Neuro Rehab Exam 3 Questions And
Answers
/. nYour pt presents with excessive knee hyper extension during gait and lacks the
ability to clear the foot during the swing phase. Which orthotic would BEST suit him?
A. Anterior pre fab with a DF stop
B. Anterior pre fab with a PF stop
C. posterior pre fab with a DF stop
D. posterior pre fab with a PF stop - Answer-posterior pre fab with a PF stop
posterior pre fab = good for excessive hyper extension;
due to excess knee hyper extension = want a PF stop to prevent further PF when the
knee tries to hyper extend
/.True or false
The shank and the thigh are both vertical in midstance - Answer-FALSE
the shank is inclined
the thigh is vertical
/.Overweight pt has strong LE synergy patterns with gait and excessive knee extension
weakness. The pt is also struggling with excessive medial ankle stability. What is the
BEST orthotic?
A. anterior shell pre-fab with DF stop
B. anterior custom AFO with DF stop
C. posterior custom AFO with PF stop
D. posterior pre-fab with PF stop - Answer-anterior custom AFO with DF stop
customer AFO
- if pt has significant abnormal tone
- significant medial lateral instability
- knee instability
- sensory deficits
- atypical body build
anterior shell = good for knee instability
,posterior shell = good for excessive knee hyperextension
DF stop = good for knee instability
PF stop = good for foot drop, or knee hyperextension
/.True or false
the anterior rods in the orthotics are for a PF stop - Answer-FALSE
anterior rods = DF stop
posterior rods = PF stop
anterior springs = PF assist
posterior springs = DF assist
/.True or false
Pt with Parkinson's will NEVER have a tremor with intent - Answer-FALSE
while most tremors start as a resting "pill rolling" tremor, pts can develop a tremor that is
with them constantly
/.True or false
Pt with Parkinson's start to present with symptoms as soon as they start having
degeneration of dopamine - Answer-FALSE
degeneration of 60-80% of dopaminergic neurons in substantia nigra before signs and
symptoms become clinically evident
/.Which of the following is not a cardinal feature of parkinsons?
A. Bradykinesia
B. pill rolling tremor
C. rigidity
D. chorea - Answer-Chorea
this is involuntary movement that is writhing movement
seen with Huntingtons disease
/.You are working with your pt with parkinsons and note that they seem to lack any
facial expressions during your session. What are yo thinking?
, A. presence of dementia
B. presence of mircographia
C. presence of masked facies
D. presence of cogwheel - Answer-presence of masked facies
this is also known as hypominia which is lack of facial expression
this is often one of the hardest symptoms for pts to deal with
/.True or false
Rigidity is velocity dependent and changes with increase in speed - Answer-FALSE
it is velocity INDEPENDENT
cogwheel - feels like your breaking adhesions along the duration of the movement
Lead pipe - sustained resistance throughout the motion
/.You are working with your pt with a dx of parkinsons and note that they struggle with
getting out of a chair as they continue to fall backwards into the chair. What are you
thinking?
A. Typical of parkinsons dx, should work on more anticipatory moves
B. this seems to present more like MSA
C. This seems to present more like PSP
D. this seems to present more like ALS - Answer-This seems to present more like PSP
and is known as rocker sign
Progressive supra nuclear palsy (PSP)
- inability to gaze downward
- rocker sign
- retropulsion
/.your pt who has Parkinsons stated that when they first noticed their symptoms, it was
because they were having gait disturbance issues. What does this tell you?
A. seems to present like MSA
B. disease will progress more slowly
C. disease will progress faster
D. seems to present like PSP - Answer-disease will progress faster
if the first sign is the resting tremor = SLOWER progression
if the first sign is postural instability or gait disturbances = FASTER progression
Answers
/. nYour pt presents with excessive knee hyper extension during gait and lacks the
ability to clear the foot during the swing phase. Which orthotic would BEST suit him?
A. Anterior pre fab with a DF stop
B. Anterior pre fab with a PF stop
C. posterior pre fab with a DF stop
D. posterior pre fab with a PF stop - Answer-posterior pre fab with a PF stop
posterior pre fab = good for excessive hyper extension;
due to excess knee hyper extension = want a PF stop to prevent further PF when the
knee tries to hyper extend
/.True or false
The shank and the thigh are both vertical in midstance - Answer-FALSE
the shank is inclined
the thigh is vertical
/.Overweight pt has strong LE synergy patterns with gait and excessive knee extension
weakness. The pt is also struggling with excessive medial ankle stability. What is the
BEST orthotic?
A. anterior shell pre-fab with DF stop
B. anterior custom AFO with DF stop
C. posterior custom AFO with PF stop
D. posterior pre-fab with PF stop - Answer-anterior custom AFO with DF stop
customer AFO
- if pt has significant abnormal tone
- significant medial lateral instability
- knee instability
- sensory deficits
- atypical body build
anterior shell = good for knee instability
,posterior shell = good for excessive knee hyperextension
DF stop = good for knee instability
PF stop = good for foot drop, or knee hyperextension
/.True or false
the anterior rods in the orthotics are for a PF stop - Answer-FALSE
anterior rods = DF stop
posterior rods = PF stop
anterior springs = PF assist
posterior springs = DF assist
/.True or false
Pt with Parkinson's will NEVER have a tremor with intent - Answer-FALSE
while most tremors start as a resting "pill rolling" tremor, pts can develop a tremor that is
with them constantly
/.True or false
Pt with Parkinson's start to present with symptoms as soon as they start having
degeneration of dopamine - Answer-FALSE
degeneration of 60-80% of dopaminergic neurons in substantia nigra before signs and
symptoms become clinically evident
/.Which of the following is not a cardinal feature of parkinsons?
A. Bradykinesia
B. pill rolling tremor
C. rigidity
D. chorea - Answer-Chorea
this is involuntary movement that is writhing movement
seen with Huntingtons disease
/.You are working with your pt with parkinsons and note that they seem to lack any
facial expressions during your session. What are yo thinking?
, A. presence of dementia
B. presence of mircographia
C. presence of masked facies
D. presence of cogwheel - Answer-presence of masked facies
this is also known as hypominia which is lack of facial expression
this is often one of the hardest symptoms for pts to deal with
/.True or false
Rigidity is velocity dependent and changes with increase in speed - Answer-FALSE
it is velocity INDEPENDENT
cogwheel - feels like your breaking adhesions along the duration of the movement
Lead pipe - sustained resistance throughout the motion
/.You are working with your pt with a dx of parkinsons and note that they struggle with
getting out of a chair as they continue to fall backwards into the chair. What are you
thinking?
A. Typical of parkinsons dx, should work on more anticipatory moves
B. this seems to present more like MSA
C. This seems to present more like PSP
D. this seems to present more like ALS - Answer-This seems to present more like PSP
and is known as rocker sign
Progressive supra nuclear palsy (PSP)
- inability to gaze downward
- rocker sign
- retropulsion
/.your pt who has Parkinsons stated that when they first noticed their symptoms, it was
because they were having gait disturbance issues. What does this tell you?
A. seems to present like MSA
B. disease will progress more slowly
C. disease will progress faster
D. seems to present like PSP - Answer-disease will progress faster
if the first sign is the resting tremor = SLOWER progression
if the first sign is postural instability or gait disturbances = FASTER progression
