Physical Rehabilitation 5th Edition

OSullivan Test Bank

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 Chapter 8: Examination of Motor Function: Motor Control and Motor Learning

1. A motor program is best defined as

A) a representation of a motor task that when initiated results in a movement sequence.
B) information about how a movement felt and the outcome of the movement sequence.
C) a plan for a movement sequence that includes multiple components of movement.
D) movement that occurs as a result of practice and feedback.

2. Which statement best describes dynamical systems theory?

A) Control occurs in a hierarchical manner with higher levels of the CNS controlling
lower levels.
B) Units of the CNS are organized around demands of specific tasks.
C) Motor elements are activated in response to specific sensory stimulation.
D) The input from higher levels are given more weight when determining the motor
response.

3. What is an appropriate method of examining if motor learning has occurred in a patient

with motor deficits?
A) Manual muscle testing of the impaired extremity
B) Active-assisted ROM of the impaired extremity
C) Measuring performance on a retention test
D) Using the Modified Ashworth Scale

4. The patient sustained a traumatic brain injury approximately 15 months ago. He exhibits
normal respiration, digestion, and blood pressure. He is able to be aroused, but he is not aware
of his environment and does not have any purposeful responses to the environment. What is this
patient's level of consciousness?
A) Vegetative state
B) Coma
C) Persistent vegetative state
D) Obtunded

5. The patient is able to walk independently from his room to the physical therapy gym
while talking to the therapist. This is an example of
A) selective attention.
B) sustained attention.
C) alternating attention.
D) divided attention.

6. The therapist asks the patient to perform a group of exercises and then monitors how
long the patient is able to follow through with the task. What type of attention is the therapist
assessing?
A) Selective attention
B) Sustained attention
C) Alternating attention
D) Divided attention

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 Chapter 8: Examination of Motor Function: Motor Control and Motor Learning

7. During the examination the therapist asks the patient to add one pair of numbers and then
subtract a pair numbers. What type of attention is the therapist assessing?
A) Selective attention
B) Sustained attention
C) Alternating attention
D) Divided attention

8. A patient demonstrates difficulty recalling the nurse and therapist's names and is unsure
why she is in the hospital. She does remember the names of her best friends and the high school
she attends. What is the best description of this patient's deficits?
A) Dementia
B) Acute confusional state
C) Retrograde amnesia
D) Anterograde amnesia

9. If a patient has impaired memory and attention, what might be an effective strategy for
the therapist when performing the examination and subsequent interventions?
A) Work with the patient in a closed, quiet environment to minimize distractions.
B) Treat the patient with another patient so they can assist each other.
C) Provide the patient with detailed instructions and directions to assist his memory.
D) Work with the patient in the physical therapy gym.

10. During a movement sequence the sensory system sends information to the central
nervous system to monitor the task and provide for correction of movement. This type of control
is
A) feedforward control.
B) synergistic units.
C) feedback control.
D) coordinative structures.

11. The patient demonstrates increased resistance to passive stretch of the right biceps. How
should this be documented?
A) The patient demonstrates hypertonia of the right biceps.
B) The patient demonstrates hypotonia of the right biceps.
C) The patient demonstrates dystonia of the right biceps.
D) The patient demonstrates normal tone of the right biceps.

12. What statement best characterizes spasticity?

A) Clinical presentation includes large involuntary movements.
B) Stretch reflexes are dampened or absent.
C) Resistance to passive stretch is velocity-dependent.
D) Clinical presentation includes uniform resistance to movement.

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 Chapter 8: Examination of Motor Function: Motor Control and Motor Learning

13. The patient presents with cyclical, spasmodic, alternating contraction and relaxation of
the left plantar flexors following a quick stretch. How could the therapist document this finding?
A) The patient presents with rigidity of the left plantar flexors.
B) The patient presents with flaccidity of the left plantar flexors.
C) The patient presents with a Babinski sign of the left plantar flexors.
D) The patient presents with clonus of the left plantar flexors.

14. The patient presents with no resistance to passive movement of the right upper extremity
and notable hyperextension of the right elbow. How should the therapist document this finding?
A) The patient presents with rigidity of the right upper extremity.
B) The patient presents with flaccidity of the right upper extremity.
C) The patient presents with a Babinski sign of the right upper extremity.
D) The patient presents with clonus of the right upper extremity.

15. If a patient has normal tone, how would the limb feel during passive motion testing?
A) Stiff and rigid
B) Heavy and unresponsive
C) Responsive and light
D) Tight and firm

16. What does the Modified Ashworth Scale measure?

A) Clonus
B) Spasticity
C) Reflexes
D) Strength

17. Deep tendon reflexes in a patient with an upper motor neuron lesion are
A) increased.
B) decreased.
C) not changed.
D) dependent on location of the lesion.

18. A patient who presents with a positive Babinski sign would demonstrate what type of
response to a stroking stimulus on the sole of the foot along the lateral border?
A) Dorsiflexion of the foot and great toe
B) Plantar flexion of the foot and great toe
C) Dorsiflexion of the big toe and fanning of the other four toes
D) Extension of the big toe and the other four toes of the foot

19. When deciding if manual muscle testing is appropriate in a patient with an upper motor
neuron lesion, what should the therapist consider first?
A) Amount of spasticity and abnormal synergy present
B) The severity of the upper motor neuron lesion
C) Previous strength as reported by the patient
D) The patient's ability to move the extremity

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 Chapter 8: Examination of Motor Function: Motor Control and Motor Learning

20. What type of assessment is preferred when examining a patient's fatigability?

A) Performance-based tests
B) Manual muscle testing
C) Self-assessment questionnaire
D) Observational assessment

21. How should the therapist examine for abnormal synergies in individuals with upper
motor neuron disease?
A) Move the patient through passive range of motion and note any changes in
resistance.
B) Ask the patient to perform a specific movement and observe how the movement is
carried out.
C) Resist a specific movement and observe the strength of the muscle being tested.
D) Encourage the patient to move within normal synergies and observe the muscles
closely.

22. The patient demonstrates the ability to move from supine to sitting while maintaining
postural control. What type of motor task is this patient demonstrating?
A) Mobility
B) Static postural control
C) Dynamic postural control
D) Skill

23. The therapist observes that the patient is able to maintain his center of mass over the
base of support in a standing position without upper extremity support. What type of motor task
is this patient demonstrating?
A) Mobility
B) Static postural control
C) Dynamic postural control
D) Skill

24. The therapist observes the patient maintaining her center of mass over the base of
support in a sitting position while reaching. What type of motor task is this patient
demonstrating?
A) Mobility
B) Static postural control
C) Dynamic postural control
D) Skill

25. The therapist observes the patient walking on a stable surface in a quiet hallway. What
type of skill is the patient demonstrating?
A) Open skill
B) Closed skill
C) Dynamic task control
D) Specificity skill

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 Chapter 8: Examination of Motor Function: Motor Control and Motor Learning

26. The therapist observes the patient walking in the grass at a hospital picnic with many
people in the area. What type of skill is the patient demonstrating?
A) Open skill
B) Closed skill
C) Dynamic task control
D) Specificity skill

27. How should the therapist examine a patient's limits of stability in a standing position?
A) Ask the patient to reach as far as he can until he begins to fall.
B) Gently push on the patient's sternum and observe the reaction.
C) Observe postural sway with the patient standing against a grid.
D) Watch the patient attempt to reach with feet in a tandem position.

28. How should peripheral vision be examined?

A) Instruct the patient while in a sitting position to visually track an object from right to
left with increasing speed.
B) Instruct the patient to read a Snellen eye chart from a distance of 20 feet.
C) Instruct the patient to move across the busy gym area while observing ability to
navigate safely, avoiding obstacles.
D) Instruct the patient to look at the therapist's nose while the therapist slowly brings a
pencil into the patient's field of view from the right or left.

29. How should ambient vision be examined?

A) Instruct the patient while in a sitting position to visually track from right to left with
increasing speed.
B) Instruct the patient to read a Snellen eye chart from a distance of 20 feet.
C) Instruct the patient to move across the busy gym area while observing ability to
navigate safely, avoiding obstacles.
D) Instruct the patient to look at the therapist's nose while the therapist slowly brings a
pencil into the patient's field of view from the right or left.

30. What is included in examination of sensory organization of postural control and balance?
A) Vision, lower extremity somatosensation, and vestibular function
B) Vision, lower extremity range of motion, and vestibular function
C) Hearing, lower extremity somatosensation, and vestibular function
D) Vision, lower extremity somatosensation, and reflex integration

31. A patient who presents with significant deficits in lower extremity somatosensation will
have to depend on what systems to maintain balance?
A) Auditory and proprioception
B) Visual and auditory
C) Auditory and vestibular
D) Visual and vestibular

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 Chapter 8: Examination of Motor Function: Motor Control and Motor Learning

32. When performing the Clinical Test for Sensory Interaction in Balance, how long must
the patient maintain standing in Condition 4 with eyes open and a moving surface?
A) 2 minutes
B) 10 seconds
C) 4 minutes
D) 30 seconds

33. After gently pushing on a patient's sternum in standing, the therapist observes the patient
shifting her center of mass forward at the ankles. How would the therapist document this
finding?
A) The patient demonstrates normal postural sway with gentle perturbations in
standing.
B) The patient has good standing balance after perturbations.
C) The patient demonstrates an ankle strategy with gentle perturbations in standing.
D) The patient is able to maintain balance in standing with gentle perturbations.

34. When might the therapist expect the patient to demonstrate a hip strategy for balance
while in a standing position?
A) With very large perturbations to stop from falling
B) With very small perturbations
C) With large perturbations while standing with a wide base of support
D) With large perturbations while standing with a narrow base of support

35. In addition to exhibiting a stepping strategy with large, fast postural perturbations, what
else will many individuals demonstrate?
A) Grasping movements with their upper extremities
B) Shifting of the limits of stability
C) Shifting of the center of mass
D) Unequal weightbearing on one extremity

36. What would be a positive finding on the Romberg Test?

A) The patient is unable to maintain balance on an unstable surface.
B) The patient is unable to maintain balance on one foot.
C) The patient is unable to maintain balance with eyes closed.
D) The patient is unable to maintain balance while turning the head from side to side.

37. What score on the Berg Balance test has been shown to be useful in evaluating risk of
falling in older adults?
A) 56
B) 24
C) 45
D) 60

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 Chapter 8: Examination of Motor Function: Motor Control and Motor Learning

38. What is the best use of the Timed Up and Go Test?

A) A comprehensive examination of balance and postural sway
B) A comprehensive examination of balance in gait
C) A reliable, quick screening of balance and postural sway
D) A reliable, quick screening of balance in functional mobility tasks

39. Which of the following could a therapist use to document changes in motor
performance?
A) The patient's perceptions
B) The number and type of errors
C) Changes in strength
D) Respiratory and heart rate

40. On Tuesday afternoon the patient practiced transfers from the wheelchair to the mat with
assistance from the therapist and progressed from minimal assist to stand-by assist. On
Wednesday morning the therapist asks the patient to perform the same transfer. What type of
assessment of motor learning is the therapist using?
A) A performance test
B) A transfer test
C) A retention test
D) A reliability test

41. On Tuesday afternoon the patient practiced transfers from the wheelchair to the mat with
assistance from the therapist and progressed from minimal assist to stand-by assist. On
Wednesday morning the therapist asks the patient to perform a transfer from the wheelchair to
the toilet. What type of assessment of motor learning is the therapist using?
A) A performance test
B) A transfer test
C) A retention test
D) A reliability test

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 Chapter 8: Examination of Motor Function: Motor Control and Motor Learning

Answer Key
1. A
2. B
3. C
4. C
5. D
6. B
7. C
8. D
9. A
10. C
11. A
12. C
13. D
14. B
15. C
16. B
17. A
18. C
19. A
20. C
21. B
22. A
23. B
24. C
25. B
26. A
27. C
28. D
29. C
30. A
31. D
32. D
33. C
34. D
35. A
36. C
37. C
38. D
39. B
40. C
41. B

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