A 22-year-old female gymnast presents to your clinic after a patellar dislocation during practice. She was treated in the emergency room with reduction of the patella and immobilization. Radiographs and magnetic resonance imaging of the knee are negative for fracture or evidence of osteochondral lesions. You choose to treat her with immobilization for 2 weeks and then begin physical therapy. The most appropriate therapy recommendation is to focus on improving

An 18-year-old female on your inpatient traumatic brain injury service is inconsistently oriented and does not recall your name on a day-to-day basis. She can follow single-step commands. She gets more confused when stressed but can be re-directed and can finish her therapy sessions with encouragement. She is more consistent with goal-directed behavior but needs cueing. Greater participation in activities of daily living is evident and she is developing a better awareness of self and others. On the Rancho Los Amigos scale, what is her level of cognitive function?

A 50-year-old man with metastatic renal cell carcinoma status post nephrectomy 1 year ago was found to have a T10 lesion on recent post-operative imaging done as part of a work-up for rightsided mid-back pain. The patient’s pain is not relieved with recumbency and is not affected by thoracic rotation. He has a normal thoracic kyphosis and is neurologically intact on physical examination. An MRI scan of the thoracic spine shows a T10 lytic lesion, normal alignment, no discernable vertebral body collapse, and unilateral involvement of the T10 posterior elements. You recommend

What is the overall leading cause of death for individuals with paraplegia?

You are asked to consult on a 60-year-old cancer patient with an acute deep vein thrombosis (DVT) in the right upper limb, secondary to a long-standing central venous catheter. What therapy restrictions would you recommend for the patient?

What secondary condition requires the most medical management in adults with cerebral palsy?

The definitive diagnostic test for inclusion body myositis is

In the United States, upper extremity amputations are

Which score range on the Galveston Orientation and Amnesia Test (GOAT) indicates the end of posttraumatic amnesia (PTA)?

Following a crush injury with axonotmesis, the approximate growth regeneration rate at the wrist is 1 centimeter per

A 62-year-old woman complains of right knee pain and stiffness. On physical examination, she has a genu varum deformity. A physical therapy prescription should include

Which finding is a relative contraindication to cryotherapy?

After completing inpatient rehabilitation, an 18-year-old male with complete tetraplegia is able to feed himself with adaptive equipment and requires some assistance with upper body dressing and grooming. He is able to assist with bed mobility, but is dependent for transfers. He is also able to use a manual wheelchair with rim projections indoors on flat surfaces, but when outdoors he prefers to use a power wheelchair with a joystick. His physical therapist reports that he has achieved his maximal expected outcome. What is his level of injury?

What is the strongest single predictor of mortality in adults with pediatric onset disabilities?

For a person with an upper extremity amputation, what is the advantage of choosing a bodypowered device over a myoelectric device?

A 23-year-old woman with C7 ASIA B tetraplegia resulting from an accident 8 months ago is complaining of nausea for several days and has vomited non-bloody, non-bilious food particles the last 3 evenings when placed back to bed after dinner. She also reports some abdominal tightness and bloating. Her symptoms are relieved when lying on the left side. Her bowel training program is going well, resulting in regular, effective bowel movements. She recently lost 25 pounds and appears quite thin on exam. Which study will confirm this patient’s most likely diagnosis?

A 70-year-old man with COPD presents to your office for follow-up. His forced expiratory volume in 1 second (FEV1) is 55% of predicted normative values. What would you expect the patient’s functional limitations to be?

According to the documentation requirements of the Center for Medicare and Medicaid Services (CMS), which factor is not considered part of a patient’s History?

An infarct in the lower division of the left middle cerebral artery division would be associated with which type of aphasia?

Which finding is associated with a more favorable prognosis in amyotrophic lateral sclerosis (ALS)?

A 57-year-old man with chronic low back pain is referred to see you. He has commercial medical insurance. The patient leaves radiologic films and medical records for review and also asks you to complete disability paperwork. That evening you review the films and records, fill out the paperwork, and call the referring physician. In addition to the charges for a New Patient Consultation, what charges may you submit to the commercial medical insurance for these services?

You see a patient in clinic with what appears to be a non-infected diabetic foot ulcer over the first metatarsal head and order an ankle-brachial index (ABI) study. The patient’s ABI is 1.4. What is your next step in treatment?

A 28-year-old male firefighter sustained deep dermal burns across his lower face, neck, anterior chest, and shoulders. To help manage the formation of hypertrophic scars, you recommend

What is the biggest barrier for participation in outdoor activities for children with physical disabilities?

A 25-year-old man comes to your office for evaluation of low back pain. As part of the physical examination, you mark a point at the L5 vertebral body and another point midline 10 cm above. You ask him to flex forward maximally while keeping his knees extended and measure the distance between the two points. This distance is 13.5 cm. You suspect he may have what diagnosis?

What is the best predictor of fractures in a person with osteoporosis?

Myotonic discharges produce a distinctive sound on electromyography (EMG). This sound results from

What prosthesis is most appropriate for a 6-month-old child who has a congenital transhumeral amputation?

When is the use of hyperbaric oxygen recommended for the treatment of diabetic foot ulcers?

A 27-year-old manual laborer presents with a 6-month history of right shoulder pain. He has a past medical history of a right shoulder dislocation after a water-skiing accident 3 years ago. On physical exam, he has normal strength and sensation with symmetric reflexes. The shoulder apprehension test is positive. Impingement tests and the O’Brien active compression test are negative. Which diagnosis is most consistent with this presentation?

A 60-year-old woman had a left total hip arthroplasty 4 weeks ago. During her gait evaluation, she is noted to have a left lateral trunk lean during left stance phase. This gait deviation is most likely a result of weakness in which left lower limb muscle?

A physiatrist assesses each of the following patients during hospitalization and determines that each one is clinically appropriate for an admission to your acute inpatient rehabilitation unit. Which patient does NOT qualify for the Center for Medicare and Medicaid Services (CMS) 60% Rule (formerly known as the 75% Rule)?

Where is the lesion site in ataxic dysarthria, as found in Friedreich’s ataxia?

Which statement is TRUE of the lower trapezius muscle?

A 45-year-old man with T4 paraplegia secondary to transverse myelitis is in acute inpatient rehabilitation. Your physical therapist reports to you that the patient is asking whether he will ever be able to have sexual intercourse with his wife again. The next day you decide to address sexuality with your patient on morning rounds. What is the best way to approach this patient?

Which ergonomic recommendation for computer stations is NOT appropriate for an injured worker with upper extremity cumulative trauma disorder?

What aspect of gait is improved when a manual locking knee design is chosen for an individual with a unilateral transfemoral dysvascular amputation?

In a patient with inflammatory arthritis, which type of exercise is LEAST likely to raise the white blood cell count in the synovial fluid of the affected joint?

What is the benefit of using ankle-foot orthoses (AFOs) for a patient with Duchenne muscular dystrophy?

Repetitive transcranial magnetic stimulation (rTMS) of the motor cortex appears to have therapeutic value in the treatment of

Which non-surgical treatment for carpal tunnel syndrome is shown to provide significant short-term benefit?

Which pharmacologic and non-pharmacologic treatment combination is the most appropriate initial program in a patient with fibromyalgia?

A negative prognostic sign in early multiple sclerosis is

A 59-year-old woman with metastatic breast cancer presents with painful swelling of her right arm over the last year. She underwent a radical mastectomy two years ago followed by radiation therapy. She describes an aching discomfort along with an ill-defined sensation of numbness and tingling. Effective decongestive therapy for the treatment of secondary lymphedema requires

An injured worker with complex regional pain syndrome (CRPS), type 1, asks his physician to prescribe methadone instead of morphine because of ongoing pain. The physician orders blood work and an electrocardiogram (EKG) first. What finding would be a strong contraindication to prescribing methadone for this patient?

Of the muscles listed, the most distal muscle receiving innervation from the C5 root is