McGraw-Hill Specialty Board Review Pain Medicine

Salahadin Abdi, Pradeep Chopra, Howard Smith

Chapter 15 Rehabilitation - all with Video Answers

Educators

Chapter Questions

Problem 949

The Henneman size principle of therapeutic exercise says motor units are recruited in order of
(A) increasing size, decreasing contraction strength, and diminishing fatigue
(B) increasing size, increasing contraction strength, and diminishing fatigue
(C) increasing size, increasing contraction strength, and escalating fatigue
(D) decreasing size, increasing contraction strength, and diminishing fatigue
(E) none of the above

Andrei Demkov

Numerade Educator

Problem 950

What is an example of an open kinetic chain exercise?
(A) Leg press
(B) Knee extensions
(C) Push up
(D) Treadmill
(E) Bench press

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Problem 951

Which type of therapy has been found to reduce the risk of falls in the elderly?
(A) Tai chi
(B) Pilates
(C) Yoga
(D) Strength training
(E) None of the above

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02:15

Problem 952

Direct participants in interdisciplinary comprehensive pain management include all of the following, EXCEPT
(A) vocational counselor
(B) physical therapist
(C) psychologist
(D) general internal medicine physician
(E) occupational therapist

Sarah Howell

Numerade Educator

Problem 953

Which of the following is true regarding aerobic training?
(A) Persons placed on bedrest will experience a decrease in resting heart rate
(B) Oxygen consumption $\left(\mathrm{VO}_2\right)$ increases in proportion to the intensity of the exercise
(C) For training to be effective, the duration of aerobic training must be at least 10 minutes at a stretch
(D) Intensity of training must be within $40 \%$ to $85 \%$ of maximal $\mathrm{VO}_2\left(\mathrm{VO}_2\right.$ max) to be considered aerobic training
(E) Patients placed at bedrest will experience an increase of $\mathrm{VO}_2$ max after 3 weeks.

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00:23

Problem 954

All of the following are examples of core strengthening programs for spine rehabilitation, EXCEPT
(A) lumbar stabilization
(B) pilates training
(C) yoga
(D) abdominal exercises
(E) all of the above

Andrei Demkov

Numerade Educator

Problem 955

A typical exercise precaution that should be followed with a patient who has chronic osteoarthritis would be
(A) no exercise in patients with osteoarthritis of three or more joints
(B) no weight bearing on a limb with knee pain of 2 years' duration
(C) no ice when knee effusion occurs after exercise
(D) only low-impact exercises in a patient with severe osteoarthritis of both knees awaiting joint replacement surgery
(E) no stretching of a lower limb in a patient with osteoarthritis of the ankle who has a tight calf muscle

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02:23

Problem 956

A patient presents to your office with T6 paraplegia. He was living independently until severity of neuropathic pain in his legs increased to $10 / 10$. Now he can no longer go to work because the pain is so severe that he cannot concentrate at work. The fact that this patient cannot work is considered as
(A) impairment
(B) disability
(C) handicap
(D) physical capacity
(E) none of the above

Sulav Pokhrel

Numerade Educator

Problem 957

A patient presents to the office with 2-week history of leg pain consistent with S1 radiculopathy. Magnetic resonance imaging (MRI) reveals a paracentral $\mathrm{L} 5-\mathrm{S} 1$ disc herniation. The pain is worsened with bending forward, driving, and lifting objects. A proper type of physical therapy exercise would be
(A) McKenzie method of physical therapy with extension exercises
(B) yoga
(C) Williams method of physical therapy with flexion exercises
(D) stationary bike
(E) no therapy

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Problem 958

Which of the following is false regarding muscle tightness in the lower extremity?
(A) Gluteus maximus inflexibility may decrease lumbar lordosis causing increased forces on the lumbar spine
(B) The Ely test evaluates rectus femoris tightness
(C) Lumbar lordosis can be increased in iliopsoas tightness
(D) Anterior pelvic tilt may cause stress on the lumbar spine and can be caused by rectus femoris or hamstring tightness
(E) The Thomas test assesses tightness of the iliopsoas muscle

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Problem 959

Which of the following statements regarding central pain is not correct?
(A) Patients with central pain are usually affected by a change in temperature
(B) More than $10 \%$ of patients with a stroke report significant central pain within the first year
(C) Central pain caused by a thalamic infarction is often a burning pain that may be described as agonizing and is on the side contralateral to the lesion
(D) Almost $90 \%$ of all central pain is caused by cerebral vascular accidents
(E) No singular pharmacologic, surgical or other treatment has been proven to be helpful in the long term

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Problem 960

Achilles tendinosis is a chronic source of pain in many active adults. Which of the following interventions has been found to be helpful in the treatment of pain for this disease process?
(A) Nonsteriodal anti-inflammatory drugs
(B) Corticosteroid injections of the tendon
(C) Heel pads
(D) Topical laser therapy
(E) Ultrasonography

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Problem 961

Chronic pain from fibromyalgia is characterized by the following statements, EXCEPT
(A) fibromyalgia affects women more often than men
(B) there is a suggestion that genetic factors contribute to the etiology of fibromyalgia
(C) mood and anxiety disorders are significant comorbidities in fibromyalgia
(D) patients with fibromyalgia may experience a range of other symptoms including irritable bowel or bladder syndromes
(E) cognitive disturbances are never part of fibromyalgia and suggest that there is an organic cause for the problem

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Problem 962

The use of physical therapy that includes "directional preference" in the treatment of low back pain has not been shown to
(A) decrease the need for surgery
(B) decrease the use of medications
(C) be associated with greater improvements in pain control
(D) be as good as intensive dynamic strengthening
(E) be better than nondirectional exercises

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Problem 963

Evaluation and treatment of anterior knee pain that is insidious in onset, bilateral, peripatellar, and most often problematic in repetitive loadbearing movements includes all the following, EXCEPT
(A) hamstring strengthening
(B) activity modification
(C) closed chain kinetic exercises
(D) patellar taping
(E) evaluation for apophysitis at the tibial tuberosity in adolescents

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04:21

Problem 964

Which of the following is true regarding phantom limb sensations?
(A) Body parts that are sparsely innervated are most commonly represented
(B) Phantom sensations are unpleasant with burning and jabbing
(C) The incidence of phantom sensations decreases with age.
(D) The amputated limb phantom may feel shortened
(E) Phantom limb sensations require peripheral input

Eric Goldman

Numerade Educator

Problem 965

Which of the following physical examination maneuvers are not found to correlate with sacroiliac joint pain as confirmed by pain ablation with diagnostic injection with lidocaine under fluoroscopy, with at least $90 \%$ specificity?
(1) Patrick test
(2) Gaenslen test
(3) Compression test
(4) Distraction tests

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01:33

Problem 966

In pain management, tissue structures are warmed via which of the following mechanism(s)?
(1) Conduction
(2) Convection
(3) Conversion
(4) Radiation

Ma Ednelyn Lim

Numerade Educator

Problem 967

The SAID principle (specific adaptation to imposed demand) of therapeutic exercise for pain management includes the following:
(1) Stronger muscles develop with strength training
(2) Oxidative capacities of skeletal muscle decrease with aerobic training
(3) Pliability of connective tissue increases with flexibility exercises
(4) Circulation to the brain increases with aerobic training

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00:45

Problem 968

Strength training consists of which type(s) of muscle contraction?
(1) Isometric
(2) Isotonic
(3) Isokinetic
(4) Isoconcentric

Joanna Quigley

Numerade Educator

Problem 969

Which of these statements is (are) true regarding lumbosacral (LSO) supports?
(1) There was moderate evidence that LSO supports were effective for primary low back pain prevention
(2) There was moderate evidence that LSO supports were ineffective for primary low back pain prevention
(3) Lumbar supports are less effective in reducing back pain than no treatment
(4) Lumbar supports are more effective in reducing back pain than no treatment

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Problem 970

A comprehensive, inpatient chronic pain treatment program advertises that they are CARF accredited treatment center. CARF is
(1) Commission on Activity with Rehabilitation Focus
(2) a certification for centers to show that they have better outcomes for pain reduction
(3) a certification for centers to show that they have better outcomes for return to work
(4) the rehabilitation accreditation commission

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01:01

Problem 971

Which of these statements regarding exercise is false?
(1) Several studies indicate an increase in all-cause mortality with long-term regular exercise participation
(2) Physical activity is considered a major risk factor for the development of cardiovascular disease
(3) Both acute and chronic exercise can increase blood pressure in the long-term
(4) Most studies indicate that aerobic exercise training increases plasma triglycerides and may lower high-density lipoprotein (HDL) cholesterol

Narayan Hari

Numerade Educator

Problem 972

Physical effects of aquatic therapy include
(1) increase in cardiac output
(2) decrease in stroke volume
(3) offloading of immersed joints
(4) increased psychological stress due the aquatic exercise

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Problem 973

The use of muscle relaxants in the rehabilitation of acute and chronic pain is common. Which of the following statements is (are) true regarding these drugs?
(1) Baclofen is a $\gamma$-aminobutyric acid analogue
(2) The active metabolite of cyclobenzaprine is meprobamate, which is a schedule intravenous controlled substance
(3) Tizanidine has been shown to be helpful in treating low back pain in several studies
(4) Skeletal muscle relaxants, like metaxalone and cyclobenzaprine, exert their effects directly on the muscle contractile mechanism in skeletal muscle

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Problem 974

In acute musculoskeletal injury, which of the following is (are) direct effect(s) of using cold as a modality for treatment?
(1) Relieve pain
(2) Increase tissue repair
(3) Reduce hemorrhage
(4) Decrease risk of chromic pain

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Problem 975

The following types of pain syndromes have been found to consistently respond to treatment with botulinum toxin $\mathrm{A}$ :
(1) Myofascial pain
(2) Chronic low back pain
(3) Headache
(4) Tennis elbow

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Problem 976

Which of the following has been validated as effective in the treatment of neck pain?
(1) Soft collar
(2) Massage
(3) Cervical traction, mechanical traction
(4) Therapeutic exercises

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Problem 977

In the treatment of a patient diagnosed with fibromyalgia syndrome, there is not a clear consensus on most therapies. Which of the following is (are) true regarding therapies for fibromyalgia?
(1) Ultrasound and massage are effective treatments for the deep muscle aches of fibromyalgia
(2) Recreational therapy can be an important aspect of return to socialization
(3) Occupational therapy is less likely to help return a patient to function than other forms of therapy
(4) Aerobic exercise is probably the most important therapeutic treatment for fibromyalgia

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Problem 978

Which of the following regarding heat and cold therapies for pain is (are) true?
(1) Both heat and cold have direct effects on the muscle spindle
(2) Heat and cold are safe modalities and should be used extensively in the long term to get the best relief in chronic pain
(3) Both heat and cold can be helpful in treatment of muscle spasm
(4) Transcutaneous electrical nerve stimulation (TENS) has been consistently shown to be helpful in treating chronic muscle pains

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Problem 979

Which of the following is (are) true regarding the treatment and rehabilitation of lateral epicondylitis (LE)?
(1) The use of extra corporeal shock wave therapy in LE has been validated and should be used early on in the disease process for best results
(2) Counterforce bracing in LE is a common treatment and has consistently been found to be of use
(3) Cold therapy has been found to be a helpful adjunct to treatment of LE
(4) Poor prognosis for recovery and return of function has been found with employment in manual jobs

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