Cardiopulmonary (37)
- Q. I’m not able to understand, in exercise prescription for cardiac patients, how to determine the exercise/rest ratio for inpatient, outpatient cardiac patients.
- For resistance training in a patient who had a cardiac transplant and CABG, how much should a patient wait to start resistance training and what should they start with?
- Can you please explain further about the difference of pneumothorax and hemothorax in terms with the tracheal and mediastinal shift?
- In a cardiac transplant patient, will there be any abnormality in heart rate and BP seen while exercising, if yes then why please explain also will we be using Borg RPE for them as well.
- For the patients with orthostatic hypotension or prolonged bed ridden cases, if we use tilt table to make them come in standing position, BP should be taken every 5 mins or all the time? Also, will the same method be applied for multiple sclerosis patients on tilt table? I’m kind of confused but had come across a question like this before.
Interventions (29)
- What is a positive vertebral artery sign and what might be an appropriate immediate response when it is elicited clinically? (question edited).
- When is it appropriate to use an ISOKINETIC machine for ACL repairs? I have a patient in clinic who is s/p 8 months ACL repair and every few months she has been going for isokinetic testing as she wants to return to playing college lacrosse. From my understanding, isokinetic machines can be set at a constant speed in which the limb has to move throughout the ROM. Is the purpose of the machine just for strengthening and to assess something like quads/hamstrings ration?
- For interventions, what is the correct progression: should you have a patient perform closed chain exercises or open chain exercises first? My initial thought was that you should do open chain first then progress to closed chain. Exceptions would be ACL surgery where open chain is contraindicated. For example, what would be the best intervention for a patient who has fair strength after long thoracic nerve injury. Would I be correct to chose the open chain activity of supine arm overhead with weights instead of closed chain activities such as standing wall push-ups?
- How do I treat patients with conversion or psychosomatic type conditions? Or should I refuse to treat them and refer to a psychologist?
- After taking other review courses and studying integ, I learned that with a venous stasis ulcer, you should NOT use intermittent compression due to it increasing the risk of causing a pulmonary embolism. I learned that more so, if the patient’s ABI is > .7 or 70% blood flow, and they have good capillary refill, normal foot temp, and a good dorsalis pedius pulse, an Unna boot or stationary compression is more so indicated. I recently took a practice test which basically said that intermittent compression was NOT a contraindication to a venous stasis ulcer and that you could use intermittent compression with a venous stasis ulcer. Do you know for a fact if intermittent compression is a contraindication to a venous stasis ulcer?
Modalities (16)
- What would be the situation or conditions that make a Physical therapist to select continuous mode/intermittent mode/burst mode/acupuncture mode of using TENS? Is there any clinical guidelines or approved by APTA etc. between the preferred choice for using TENS by a PT?
- What are some guidelines when ultrasound is used with stretching? Is stretching used before ultrasound or after? I tried to look it up in different resources, but didn’t found appropriate answer.
- In Ultrasound to gain higher tissue temperatures should we use Longer duration, Lower frequency and Lower intensity settings?
- Will ERA be listed on the device? How do we calculate ERA for ultrasound?
- In Ultrasound it says the higher the quality of the crystal, the lower the BNR. What does this mean? Scorebuilders, Chapter 9.
Musculoskeletal (103)
- Q. Does the scapular move in an upward or downward rotation with push up?, pull ups? and/or chin ups? I am having difficulty understanding. I cannot find a good source to explain it.
- Q. Could you please explain (1) TMJ disfunction in such cases of : capsular restriction,hyper mobility and capsulitis (2)mobilization direction in case of capsular restriction.
- Q. What are the five positions of grip strength test by using handheld dynamometer?
- A. What is the correct direction for glenohumoral mobilization for a patient with adhesive capsulitis? Anterior-inferior gliding or posterior inferior gliding? I am confused because I found two differing answers from both the Scorebuilders and TherapyEd texts. (Edited).
- Q. How can I differentiate between synovitis and capsulitis in TMJ dysfunction?
Neuromuscular and Nervous Systems (28)
- Can you please clarify special test for meningeal irritation: KERNIG’s SIGN vs BRUDZINSKI’s SIGN….Sullivan 2017 has a different way of explaining compared to other sources on you tube.
- Concerning Obligatory Synergy Patterns, I’ve come across a couple different questions that ask what muscles or action would be the most limited based on a “typical pattern of spasticity” but wouldn’t it dependent if they were experiencing a flexion or extension synergy pattern? (question edited)
- Why is the leg more affected than the arm in anterior spinal cord injury patients?
- If we are assessing a patient with a vestibular dysfunction, and we perform the hall-pike dix test and the patient has nystagmus present on both the L and R that is unidirectional, is it a peripheral dysfunction? If they had nystagmus that was bi-directional at both the L or R would this be central? I am having trouble deciphering if peripheral is strictially positional and both those scenarios would make the answer peripheral where as central the nystagmus would not be altered.
- If functional reach test is a test used to measure risk of fall, could the scores also be caused by merely muscle tightness causing limiting the forward reach due to tight muscles?
Non-systems (22)
- Q. Could you please explain the following terms; Effect size and likelihood ratio?
- Q. Could you please demonstrate the main differences between the following strategies of behavior therapy and how can I use this types of technique to promote learning?
- I just had a confusion in regards as to where to put the cane on walking. Is it on the strong side, or the weak side? Why some people will say its better on the weak side? Please advice. Thank you
- While wearing the glove, which part of the glove is not sterile? I have a hard time understanding this.
- Is a heel wedge the same as a rearfoot post or do they at least produce the same effect? I haven’t been able to find a clear answer on this. I know that a medial heel wedge based on O’sullivan is on the outside of the bottom of the shoe on the medial side that corrects pes valgus. What about medial rearfoot post?
Other Systems (8)
- What is the difference between Upper UTI vs Lower UTI besides the location of it? The signs and symptoms both seem similar including Low back pain, frequency, and blood in urine.
- What is the main difference between a patient presentation in septic versus hypovolemic shock? To my understanding, the main difference is fever and warm, dry skin present in septic shock, while no fever and cool dry skin in hypovolemic. Am I correct?
- For selection of a dressing for a wound, what criterion would hold more priority, the type of dressing or the cost of it?
- What are the causes if menstrual cycle is disturbed? Increased LH and FSH level or decreased LH and FSH level? I know that will affect this cycle but I don’t know the exact cause.
- How do we identify to select an assistive device for a patient rehabilitating from TBI, SCI, etc.? There are lots of options that we can take it like cane, axillary crutch, and walker. How do I distinguish between them?