Ethics and Therapeutics Flashcards
A beneficial effect of aquatic therapy in cardiac rehabilitation is:
Aquatic immersion causes increased stroke volume, decreased heart rate, lower end diastolic blood pressure, increased cardiac output, in large part due to fluid dynamic shifts and the resultant reduction in venous and arterial vascular resistance.
The effect of aquatic therapy for patients with osteoporosis is:
Despite the concerns to the contrary, patients with osteoporosis who exercise have no loss of bone mineral density and preserve density better than non-exercising controls. There is no clear evidence of increased bone deposition however. The major benefits in patients with osteoporosis are from improved balance, decreased postural sway and lowered fall risks, with subsequent lower morbidity and mortality.
A specific benefit of music therapy that has been proven in patients with acquired brain injury is improvement in:
Although there were few studies overall, only gait was improved with the use of music therapy in patients with acquired brain injury. Further studies would be needed to evaluate the potential benefits of music therapy for the other outcomes.
Rhythmic auditory stimulation improves what aspect of gait the most in individuals with acquired brain injury?
The pooled data from the studies in the Cochrane review demonstrated potential improvements in gait symmetry in all the studies, while there was inconsistent improvements in velocity and stride length and inconsistent level of improvement in cadence. Balance was not assessed in the pooled data.
The institution of an exercise program has many benefits for a patient’s health. Which of the below is true?
Exercise has many physiological and psychological benefits including reduction in cardiovascular disease risk factors, anxiety, depression, and fall risk in older individuals. Exercise programs cannot change a person’s socioeconomic status.
According to the U.S. Department of Health and Human Services (HHS) published Physical Activity Guidelines, the target level of exercise to maintain health is:
60 minutes a day of moderate to vigorous exercise is the recommendation for children, while the recommendations for adults are 150 minutes a week of moderate intensity exercise or 75 minutes a week of vigorous intensity exercise.
Cardiopulmonary exercise testing is used to evaluate:
While estimates can be made of cardiac stroke volume, muscle strength and sprint velocity, aerobic capacity is what is measured by cardiopulmonary exercise testing. Cardiac ischemia may be detected by the 12-lead monitoring used on cardiopulmonary exercise testing (CPET), but CPET is a functional test, not a diagnostic test like cardiac exercise testing or the variants such as thallium, persantine, or other tests
For patients with peripheral vascular disease, the best method of assessing their walking endurance is:
Constant load treadmill testing is the best method for assessing endurance with walking in patients with claudication. Non-invasive flow studies (NIFS) detect disease, but in some instances, over 40% of symptomatic patients with normal NIFS have been shown to have abnormal constant load tests, and may then have abnormalities develop on the post walk NIF if it is repeated right after exercise. 6-minute walk tests do not test the endurance (but a walk to fatigue field test with time would be appropriate). Cycle ergometry is better for assessing cardiopulmonary capacity in vascular patients as they can achieve a higher workload on the cycle than walking, but does not assess endurance in walking activity. Angiography helps to define the extent of disease and plan for treatment, but also does not assess endurance.
Cardiopulmonary exercise testing can help determine:
Exercise capacity as determined on cardiopulmonary exercise testing is associated with the prognosis of patients with heart failure. Although the other answers may be associated with changes in exercise testing, they have not been validated as well as peak oxygen uptake has for heart failure.
A difference between field exercise testing compared to laboratory exercise testing is:
Field testing is less accurate and is relatively unmonitored, using estimates to determine values for V02 Maximum. The benefit of field testing is that it is easier to administer, can be administered to large numbers of individuals quickly and is able to be done with very simple equipment (often a stopwatch and a marked flat course). Laboratory testing is better at evaluating at risk individuals, is more closely monitored and gives exact values for anaerobic threshold and peak exercise capacity, but does require time and a significant equipment investment.
Manual therapy utilizes instructions and maneuvers to achieve maximal painless movement of the musculoskeletal system and
This definition of manual therapy is derived from consensus on the goals of the provision of this treatment modality. Manual therapy includes instruction of the patient and the use of the provider’s hands to allow for restoration of painless movement with a goal of restoring postural balance in patients.
Which of the following is NOT a form of manual therapy?
There are many forms of manual therapy that are found in osteopathic, chiropractic and other forms of treatment. They all share a common thread of a combination of instruction and actual manual treatment aiming to relieve pain and restore normal function.
An absolute contraindication for massage therapy is:
Some of the above (pregnancy) are potential relative contraindications to massage, while others such as malignancy, myelopathy and aseptic necrosis are contraindicated in high velocity/low amplitude manipulation. Deep venous thrombosis is contraindicated in massage because increased blood flow in a limb could cause a thrombus to detach from the vessel wall, creating an embolism.
Isometric exercise has which of the following characteristics?
Isometric exercise is a muscle contraction without noticeable change in the length of the muscle. Thus, no physical work is performed (work is force over distance, so motion is needed). Answers a and c apply to isotonic exercise and answer d applies to isokinetic exercise.
For patients who have pulmonary disease, which of the following is an easy and commonly performed assessment of muscle strength?
Although all of the listed tests have been used for assessing strength in patients with frailty, in patients with lung disease (and most other conditions) the most commonly used and most validated test is the isometric hand grip test.
Creatine is commonly used to enhance performance for athletes. The evidence available indicates that it is beneficial for:
Although used in many settings, the only clear benefits for creatine for increasing performance in exercise have been found in short duration, high intensity activity. Because of the variation in the quality of commercially available preparations, even these benefits may also be limited and so advice should be given to athletes that creatine is only indicated for the short duration, high intensity activities.
