Occupational Therapy Modalities
Pre-Test Questions
Course Introduction
Occupational Therapy Modalities introduces students to the theory, application, and clinical reasoning behind various therapeutic interventions used in occupational therapy practice. The course covers both traditional and emerging modalities, such as thermal agents, electrical stimulation, ultrasound, orthotics, splinting, and sensory integration techniques, highlighting their roles in promoting functional outcomes for diverse populations. Through lectures, demonstrations, and hands-on practice, students develop foundational skills in selecting, safely administering, and documenting therapeutic modalities, while considering client needs, contraindications, safety precautions, and evidence-based practice.
Recommended Textbook
Michlovitzs Modalities for Therapeutic Intervention 6th Edition by James W. Bellew PT EdD
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2
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Sample Questions
Q1) Which of the following modalities will reduce blood flow to tissues?
A) Thermotherapy
B) Ultrasound
C) Traction
D) Cryotherapy
Answer: D
Q2) Why is pregnancy widely considered a contraindication to the use of modalities?
A) Ligamentous laxity during pregnancy may be increased.
B) Effectiveness of modalities during pregnancy has not been determined.
C) The effect of modalities on fetal development is unknown.
D) Pregnant patients cannot be properly positioned to receive modality treatments. Answer: C
Q3) Which of the following best describes the appropriate use of therapeutic modalities for rehabilitation programs?
A) Adjunctive components of a comprehensive therapy program
B) Primary components of most therapy programs
C) Exclusive application for curative purposes
D) Promotion of post-therapy goals and outcomes
Answer: A
Page 3
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Chapter 2: Cold Therapy Modalities
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Q1) Which of the following is true regarding cold therapy application methods?
A) A bag of frozen peas can be used for home cold pack application.
B) Recommendations for temperature and duration of water baths are inversely related.
C) The risk of frostbite is very high with ice massage, so treatments should not exceed 3 minutes.
D) Menthol gels or creams decrease subcutaneous tissue temperature as well as a cold pack.
Answer: A
Q2) Which of the following statements is true regarding vapocoolant sprays?
A) They are effective in decreasing muscle temperature to allow stretching without pain.
B) They can decrease skin temperature to about 15°C.
C) Multiple clinical trials demonstrate their efficacy.
D) They transfer heat from the body via convection.
Answer: B
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4
Chapter 3: Therapeutic Heat
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Sample Questions
Q1) 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
Q2) Which of the following statements is true regarding air-activated heat wraps?
A) They maintain a temperature of 40°C up to 8 hours.
B) Air activates small magnetic coils in the wraps, which produce heat.
C) They can be reused up to five times after activation.
D) They provide a comfortable prolonged low-level moist heat.
Answer: A
Q3) Which of the following temperature ranges is required for a thermal modality to cause a therapeutic effect?
A) 20°C to 25°C
B) 30°C to 35°C
C) 40°C to 45°C
D) 50°C to 55°C
Answer: C
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Chapter 4: Therapeutic Ultrasound
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Q1) 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
Q2) There is strong substantiated evidence for the use of pulsed US to treat
A) Various inflammatory conditions including lateral epicondylitis
B) Pain and dysfunction of carpal tunnel syndrome
C) Calcific tendinitis and bursitis
D) There is no compelling evidence for any use of pulsed US.
Q3) The technique used to reduce the risk of burning while still getting an effective treatment with an ultrasound applicator with a high beam nonuniformity ratio (BNR) is to
A) Move the US applicator while applying the US.
B) Use pulsed rather than continuous US.
C) Turn down the intensity of the applied US.
D) Use water rather than ultrasonic gel during the US application.
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Chapter 5: Hydrotherapy: the Use of Water As a Therapeutic Agent
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Q1) How can excessive edema formation in the hand be prevented during an upper extremity whirlpool treatment?
A) Increase the temperature of the whirlpool to the maximum tolerable to increase venous return.
B) Avoid a completely dependent position and perform active range-of-motion (ROM) exercises during the treatment.
C) Let the hand hang down as much as possible to take advantage of increased hydrostatic pressure at greater depths.
D) Keep the limb relatively still to minimize oxygen demand in the extremity.
Q2) Which of the following correctly describes the use of PLWS for treatment of an open wound?
A) Controlled pressure of pulsations maintained between 4 and 15 psi
B) Cleansing of wound bed with maximum irrigation forces up to 30 psi
C) Delivery of antiseptic via pulsations of water into all areas of the wound
D) Lavage of wound tissues with strong suction to increase blood flow into the wound
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Chapter 6: Electromagnetic Modalities: Laser, Diathermy, and
Pulsed Electromagnetic Fields
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Q1) Which of the following should not be treated with LLLT?
A) Chronic epicondylitis
B) Herpes simplex wounds
C) Carpal tunnel syndrome
D) Open growth plates of bones
Q2) Your patient has a medical history of impaired sensation in her lower extremities. If you chose laser for treatment of a condition in her lower extremities, which of the following laser therapy treatments must be performed with caution?
A) High-intensity lasers and superluminescent light-emitting diode (SLED) arrays
B) Infrared laser at a dosage of 2 J/point
C) HeNe laser at a dosage of 8 J/point
D) Nd-YAG pulsed laser at 12 J/point
Q3) Why must all external metallic objects be removed in the vicinity of diathermy treatments?
A) Metals can interfere with the flow of electromagnetic waves.
B) Metallic objects will block the transmission of electromagnetic waves.
C) Metals will heat faster than tissues, which may cause burns.
D) Metallic objects will prevent proper positioning of the capacitive plates or inductive drums.
Page 8
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Chapter 7: Spinal Traction
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Q1) 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.
Q2) What is the evidence of the effect of lumbar traction on intradiscal pressures?
A) Intradiscal pressures increase during traction then gradually decrease after traction.
B) Intradiscal pressures decrease during traction then rapidly return to normal after traction.
C) There is no effect on intradiscal pressure during or after traction.
D) The effect on intradiscal pressure during traction is unpredictable.
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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Page 9
Chapter 8: Intermittent Pneumatic Compression
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Q1) IPC pressure must be above which of the following arterial capillary pressures to be useful in assisting an arteriovenous (A-V) pressure gradient and encouraging the absorption of edema?
A) 30 mmHg
B) 10 mmHg
C) 60 mmHg
D) 120 mmHg
Q2) Which of the following instructions would be most helpful for a patient who has just completed the first IPC treatment for lower extremity edema?
A) Put the leg in a dependent position as soon as possible to prevent ischemia.
B) Compensatory swelling in other areas of the body is an expected response to IPC.
C) Avoid moving the treated limb for as long as possible.
D) Wear compression garments to maintain changes in limb volume.
Q3) Which of the following is a common benign response following an IPC treatment?
A) Slight transient dizziness and unsteadiness
B) Numbness of the extremity
C) Persistent shortness of breath for several hours
D) Depressed circumferential lines on limb
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Chapter 9: Foundations of Clinical Electrotherapy
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Q1) Why does electric current depolarize nerves more easily than it does skeletal muscles?
A) Nerves are closer to the surface of the skin than most muscles.
B) The resting membrane potential of nerves is more negative than that of muscles.
C) The resting membrane potential of nerves is less negative than that of muscles.
D) The neurolemma of nerves is thinner than the sarcolemma of muscles.
Q2) 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
Q3) According to Ohm's law, when using a device that has a constant voltage, what will happen to the current when the skin resistance increases?
A) The current increases.
B) The patient will feel a short-duration shock.
C) There is no change in current.
D) The current decreases.
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Chapter 10: Clinical Electrical Stimulation: Application and Techniques
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Q1) Which of the following electrode placements is best for achieving a contraction of the wrist extensors?
A) One electrode proximal near the elbow and the other distal near the wrist
B) Cross-section arrangement on the forearm, one anterior and one posterior
C) Close together over the wrist extensor muscles in the forearm
D) One large electrode over the muscle belly and a smaller electrode distally near the wrist
Q2) Which of the following is the correct equation for determining the dosage for iontophoresis treatments?
A) Dosage ( A·pps) = Current ( amp) × Frequency (pps)
B) Dosage (mA·min) = Current (mA) × Duration (min)
C) Dosage (V·sec) = Voltage (V) × Duration (sec)
D) Dosage (V/pps) = Voltage (V) × Frequency (pps)
Q3) Which of the following most likely explains the physiological response to noxious-level stimulation (hyperstimulation) that results in analgesia?
A) Release of endogenous opioids in the central nervous system
B) Closing the "gate" to nociception in the spinal cord
C) Blocking of nociceptive receptors in the skin
D) Release of histamine and prostaglandins into the circulatory system
Page 12
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Chapter 11: Mechanisms of Pain and Use of Therapeutic Modalities
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Q1) Analgesic tolerance is most likely to occur with what type of opioid receptor?
A) Kappa
B) Mu
C) Delta
D) Gamma
Q2) Which of the following best reflects the evidence-based recommendations for the duration of a TENS treatment when used for knee osteoarthritis?
A) Less than 15 minutes
B) 40 minutes
C) 1 hour
D) Several hours of continuous stimulation
Q3) Modulation of the beat frequency when using interferential current is known as which of the following?
A) Swing
B) Sweep
C) Scan
D) Swift
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Page 13
Chapter 12: Therapeutic Modalities for Improving Range of Motion
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Sample Questions
Q1) For a patient having undergone ankle immobilization following a sprain, which of the following clinical measures best supports the administration of therapeutic modalities?
A) Active range of motion (AROM) ankle dorsiflexion of +2 degrees
B) AROM ankle inversion of 40 degrees
C) 4+/5 strength of the ankle evertors
D) Decreased stance time during gait
Q2) Which one of the following is not a commonly used clinical method of using electrical stimulation for improving range of motion (ROM) affected by spasticity?
A) Motor level stimulation over the antagonist muscle
B) Motor level stimulation over the spastic muscle
C) Sensory level stimulation over the spastic muscle
D) Sensory level stimulation over the antagonist muscle
Q3) 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
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Chapter 13: Electrotherapy for Musculoskeletal Disorders
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Q1) A possible limitation of NMES is which of the following?
A) The inability of NMES to achieve greater than 50% maximum voluntary contraction (MVC).
B) Recruitment of fast fibers occurs before recruitment of slow fibers.
C) Firing frequencies of muscle fibers are lower than frequencies used during NMES.
D) Duration of NMES treatments is much longer than comparable voluntary strengthening programs.
Q2) The recommended amplitude for NMES to achieve a given level of muscle force is termed which of the following?
A) Dosage
B) Quantum
C) Threshold
D) Frequency
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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Chapter 14: Neuromuscular Electrical Stimulation Nmes
and Functional Electrical Stimulation Fes in Patients With
Neurological Diagnoses
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Q1) Which of the following is known about the use of biofeedback for patients who have had a stroke?
A) Current evidence does not show support.
B) Studies confirm it is useful for recovery.
C) It is ineffective for stroke victims because of spasticity.
D) It can be combined with NMES for retraining of gait.
Q2) Which of the following is supported by the literature when performing cycling FES for patients with spinal cord injuries?
A) 10 or 20 minutes every day
B) 30 to 60 minutes three times per week
C) 10 minutes three times per day, three to four times per week
D) 60 to 90 minutes five times per week
Q3) NMES applied to the antagonist muscle for patients with spasticity will reduce spasticity based on which of the following theories?
A) Reciprocal inhibition of the spastic agonist muscle
B) Recurrent inhibition via Renshaw cells
C) Sensory habituation of the antagonist muscle
Page 16
D) Facilitation of parasympathetic neurons in the limb
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Chapter 15: Therapeutic Modalities for Tissue Healing
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Sample Questions
Q1) The recommended range of water pressure for pulsed lavage with concurrent suction (PLWCS) is
A) 4 to 15 pounds per square inch
B) 20 to 40 kilograms per cubic centimeter
C) 100 to 150 pounds per square foot
D) 500 to 1,000 grams per cubic meter
Q2) What does the current research literature on the use of MIRE for the treatment of sensory neuropathy show?
A) Research is conclusive that MIRE is effective in restoring sensation.
B) No studies demonstrate that MIRE is effective for this condition.
C) No consistent body of evidence exists supporting MIRE for this condition.
D) Research remains inconclusive regarding effectiveness and concern about harmful side effects.
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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Page 17
Chapter 16: Alternative Modalities for Pain and Tissue Healing
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Q1) Which of the following patients should not have hyperbaric oxygen therapy treatment?
A) A 23-year-old male with migraine headaches
B) A 36-year-old female with untreated pneumothorax
C) A 66-year-old male with complex regional pain syndrome
D) An 82-year-old female with refractory osteomyelitis
Q2) 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.
Q3) 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
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Page 18
Chapter 17: Electrophysiological Testing of Nerves and Muscles
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Q1) Which of the following are primary indicators of demyelination of a nerve?
A) Positive sharp waves and decreased sensory and muscle action potentials
B) Prolonged distal latencies and slowing of nerve conduction velocity
C) Decreased amplitude and blocked nerve conduction
D) Shorter distal latencies and increased nerve conduction velocity
Q2) 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
Q3) Which of the following is a normal characteristic of a motor unit potential?
A) Amplitude of 10 to 50 mV
B) Duration of 5 to 15 msec
C) Usually has multiple phases (polyphasic)
D) Low frequency (usually 1 to 5 per second)
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