CSRS ACTUAL 2026 TEST PAPER QUESTIONS AND
SOLUTIONS RATED A+
✔✔Attention (MIA)
Knowledge of Results
External Cues - ✔✔FOCUS MORE ON:
external feedback & knowledge of results
Extrinsic feedback
-KP: (knowledge of performance) external feedback that focuses on the "quality of
movement"
-KR: (knowledge of results) external feedback that focuses on the "outcome or goal of a
skills"
-Motivational feedback: "your going to do great with this, can't wait to see how you do",
ADD: autonomy/self-control: How fast do you think you can do it?
Intrinsic feedback: A person's own sensory-perceptual information that is a result of
movement being performed (ie proprioception, vision, auditory, vestibular that can
mediate this information)
✔✔Skill Acquisition - ✔✔Prepare/practice and get feedback
voluntary control over movements of joints and body segments in an effort to solve a
motor skill problem and achieve a task goal.
-FOCUS on skills acquisition instead of movement with "TASK SPECIFICTY"
-how can we turn an activity into something the patient wants to do, needs to do, and
has to do in order to enhance outcomes
-This helps to ensure that your patient is engaged in your therapy session not merely
practicing
-Repetitive and Specific practice are necessary to promote changes in the cortex
✔✔Visual Loss Post Stroke - ✔✔-Visual fields loss 52%
-Central visual problems 70%
-Eye movement disorders 68%
-Visual perceptual disorders 80% (inclusive of visual inattention)
-Other deficits include: burry vision, double vision, reading difficulty, moving images, dry
eyes, sensitivity to light, visual neglect, difficulty judging depth/movements, agnosia
(object recognition), visual hallucinations, hemianopsia's (multiple versions)
Note: I movement disorders have a very close link to vestibular dysfunction (screen
patients for motion sickness, lightheadedness, and vertigo)
✔✔Visual Impairments (Most Common) - ✔✔Visual Fields
-Homonymous hemianopsia
-Quadtrantanopia
-Scotoma
-Bitemporal hemianopsia (tunnel vision)
Visual Perceptual Impairments
,-Diplopia
-Visual Midline Shift
-Unilateral Visual Neglect/inattention
-Visual agnosia
-Strabismus
-Nystagmus
-Cortical blindness
✔✔Functional Affects of Visual Impairments - ✔✔-increased risk of falls
-loss of confidence
-fear of falling, and/or going out alone
-social isolation
-loss of independence/ decreased QoL
✔✔Affected Artery and Corresponding Vison Impairments - ✔✔Middle Cerebral Artery
(MCA)
-visual filed impairment (B)
-visuospatial impairment (R)
-contralateral homonymous hemianopsia (B)
-visual perceptual and unilateral neglect (R)
Posterior Cerebral Artery (PCA)
-contralateral homonymous hemianopsia (B)
-visual agnosia (B)
-cortical blindness (R)
-visuospatial impairments (R)
✔✔Visual Field Loss - ✔✔Damage to receptor cells along the optic pathway, any where
from the retina to the occipital cortex
-The location and extent of the visual flied loss is dependent on where the damage
occurs along the pathway
-Hemianopsia: loss of vision in half of the visual field both eyes
-Homonymous hemianopsia: 1/2 loss of half of the field of view on the same side of both
eyes
-Heteronymous Hemianopsia: Loss of visual field on different sides of both eyes
-Quadrantopsia: Loss of visual field in one quadrant of one or both eyes
✔✔Heminopsia - ✔✔blindness over half the field of vision
-Spontaneous recovery is less than 40%
-Most recovery in the first 3 mths post stroke
-Often confused with neglect-especially acutely (Differential diagnosis is key!)
✔✔Visual Spatial Impairments - ✔✔Diplopia (double vision) primary functional
disruption observed in patients with cranial nerve lesions
-3 pairs of cranial nerves control the extraocular muscles
-Oculomotor nerve (3), Trochlear nerve (4), Abducens (6)
, -Affects eye-hand coordination, postural control, and binocular use of the eyes
Can occur throughout focal range
-within 20 inches of face: writing, grooming/hygiene
-distance greater than 4 feet/ walking and driving
Unilateral visual inattention/neglect: disruption of visual attention creates asymmetry
and gaps in visual information gathered through visual search (ie. driving and reading
are often significantly affected by inattention)
✔✔Brief Visual Screen - ✔✔-Left Visual Screen: Patient is unaware of items located to
the left (e.g clothing, grooming items) but is able to locate them when cued
-Focusing; Patient is unable to bring objects into focus at near as demonstrated by
holding them out or moving back to view them
-Near acuity: Patient complains that print is blurred when viewing menu or daily
schedule
-Low contrast acuity: Patient is unable to distinguish between items that are the same or
similar color as the background during dressing, grooming etc. or difficulty completing
ask in dem-lighting
✔✔Questions to ask during eval: VISION - ✔✔1. Do you wear glasses or contacts /
bifocals ?
2. Do you have your glasses with you ?
3. Have you ever had any issue with your vision?
4. Are you seeing double?
5. Do you feel dizzy ?
✔✔Key symptoms to look for during eval " VISION - ✔✔-Facial expression: head
turning, slanting, squinting, facial droop, ptosis (eye drooping),
-Eyes misaligned, closing one eye
-Nystagmus (involuntary eye movement rapidly moves)
-Strabismus: crossed eyed
-Difficulty focusing
-Smooth pursuits: following moving object/ deficits Saccades ( rapid eye movements)
-Fatigue, frustration, complaints of headache
-Complaints of losing place when reading/ holding material far away
-Complaints of objects moving or appear distorted
-Complaints of walls or floor being "wavy"
-Quality of eye movements: smooth vs jerking movement
-Eye missing or losing targets (over under shooting)
✔✔Interventions for Visual Fields Loss - ✔✔Patient education awareness and safety
-Increase search area and pattern (e.g head and shoulder turning, length of saccades)
-Increase sensory awareness
-Position items on affected side
-Distinct starting "anchor" point (white board w/ colored tape on L edge, colored line on
a paper
SOLUTIONS RATED A+
✔✔Attention (MIA)
Knowledge of Results
External Cues - ✔✔FOCUS MORE ON:
external feedback & knowledge of results
Extrinsic feedback
-KP: (knowledge of performance) external feedback that focuses on the "quality of
movement"
-KR: (knowledge of results) external feedback that focuses on the "outcome or goal of a
skills"
-Motivational feedback: "your going to do great with this, can't wait to see how you do",
ADD: autonomy/self-control: How fast do you think you can do it?
Intrinsic feedback: A person's own sensory-perceptual information that is a result of
movement being performed (ie proprioception, vision, auditory, vestibular that can
mediate this information)
✔✔Skill Acquisition - ✔✔Prepare/practice and get feedback
voluntary control over movements of joints and body segments in an effort to solve a
motor skill problem and achieve a task goal.
-FOCUS on skills acquisition instead of movement with "TASK SPECIFICTY"
-how can we turn an activity into something the patient wants to do, needs to do, and
has to do in order to enhance outcomes
-This helps to ensure that your patient is engaged in your therapy session not merely
practicing
-Repetitive and Specific practice are necessary to promote changes in the cortex
✔✔Visual Loss Post Stroke - ✔✔-Visual fields loss 52%
-Central visual problems 70%
-Eye movement disorders 68%
-Visual perceptual disorders 80% (inclusive of visual inattention)
-Other deficits include: burry vision, double vision, reading difficulty, moving images, dry
eyes, sensitivity to light, visual neglect, difficulty judging depth/movements, agnosia
(object recognition), visual hallucinations, hemianopsia's (multiple versions)
Note: I movement disorders have a very close link to vestibular dysfunction (screen
patients for motion sickness, lightheadedness, and vertigo)
✔✔Visual Impairments (Most Common) - ✔✔Visual Fields
-Homonymous hemianopsia
-Quadtrantanopia
-Scotoma
-Bitemporal hemianopsia (tunnel vision)
Visual Perceptual Impairments
,-Diplopia
-Visual Midline Shift
-Unilateral Visual Neglect/inattention
-Visual agnosia
-Strabismus
-Nystagmus
-Cortical blindness
✔✔Functional Affects of Visual Impairments - ✔✔-increased risk of falls
-loss of confidence
-fear of falling, and/or going out alone
-social isolation
-loss of independence/ decreased QoL
✔✔Affected Artery and Corresponding Vison Impairments - ✔✔Middle Cerebral Artery
(MCA)
-visual filed impairment (B)
-visuospatial impairment (R)
-contralateral homonymous hemianopsia (B)
-visual perceptual and unilateral neglect (R)
Posterior Cerebral Artery (PCA)
-contralateral homonymous hemianopsia (B)
-visual agnosia (B)
-cortical blindness (R)
-visuospatial impairments (R)
✔✔Visual Field Loss - ✔✔Damage to receptor cells along the optic pathway, any where
from the retina to the occipital cortex
-The location and extent of the visual flied loss is dependent on where the damage
occurs along the pathway
-Hemianopsia: loss of vision in half of the visual field both eyes
-Homonymous hemianopsia: 1/2 loss of half of the field of view on the same side of both
eyes
-Heteronymous Hemianopsia: Loss of visual field on different sides of both eyes
-Quadrantopsia: Loss of visual field in one quadrant of one or both eyes
✔✔Heminopsia - ✔✔blindness over half the field of vision
-Spontaneous recovery is less than 40%
-Most recovery in the first 3 mths post stroke
-Often confused with neglect-especially acutely (Differential diagnosis is key!)
✔✔Visual Spatial Impairments - ✔✔Diplopia (double vision) primary functional
disruption observed in patients with cranial nerve lesions
-3 pairs of cranial nerves control the extraocular muscles
-Oculomotor nerve (3), Trochlear nerve (4), Abducens (6)
, -Affects eye-hand coordination, postural control, and binocular use of the eyes
Can occur throughout focal range
-within 20 inches of face: writing, grooming/hygiene
-distance greater than 4 feet/ walking and driving
Unilateral visual inattention/neglect: disruption of visual attention creates asymmetry
and gaps in visual information gathered through visual search (ie. driving and reading
are often significantly affected by inattention)
✔✔Brief Visual Screen - ✔✔-Left Visual Screen: Patient is unaware of items located to
the left (e.g clothing, grooming items) but is able to locate them when cued
-Focusing; Patient is unable to bring objects into focus at near as demonstrated by
holding them out or moving back to view them
-Near acuity: Patient complains that print is blurred when viewing menu or daily
schedule
-Low contrast acuity: Patient is unable to distinguish between items that are the same or
similar color as the background during dressing, grooming etc. or difficulty completing
ask in dem-lighting
✔✔Questions to ask during eval: VISION - ✔✔1. Do you wear glasses or contacts /
bifocals ?
2. Do you have your glasses with you ?
3. Have you ever had any issue with your vision?
4. Are you seeing double?
5. Do you feel dizzy ?
✔✔Key symptoms to look for during eval " VISION - ✔✔-Facial expression: head
turning, slanting, squinting, facial droop, ptosis (eye drooping),
-Eyes misaligned, closing one eye
-Nystagmus (involuntary eye movement rapidly moves)
-Strabismus: crossed eyed
-Difficulty focusing
-Smooth pursuits: following moving object/ deficits Saccades ( rapid eye movements)
-Fatigue, frustration, complaints of headache
-Complaints of losing place when reading/ holding material far away
-Complaints of objects moving or appear distorted
-Complaints of walls or floor being "wavy"
-Quality of eye movements: smooth vs jerking movement
-Eye missing or losing targets (over under shooting)
✔✔Interventions for Visual Fields Loss - ✔✔Patient education awareness and safety
-Increase search area and pattern (e.g head and shoulder turning, length of saccades)
-Increase sensory awareness
-Position items on affected side
-Distinct starting "anchor" point (white board w/ colored tape on L edge, colored line on
a paper
