Modality questions

Which is an acute statement regarding the effect of modalities and the healing process?

Modalities attempt to provide the optimal environment for healing to occur

During the healing process, when do you see the formation of granulation tissue and the migration of phagocytes and fibroblasts to the injured area?

proliferation phase

Which inflammatory pain mediator is released by mast cells to directly stimulate nociceptors?

Histamine

While treating a patient with back spasms, the AT decides to perform a massage. Which pain theory supports this decision?

Gate control theory

Pain threshold is often based on the recruitment of what kind of fibers?

A-delta

Cold whirlpools are able to produce which effects? Select all that apply

Decreased muscle spasm.

Muscle relaxation.

All therapeutic equipment must be inspected and calibrated by a qualified technician at least …

yearly

what medical record document provides an ongoing record of the patient’s intervention plan?

treatment record

At what skin temperature is maximum analgesia reached when applying a cold pack?

58 degrees F

Which treatment is best suited for applying cold to injuries involving an irregular surface?

ice immersion

Which nerves are most susceptible to cold-induced neuropathy? Select all that apply

Ulnar

Peroneal

In which scenarios is heat indicated? Select all that apply.

To encourage tissue healing

To control the inflammatory reaction in its subacute or chronic stages

To improve ROM

Which local response will occur as the body responds to heat loss from cryotherapy?

decreased metabolic rate

What is the correct order of cooling in tissues?

skin, adipose, fascia, muscle

How many layers of terry-cloth towel should be placed between the skin and moist heat pack?

6 towels

Ohm’s law describes the relationship between what characteristics of electrical currents? Select all that apply.

Amperage.

Voltage.

Resistance.

Electrical stimulation has little to no effect on which of the follow?

Inflammatory process

When targeting deeper tissues, how should you place the electrodes?

farther apart

What is an indication for the use of iontophoresis?

Arthritis

When attempting to control pain via the gate control mechanism, what are correct high-voltage pulsed stimulation parameter settings?

pulse frequency of 60-100 pps

Due to its _ frequencies, ultrasound is unable to pass through the air and requires a dense transmission medium

high

How large of a treatment area can be effectively exposed to ultrasonic energy?

slightly larger than the diameter of the sound head

Which is an accurate statement concerning the use of 3 MHz ultrasound?

energy is rapidly absorbed by tissues

Which medications commonly administered via phonophoresis target nerves, muscles, and subcutaneous tissues? Select all that apply

Hydrocortisone

Dexamethasone 0.4 %

Which output frequency will penetrate deeper into the tissue?

1 MHz

Which are contraindications to the application of intermittent compression? Select all that apply

Peripheral vascular disease

Arteriosclerosis

Thrombophlebitis

Which are indications for the use of intermittent compression as a treatment? Select all that apply

Post traumatic edema

Postsurgical edema

Prevention of DVT

What is the normal pressure range when using intermittent compression to treat the upper extremity?

30 to 60 mm Hg

Cervical and lumbar traction applies a force that separates vertebrae and increases the intervertebral space and leads to what effects? Select all that apply

Reduces pressure on intervertebral disks

Reduces pressure on spinal nerve roots

Opens facet joins

Elongates soft tissue

Which of the following are indications for the use of lumbar traction? Select all that apply

Nerve root compression

Osteoarthritis

In what region of the spine is stenosis most prevalent?

Cervical and lumbar

What is the common treatment duration when using lumbar or cervical traction to treat muscle spasm?

20 minutes

Which of the following is considered a contraindication to the use of lumbar traction?

Extruded disk fragmentation

Which of the following are contraindications to the use of therapeutic massage? Select all that apply

Varicose veins

Thrombophlebitis

Arteriosclerosis

In general, massage is an effective treatment for what condition? Select all that apply

Reduce muscle spasm

Promote relaxation

Improve blood flow

Increase venous drainage

Increase cellular metabolism

Which form of massage is described as a stroking of the skin?

Effleurage

What is the most fundamental form of myofascial release?

skin rolling

Which of the following are similar between shortwave diathermy and ultrasound?

thermal and nonthermal effects

Pain receptors in the body are called

nociceptors

What are the various forms of energy produced by therapeutic modalities?

thermal, electrical, mechanical, electromagnetic, and sound

The goal of using biofeedback in muscle reeducation is to elicit a

muscle contraction

All of the following are excitable tissues except

Meniscus cartilage

Which of the following are responsible for lymph movement?

Muscle activities

Active and passive movement

Elevated positions

A patient sustained an acute ulnar collateral ligament sprain during wrestling practice, and the athletic trainer provides immediate treatment. Which of the following therapeutic modalities would be contraindicated for this patient? Choose all that apply.

Continuous ultrasound at 3.0 MHz and 1.0 w/cm2

Diathermy

Heat pack

What should guide a clinician’s decision when selecting a therapeutic modality?

scientific theory, practical experience, and research based evidence

According to the CAATE standards for athletic training education, which of the following best reflects the appropriate use of electrical stimulation (e-stim) for pain modulation in clinical practice?

Athletic trainers must demonstrate the ability to select and apply e-stim modalities based on evidence-based rationale for pain management.

Which of the following is the primary physiological effect of therapeutic ultrasound used in soft tissue healing?

increased tissue extensibility and deep heating

What is the primary goal of mechanical cervical traction?

reduce nerve root compression and muscle guarding

Which patient position is most commonly used during lumbar traction to target the lower lumbar spine?

supine with hips and knees flexed

During intermittent compression treatment, the compression sleeve works by

applying alternating pressure to move fluid out of the extremity

Which body region is most commonly treated using intermittent compression devices?

extremities experiencing swelling or edema

What is the primary purpose of Instrument-Assisted Soft Tissue Mobilization (IASTM)?

detect and treat soft tissue restrictions and adhesions

Which of the following are contraindications for the application of spinal traction? Select all that apply

osteoporosis

spondylolisthesis

In which scenario is the use of electromyographic biofeedback indicated? Select all that apply

Decrease muscle spasm on the erector spinae

Promote systemic relaxation

Regain neuromuscular control of the vastus medialis oblique

Facilitate contraction of the biceps femoris

The FDA has approved low-level laser therapy for treatment of what conditions? Select all that apply

Carpal tunnel syndrome

Musculoskeletal shoulder pain

Musculoskeletal neck pain

Which of the following contraindications the use of therapeutic laser? Select all that apply

Application over the thyroid

Application over DVT

Lasers produce highly refined _ light in the ultraviolent, visible, or infrared range

Monochromatic

A patient presents with soft tissue restrictions following a sub-acute strain to the hamstring muscle. The AT elects to use ultrasound as a treatment protocol. Which of the following parameters is MOST appropriate at this time?

1.5 wcm2, 1 MHz, 12 minutes continuous

Over which areas can ultrasound be applied when caution is used? Select all that apply

Vertebral column

Nerve roots

Large nerve plexus

Which interface results in 99.9% of ultrasound energy being reflected?

Soft tissue - air

Which are contraindications to the application of intermittent compression? Select all that apply

Peripheral vascular disease

Arteriosclerosis

Thrombophlebitis

Continuous passive motion can possibly provide pain reduction via the gate mechanism, which occurs from the stimulation of afferent nerves located in what tissues?

skin, joint, and muscle

Which of the following are indications to treat with continuous passive motion? Select all that apply

After joint arthroplasty

Joint contracture

Thrombophlebitis

After meniscectomy

Which are considered contraindications to the use of continual passive motion? Select all that apply

Unstable fracture

Uncontrolled infection

The effect and effectiveness of traction is related to which of the follow? Select all that apply

Position of the body part

Position of the patient

Force and duration of traction

Angle of pull

What type of traction is best suited for treating degenerative disk disease of the cervical spine?

Sustained traction with a flexion angle

What describes the proper procedure when performing the active-assistive technique of “sports massage”?

distal to proximal and perpendicular to the muscle fibers

Which describes the amount of energy passing through the second head’s effective radiating area?

spatial average intensity

When using intermittent compression to treat lymphedema, what is the common duration of treatment?

several hours

Which statement is true concerning the evidence of intermittent compression?

Research on the optimal treatment duration and duty cycle for reducing lymphedema is inconclusive

According to the practical evidence, when is it most beneficial to incorporate electromyographic biofeedback in neuromuscular rehabilitation?

early on

A patient sustained an acute ulnar collalateral ligament sprain during wrestling practice, and the athletic trainer provides immediate treatment. Which of the following therapeutic modalities would be contraindicated for this patient? Choose all that apply.

Continuous ultrasound at 3.0 MHz and 1.0 w/cm2

Diathermy

Heat pack

Ron reports that he is taking blood pressure medication regularly but checks his blood pressure occasionally. You check his blood pressure manually, and it reads 135/70 mmHg. Can you continue with traction?

yes his BP is within the appropriate range, and he is managing it through medication

Which of the following is a contraindication for cervical traction?

joint instability

What should the hold/relax ratio be for joint distraction effects?

15/15 seconds

What duration of cervical traction would be most appropriate for Ron?

20-30 minutes

The next set of questions 47-55 pertain to this scenario: Derek is a patient 42 y/o in your clinic. He is complaining of severe shoulder pain. He lifted a heavy box over his head at work 5 days ago. Now he is unable to wash his hair or get dressed. After evaluating him, you find that he has signs and symptoms consistent with a first-degree rotator cuff strain. As part of his care plan, you decide you will treat him with IFC to assist with his pain. What are the contraindications for IFC? Select all that apply.

Later pregnancy

Malignant tumor in area

Osteomyelitis

Thrombophlebitis

You are targeting acute pain and inflammation due to the acute rotator cuff injury. What frequency should you choose?

100-150 Hertz

What is the purpose of using a cold modality on a patient? Select all that apply

Initially decrease blood flow

Increase pain threshold

Decrease spasticity

What are some contraindications for utilizing a moist heat pack? Select all that apply

Acute inflammation

Thrombophlebitis