Advanced Therapeutic Modalities Study Guide Questions
Course Introduction
Advanced Therapeutic Modalities explores contemporary and emerging interventions used in physical rehabilitation to promote healing, pain relief, and functional recovery. The course provides an in-depth analysis of the physiological principles, clinical applications, and evidence-based practice of modalities such as ultrasound, electrical stimulation, laser therapy, cryotherapy, heat therapy, and newer technologies. Students will develop critical skills in patient assessment, modality selection, device operation, and outcome measurement, while also considering safety, ethical issues, and contraindications. Emphasis is placed on integrating therapeutic modalities with comprehensive rehabilitation plans to optimize patient outcomes across various clinical settings.
Recommended Textbook
Michlovitzs Modalities for Therapeutic Intervention 6th Edition by James W. Bellew PT EdD
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17 Chapters
315 Verified Questions
315 Flashcards
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Chapter
Their Roles in the Patient Care Management Model
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Sample Questions
Q1) Which of the following modalities is capable of delivering heat to tissues?
A) Intermittent compression
B) Handheld ice cups
C) Continuous ultrasound
D) TENS
Answer: C
Q2) In the patient care management model, therapeutic modalities include the use of physical agents to provide which of the following?
A) Palliative care alone
B) Therapeutic benefits
C) Discharge planning
D) Assessment of patient prognosis
Answer: B
Q3) What type of energy does diathermy use to heat biological tissues?
A) High-frequency sound waves
B) Electromagnetic radiation
C) Compressive and distractive forces
D) Convective currents
Answer: B
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Chapter 2: Cold Therapy Modalities
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Sample Questions
Q1) Which of the following patient examination procedures should not be performed following cryotherapy?
A) Range of motion
B) Posture assessment
C) Joint play
D) Manual muscle testing
Answer: D
Q2) The greater the temperature gradient between the skin and the cryotherapy modality, which of the following will be greater?
A) Tissue temperature change
B) Duration of vasoconstriction
C) Increase in modality temperature
D) Tolerance for cold application
Answer: A
Q3) Which of the following is an abnormal response to the application of cold?
A) Reddening of the skin
B) Raised, red, irregularly shaped areas on the skin
C) Numbness of the skin
D) Feelings of burning or aching of the skin
Answer: B
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Chapter 3: Therapeutic Heat
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Sample Questions
Q1) Which of the following would be the best choice in a clinic setting to minimize rheumatoid arthritis wrist pain and stiffness in an elderly female?
A) Any heating agent, because elderly people always prefer heat over cold.
B) Any cold therapy modality would be preferable to heat for this inflammatory problem.
C) Fluidotherapy, because the patient can do active range of motion during the heat treatment.
D) Electric heating pad, because it is easy to apply and the patient can use one at home.
Answer: C
Q2) One advantage of heat over cold therapy is
A) Heat increases the resistance of collagen to a deforming force, resulting in improved scar strength.
B) Heat decreases soft tissue swelling more than cold.
C) Heat decreases joint stiffness, while cold increases stiffness.
D) Heat decreases cellular metabolism, reducing the risk of hypoxic injury.
Answer: C
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5
Chapter 4: Therapeutic Ultrasound
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Sample Questions
Q1) A common mistake made by therapists in heating a tissue using ultrasound is
A) Selecting the incorrect frequency
B) Selecting the incorrect applicator size
C) Selecting the incorrect mode: pulsed or continuous
D) Applying US over too large of an area
Q2) Noncontact low-frequency ultrasound (NCLFUS) involves all of the following except
A) It is the aerosolization of saline water to treat wounds.
B) It is commonly known by its commercial name of MIST Therapy.
C) Evidence suggests that the NCLFUS stimulates wound healing by atraumatic selective tissue debridement, wound stimulatory effects, and antibacterial activity.
D) The approach is done by applying ultrasound in the same say as conventional ultrasound using the same frequencies and intensities.
Q3) Which of the following does NOT have an influence on the amount of heating produced in a tissue by US?
A) US frequency
B) US intensity
C) Movement speed of the US applicator
D) Use of pulsed or continuous US
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6
Chapter 5: Hydrotherapy: the Use of Water As a Therapeutic Agent
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Sample Questions
Q1) A 38-year-old male with cerebral palsy is referred for balance and gait training secondary to severe balance and endurance problems that were the result of a medication reaction used to treat anxiety. Which of the following is true regarding pool therapy for this patient?
A) Pool therapy is contraindicated for this patient because of his severe balance problems.
B) He would likely benefit from exercise on a treadmill in a pool to improve endurance. C) Pool therapy can be used to improve endurance, balance, and gait.
D) He cannot begin pool therapy until his anxiety is controlled by medication.
Q2) Which of the following patients would be most appropriate for a warm whirlpool at 37°C?
A) A 76-year-old male with stiffness of his left wrist 3 months after a Colles fracture
B) An 18-year-old female basketball player who sprained her ankle 2 days ago
C) A 48-year-old male with hip stiffness who had a total hip replacement 2 weeks ago
D) A 36-year-old female with bilateral knee pain after running a marathon yesterday
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Page 7
Chapter 6: Electromagnetic Modalities: Laser, Diathermy, and
Pulsed Electromagnetic Fields
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Sample Questions
Q1) Which of the following is true about electromagnetic energy?
A) Has matter that is equal in mass to its frequency
B) Transfers heat via conduction
C) Travels through space without a transport medium
D) Requires contact with the body or another conducting pathway
Q2) Which of the following correctly describes the inductive method of diathermy?
A) Creation of electromagnetic eddy currents in conductive tissues
B) Preferential heating of tissues with high electrical resistance
C) Induction of capacitive currents around the electrical field
D) Body part between electrodes becomes part of the electrical field
Q3) You have decided to use LLLT for treatment of lateral epicondylitis. Which of the following lasers is the best choice for absorption of light energy in the tissues attached to the lateral epicondyle at a depth of 2 to 3 millimeters from the skin?
A) HeNe red laser at 632 nm
B) GaAs infrared laser at 830 nm
C) GaAl laser at 930 nm
D) Nd-YAG pulsed laser at 1,200 nm
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Page 8
Chapter 7: Spinal Traction
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Sample Questions
Q1) Which of the following lists contains only contraindications or precautions for traction?
A) Spinal instability, uncontrolled hypertension, claustrophobia
B) Infection, osteoarthritis, hiatal hernia
C) Rheumatoid arthritis, facet joint capsulitis, upper extremity radiculopathy
D) Spine cancer, hiatal hernia, herniated nucleus pulposus
Q2) Which of the following is true regarding lumbar spine decompression units?
A) Research has demonstrated that these units are more effective than standard traction tables.
B) There is lack of evidence in the literature to validate the effectiveness of these units.
C) These units are effective in relieving back pain but not radiculopathy.
D) Space-age technology is applied to reduce bulging and herniated discs effectively.
Q3) Clinical effectiveness of traction appears to be best when performed
A) Alone, without other interventions
B) Combined with heat and massage
C) Combined with manual therapy and exercise
D) Combined with ultrasound and epidural injections
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Chapter 8: Intermittent Pneumatic Compression
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Sample Questions
Q1) Which of the following is appropriate prior to applying the garment to the limb?
A) A stockinette without wrinkles should be placed over the limb.
B) Deep effleurage should be performed to decrease edema in the limb.
C) Application of an analgesic cream to the skin will limit discomfort during treatment.
D) Light aerobic exercise, such as stationary bicycling, will increase circulation to the limb.
Q2) Which of the following parameters for IPC should be chosen for a patient who has a lower extremity venous ulcer?
A) Slow inflation cycles
B) Long inflation times and slow deflation times
C) Rapid inflation cycles
D) Slow inflation times and rapid deflation times
Q3) Which statement about IPC is correct?
A) Effective for post-traumatic edema only if applied immediately after trauma
B) May help decrease high extremity blood pressure related to pulmonary edema
C) Effective in prevention of deep venous thrombosis formation in a person who is immobilized
D) Contraindicated for open wounds because of decreased oxygen delivery to the wound
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Page 10
Chapter 9: Foundations of Clinical Electrotherapy
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Sample Questions
Q1) Which of the following is the correct description of "charge"?
A) An object that has an equal number of protons and electrons
B) Movement of a current along a conductor
C) Gain or loss of protons by an atom
D) Addition or removal of electrons, creating an electromagnetic force
Q2) Which of the following is the correct description of "direct current"?
A) Flow of electrons directly from a charged object to another object
B) Bidirectional flow of electrons in opposite directions for at least 1 minute
C) Unidirectional flow of electrons for at least 1 second
D) Electrons that flow through a conductor in one direction for less than 1 second
Q3) Which type of current will most likely cause changes in the tissues underlying the electrodes as a result of electrode polarity?
A) Direct current
B) Monophasic pulsed current
C) Balanced, asymmetrical biphasic pulsed current
D) Russian current
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11
Chapter 10: Clinical Electrical Stimulation: Application and Techniques
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Sample Questions
Q1) Which of the following is NOT believed to occur during treatments using iontophoresis?
A) Electromigration
B) Electroporation
C) Electrosaturation
D) Electroosmosis
Q2) Which of the following statements best summarizes the research on neuromuscular electrical stimulation (NMES) for muscle strengthening?
A) The strength benefits of NMES are superior to no exercise at all for healthy muscle.
B) In the initial periods of rehabilitation the strength benefits of NMES are not superior to voluntary exercise in weakened muscle.
C) There is no correlation between the intensity of NMES and strength gains.
D) NMES is no better than exercise for strengthening healthy muscle.
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12
Chapter 11: Mechanisms of Pain and Use of Therapeutic Modalities
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Sample Questions
Q1) Electrode placement for TENS should be selected based on which of the following?
A) Chronicity of pain
B) The mode of TENS used
C) In accordance with the painful area or over the peripheral nerve responsible for the pain
D) The cost of the electrodes
Q2) Modulation of the temporal characteristics of interferential current is best known as what?
A) Swing
B) Sweep
C) Scan
D) Swift
Q3) What are the three most common parameters used to provide the different modes of TENS?
A) Current waveform, pulse frequency, and fall time
B) Pulse frequency, pulse duration, and current amplitude
C) Current amplitude, pulse duration, and carrier frequency
D) Pulse duration, pulse frequency, and waveform shape
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Chapter 12: Therapeutic Modalities for Improving Range of Motion
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Sample Questions
Q1) Which of the following modalities is most appropriate for use over the Achilles tendon to facilitate an increase in dorsiflexion ROM?
A) Heating pack
B) Fluidotherapy
C) Continuous ultrasound
D) Paraffin wax
Q2) Which of the following recommendations is most critical when using therapeutic modalities to increase ROM?
A) Stretching of the restricted tissue should occur during and/or immediately after administration of the therapeutic modality.
B) Thermal modalities should never be used to increase ROM in tissues that are restricted as a result of a burn.
C) Only aggressive manual stretching should be used after administration of a therapeutic modality to increase ROM.
D) Benefits from using therapeutic modalities to increase ROM are only observed for chronic conditions resulting in restricted ROM.
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14
Chapter 13: Electrotherapy for Musculoskeletal Disorders
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Sample Questions
Q1) Research studies on the effect of NMES on quadriceps strength following anterior cruciate ligament (ACL) reconstruction found increased strength in the quadriceps using which of the following stimulation intensities?
A) 10% below muscle contraction
B) 50% of maximum voluntary contraction
C) 100% maximum voluntary contraction
D) Maximum tolerated current
Q2) Which of the following ranges of frequencies represents the force-frequency relationship?
A) 10 to 20 Hz
B) 30 to 50 Hz
C) 50 to 80 Hz
D) 80 to 100 Hz
Q3) Which of the following is a contraindication for biofeedback?
A) Muscle spasticity
B) Diabetes
C) Peripheral neuropathy
D) There are no contraindications for biofeedback.
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15
Chapter 14: Neuromuscular Electrical Stimulation Nmes
and Functional Electrical Stimulation Fes in Patients With
Neurological Diagnoses
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Sample Questions
Q1) In patients with neurological conditions who have spasticity, why is a longer ramp-up time required when stimulating the antagonist muscle?
A) Increases tolerance to the onset of the stimulation
B) Causes greater recruitment of motor units
C) Avoids a quick stretch of the spastic muscle
D) Offsets the shorter ramp-down time
Q2) Studies have shown that FES for upper extremity function has been effective in facilitating functional use of the extremity in which of the following patient populations?
A) Those who have had a stroke
B) Those with traumatic brain injury
C) Those having a spinal cord injury
D) All of the above
Q3) FES for dorsiflexion assist during ambulation
A) Cannot be performed on patients who have CP because of spasticity
B) Improves ankle dorsiflexion required during swing phase of gait
C) Can result in full recovery of muscle function in patients post-CVA
D) Has not been shown to be effective for dorsiflexion assist
Page 16
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Chapter 15: Therapeutic Modalities for Tissue Healing
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Sample Questions
Q1) Which of the following is true regarding the effects of low-level laser therapy (LLLT) on wound healing?
A) Results in decreased necrotic tissue and cellular exudate
B) Results in increased proliferation of inflammatory cells
C) Results in increased rate of healing of wounds.
D) Lacks evidence that cellular effects translate into wound healing in humans.
Q2) Which of the following best describes the proposed therapeutic effect of monochromatic infrared energy (MIRE)?
A) Reduction of edema and improved lymph flow restores normal circulation.
B) Increased circulation leads to healthier nerves and return of sensation.
C) Facilitation of migration of cells to affected tissue promotes healing.
D) Promotion of cellular proliferation in fibroblasts facilitates healing.
Q3) The role of the inflammatory process that occurs following soft tissue injury can best be described as
A) Excessive and counterproductive to healing
B) Critical for successful tissue healing
C) Inadequate to promote scar formation
D) Required so the central nervous system (CNS) can produce mucopolysaccharides
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17
Chapter 16: Alternative Modalities for Pain and Tissue Healing
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Sample Questions
Q1) Which of the following are typical parameters used during hyperbaric oxygen therapy (HBOT)?
A) 2 to 3 atmospheres absolute (ATA) for a duration of 30 to 120 minutes
B) 5 to 10 ATA for a duration of 2 to 4 hours
C) 50 to 100 ATA for a duration of 4 to 6 hours
D) 500 to 1,000 ATA for a duration of 6 to 8 hours
Q2) Which of the following is considered a contraindication for use of therapeutic magnets?
A) Placement near internally implanted electronic devices
B) Implanted metal plates and screws for fracture fixation
C) Decreased sensation of the skin caused by peripheral neuropathy
D) Patients with a history of cardiovascular or pulmonary disease
Q3) Is it safe for a person with cancer to use therapeutic magnets for pain control?
A) Yes, there is no evidence that magnets will enhance the growth of cancerous cells.
B) No, magnets create electrical fields that can limit blood flow to cancerous cells.
C) Yes, static magnets can decrease pain and limit cancer cell growth.
D) No, magnetic fields may facilitate the growth and spread of cancerous cells.
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Page 18
Chapter 17: Electrophysiological Testing of Nerves and Muscles
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Sample Questions
Q1) Which of the following best describes a nerve conduction study (NCS)?
A) Recording resting membrane activity of peripheral axons
B) Measuring the speed of contraction of a muscle following electrical stimulation of a motorneuron
C) Recording evoked responses produced by electrically stimulating a motor or sensory nerve
D) Measuring the difference between nerve conduction velocities of motor and sensory nerves
Q2) Why must an ENMG examination be delayed until about 21 days after an axonopathy?
A) Three weeks is the approximate amount of time needed for Wallerian degeneration of the nerve to proceed.
B) It takes about 3 weeks for axons to begin regeneration.
C) Anterior horn cells will restore axoplasmic flow after 21 days.
D) It takes about 3 weeks for post-injury inflammation to subside.
Q3) Results of electroneuromyography (ENMG) are best used for which of the following purposes?
A) Identifying the location of a neuromuscular impairment
B) Diagnosing impairments that lead to peripheral neuropathies
C) Indentifying the actual cause of a nerve or muscle impairment
D) Diagnosing anatomical anomalies that may compress a nerve
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