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Exam 17: Assistive Technology in Intervention: Focus on Wheelchairs,assistive Devices,and Orthoses

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Question 1

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A 35 year-old male presents with a complete thoracic spinal cord injury (no motor or sensory nerve impulses below the level of the lesion) .During the initial physical therapy evaluation,tight hip external rotators,hamstrings,and gastroc-soleus muscles were noted.Each of the following is a likely rationale for recommending orthoses for this client EXCEPT:

A) Improving joint alignment
B) Providing joint protection for the knees and ankles
C) Preventing further contracture(s) at the knees and ankles
D) Improving proprioceptive feedback to the joints in the legs

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Question 2

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Ankle foot orthoses (AFOs) typically do not improve the gait of children with Duchenne muscular dystrophy (DMD) presumably because of the weight of the orthoses and decreased mobility in the foot/ankle.Which of the following IS NOT a likely use of AFOs in this population?

A) Wearing them at night to help prevent shortening of the gastroc-soleus
B) Wearing them as tolerated to inhibit clonus that is common in boys with DMD
C) Wearing them to help prevent shortening of the gastroc-soleus and position the foot for improved stability in sitting when the disease has progressed to a point where function is primarily in a wheelchair
D) Wearing them in supported standing to improve alignment

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Question 3

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Which of the following definitions is most closely aligned with the definition of assistive technology in the Technology-Related Assistance for Individuals with Disabilities Act?

A patient arrives in your outpatient clinic with a slumped posture and posterior pelvic tilt while seated in a poorly fitted standard wheelchair with a sling back and sling bottom.Each of the following options are likely to improve her hip position in the chair EXCEPT?

What is the minimum "dosing" you would recommend for a child in a supported standing device if your goals are to: maintain strong bones,prevent hip dislocation,and prevent hip and knee flexion contractures?

Which of the following purported benefits of supported standing has minimal evidence to justify its inclusion in the list of benefits?

The definition of an "assistive technology device" used in most federal legislation includes ALL of the following concepts EXCEPT:

An otherwise healthy 54 year-old male who had a cerebrovascular accident (CVA) less than a month ago is being discharged from an inpatient therapy program.Which of the following is NOT an appropriate suggestion from the treating therapists?

A patient ("John Doe") is in need of a standing frame for home use.ALL of the following statements in the below letter of medical necessity satisfies the requirement to show medical necessity EXCEPT: This letter of medical necessity is being written on behalf of John Doe who is in need of a standing frame for home use.John is a 3 year-old boy who has right-sided hemiparesis with spasticity secondary to cerebral palsy.He is developing hip,knee,and ankle contractures because of the spasticity on his right side.

If a child has a tendency to crouch during standing and walking primarily because of weakness in the gastroc-soleus muscle group,what type of orthoses might be most effective?

What type of adaptive seating would be most beneficial for a child with spastic diplegia (cerebral palsy) who has a tendency to "scissor" her legs because of increased extensor muscle tone (primarily in adduction and internal rotation) .

Which of the following is a type of assistive technology device typically used with a young child (as early as 10-12 months and up to preschool) who has myelomeningocele (L3 level) to allow supported standing and forward progression?

ALL of the following statements related to safe patient handling and mobility are true EXCEPT?

Federal legislation that directly or indirectly supports the use of assistive technology to improve the lives of people with disabilities includes ALL of the following EXCEPT?

Which of the following shows a progression from most restrictive to least restrictive devices for assisted ambulation?

A school-aged child in a large public school system has visual and physical impairments.The child needs to be assessed to recommend the most appropriate assistive technology to allow her to benefit from special education.Which of the following describes the MOST IDEAL scenario for this child?