach has the MOST evidence?