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Rehabilitation Therapist (China) study materials
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Rehabilitation Therapist (China) practice questions

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Question 1Functional anatomy, movement and localization

A patient presents with 'wrist drop' (垂腕) and loss of sensation over the first dorsal interosseous space following a mid-shaft humeral fracture. Which peripheral nerve is most likely damaged?

  1. Median nerve (正中神经)
  2. Radial nerve (桡神经) Correct answer.
  3. Ulnar nerve (尺神经)
  4. Axillary nerve (腋神经)

Explanation

The radial nerve runs in the spiral groove (radial groove) along the mid-shaft of the humerus. Fractures at this level frequently injure the radial nerve, paralyzing the wrist and finger extensors (causing characteristic wrist drop 垂腕) and causing sensory loss over the dorsal aspect of the first web space.

Question 2Functional anatomy, movement and localization

During a muscle contraction test, the therapist observes that muscle tension develops but the joint angle and overall muscle length remain unchanged. Which type of muscle contraction is being performed?

  1. Concentric isotonic contraction (向心性等张收缩)
  2. Eccentric isotonic contraction (离心性等张收缩)
  3. Isometric contraction (等长收缩) Correct answer.
  4. Isokinetic contraction (等速收缩)

Explanation

An isometric contraction (等长收缩 / 静力性收缩) is defined as muscle activation where internal muscle tension increases while external muscle length and joint angle remain constant, producing zero external mechanical work.

Question 3Assessment, measurement and functional goals

According to the Lovett 6-grade Manual Muscle Testing (徒手肌力评定 MMT) system, which grade is assigned when a muscle can complete the full active range of motion against gravity but cannot overcome any added resistance?

  1. Grade 3 (Fair / 3级) Correct answer.
  2. Grade 2 (Poor / 2级)
  3. Grade 4 (Good / 4级)
  4. Grade 1 (Trace / 1级)

Explanation

Under the Lovett MMT grading system (0 to 5): Grade 0 = No contraction; Grade 1 (Trace) = Palpable/visible contraction, no joint motion; Grade 2 (Poor) = Full ROM with gravity eliminated; Grade 3 (Fair) = Full ROM against gravity with no added resistance; Grade 4 (Good) = Full ROM against moderate resistance; Grade 5 (Normal) = Full ROM against maximal resistance.

Question 4Assessment, measurement and functional goals

When assessing spasticity of the elbow flexors using the Modified Ashworth Scale (MAS / 改良Ashworth分级), the therapist feels a sudden catch followed by minimal resistance throughout the remainder (less than half) of the ROM. What is the correct MAS grade?

  1. Grade 1 (1级)
  2. Grade 1+ (1+级) Correct answer.
  3. Grade 2 (2级)
  4. Grade 3 (3级)

Explanation

According to MAS criteria: Grade 0 = No increase in tone; Grade 1 = Slight increase with a catch and release or minimal resistance at the end of the ROM; Grade 1+ = Slight increase manifested by a catch followed by minimal resistance throughout the remainder (less than half) of the ROM; Grade 2 = Marked increase through most of ROM, but affected part easily moved; Grade 3 = Considerable increase, passive movement difficult; Grade 4 = Rigid in flexion or extension.

Question 5Exercise, motor learning and physical interventions

In Proprioceptive Neuromuscular Facilitation (PNF / 本体感觉神经肌肉促进技术), what is the movement sequence of the Upper Extremity D1 Flexion (D1F) diagonal pattern (D1屈曲模式)?

  1. Shoulder extension, abduction, internal rotation; forearm pronation; wrist and finger extension (肩伸展-外展-内旋，前臂旋前，腕指伸展)
  2. Shoulder flexion, abduction, external rotation; forearm supination; wrist and finger extension (肩屈曲-外展-外旋，前臂旋后，腕指伸展)
  3. Shoulder extension, adduction, internal rotation; forearm pronation; wrist and finger flexion (肩伸展-内收-内旋，前臂旋前，腕指屈曲)
  4. Shoulder flexion, adduction, external rotation; forearm supination; wrist and finger flexion (肩屈曲-内收-外旋，前臂旋后，腕指屈曲) Correct answer.

Explanation

PNF Upper Extremity D1 Flexion (D1F, often remembered as 'bringing food to mouth') consists of: Shoulder flexion, adduction, external rotation; Forearm supination; Wrist and finger flexion toward the contralateral ear. Its antagonist pattern is D1 Extension (D1E).

Question 6Exercise, motor learning and physical interventions

Conventional high-frequency Transcutaneous Electrical Nerve Stimulation (TENS / 经皮神经电刺激疗法, 80–100 Hz) primarily achieves acute analgesia through which neurophysiological mechanism?

  1. Endogenous opioid (endorphin) release via noxious C-fiber stimulation (内源性阿片肽释放)
  2. Gate control mechanism via selective stimulation of large-diameter A-beta cutaneous afferents (闸门控制学说，激活粗纤维Aβ) Correct answer.
  3. Direct permanent chemical ablation of nociceptive dorsal horn neurons
  4. Total neuromuscular membrane hyperpolarization preventing all action potential generation

Explanation

High-frequency conventional TENS is commonly explained in part through activation of large sensory afferents and modulation of nociceptive transmission. This is a mechanistic teaching model, not a guaranteed analgesic response or a complete dosing instruction. Suitability and settings require the actual qualified assessment and device instructions.

Question 7Neurological rehabilitation and communication

A stroke patient demonstrates non-fluent, halting speech with significant word-finding difficulty and telegraphic phrases, but exhibits relatively preserved auditory comprehension and severely impaired repetition. Where is the classic lesion located, and what is this aphasia type?

  1. Wernicke aphasia (Wernicke失语 / 感觉性失语); Left superior temporal gyrus (左侧颞上回后部 / Brodmann 22区)
  2. Conduction aphasia (传导性失语); Arcuate fasciculus (左侧弓状束)
  3. Global aphasia (完全性失语); Entire middle cerebral artery territory (大脑中动脉供血全区)
  4. Broca aphasia (Broca失语 / 运动性失语); Left inferior frontal gyrus (左侧额下回后部 / Brodmann 44、45区) Correct answer.

Explanation

Broca aphasia (运动性失语 / 表达性失语) is classically associated with a lesion in the posterior part of the inferior frontal gyrus (Broca area, Brodmann 44/45) of the dominant hemisphere. Hallmark features are non-fluent, effortful, telegraphic speech output, relatively preserved auditory comprehension, and impaired verbal repetition. Real neurological presentations and lesion distributions vary; this is pattern recognition, not a complete diagnosis or proof of one exclusive lesion site.

Question 8Neurological rehabilitation and communication

A patient following a left temporoparietal stroke speaks fluently with normal rate and intonation, but sentences are empty of meaning with frequent phonemic and semantic paraphasias ('word salad'). The patient is completely unable to understand spoken commands or repeat phrases. What type of aphasia is present?

  1. Wernicke aphasia (Wernicke失语 / 感觉性失语) Correct answer.
  2. Broca aphasia (Broca失语 / 运动性失语)
  3. Transcortical Motor aphasia (经皮质运动性失语)
  4. Anomic aphasia (命名性失语)

Explanation

Wernicke aphasia (感觉性失语 / 接受性失语) is classically associated with damage to Wernicke's area (Brodmann 22) in the left superior temporal gyrus. It is characterized by fluent but meaningless speech (paraphasias, neologisms, jargon), severely impaired auditory comprehension, and impaired repetition, with unawareness of language deficits (anosognosia). Real neurological presentations and lesion distributions vary; this is pattern recognition, not a complete diagnosis or proof of one exclusive lesion site.

Question 9Occupation, adaptation and participation

In Occupational Therapy (作业治疗), which of the following activities is classified as an Instrumental Activity of Daily Living (IADL / 工具性日常生活活动) rather than a Basic Activity of Daily Living (BADL / 基础性日常生活活动)?

  1. Independent feeding (进食)
  2. Bed and chair transfers (床椅转移)
  3. Managing personal finances and grocery shopping (财务管理与购物) Correct answer.
  4. Personal grooming and tooth brushing (洗漱与修饰)

Explanation

Basic Activities of Daily Living (BADL / PADL: feeding, dressing, bathing, grooming, toileting, transfers, mobility) represent fundamental self-care tasks. Instrumental Activities of Daily Living (IADL: meal preparation, housekeeping, shopping, managing finances, using transportation, taking medications) represent more complex cognitive and motor activities required for independent community living.

Question 10Occupation, adaptation and participation

What is the primary clinical function of a posterior leaf spring Ankle-Foot Orthosis (AFO / 踝足矫形器) prescribed for a hemiplegic stroke patient with foot drop (足下垂)?

  1. Completely immobilize the knee joint in 15° flexion during stance
  2. Provide rigid skeletal fixation for acute tibial shaft fractures
  3. Maintain the ankle at 90° neutral during the swing phase to prevent toe dragging and tripping (在摆动相维持踝关节90°中立位，防止足尖拖地) Correct answer.
  4. Eliminate hip circumduction by locking the pelvic band

Explanation

A posterior leaf spring AFO can assist swing-phase foot clearance by resisting unwanted plantarflexion while permitting its designed flexibility. Actual alignment, stance control, tone and skin tolerance need assessment and fitting. It is not a guarantee of an exact neutral angle throughout every phase or the best device for all foot drop.

Question 11Cardiorespiratory tolerance, skin and safe mobility

The Modified Borg Dyspnea/Exertion Scale commonly used in cardiopulmonary rehabilitation ranges over what numeric scale, in contrast to the original Borg RPE scale (6-20)?

  1. 0 to 10 Correct answer.
  2. 1 to 5
  3. 0 to 100
  4. 6 to 20, identical to the original scale

Explanation

The Modified Borg Scale uses a 0-10 range (0 = no exertion/dyspnea, 10 = maximal), while the original Borg RPE scale ranges from 6 to 20; both are used to gauge perceived exertion during exercise.

Question 12Cardiorespiratory tolerance, skin and safe mobility

One metabolic equivalent (1 MET) is defined as an oxygen consumption of approximately how much, and what does this value represent?

  1. Approximately 3.5 mL O2/kg/min, representing resting oxygen consumption Correct answer.
  2. Approximately 10 mL O2/kg/min, representing light activity
  3. Approximately 1.0 mL O2/kg/min, representing minimal detectable oxygen use
  4. Approximately 35 mL O2/kg/min, representing maximal exertion

Explanation

One MET is defined as approximately 3.5 mL O2 per kg of body weight per minute, corresponding to resting metabolic oxygen consumption; other activities are expressed as multiples of this resting value.

Question 13Professional reasoning, evidence and continuity

Before beginning treatment, a PT explains the proposed intervention, expected benefits, potential risks, and reasonable alternatives to a patient, who then agrees to proceed. What ethical/legal principle does this process reflect?

  1. Informed consent Correct answer.
  2. HIPAA minimum necessary standard
  3. Direct access
  4. Scope of practice delegation

Explanation

Informed consent requires disclosing the nature of treatment, expected benefits, risks, and alternatives so the patient can make an autonomous, informed decision about whether to proceed, including the right to refuse.

Question 14Professional reasoning, evidence and continuity

The SOAP note format (Subjective, Objective, Assessment, Plan) is a widely used documentation structure in physical therapy. What is the primary purpose of maintaining timely, accurate documentation in this format?

  1. To support clinical decision-making, continuity of care, legal accountability, and billing/reimbursement requirements Correct answer.
  2. Documentation exists solely to satisfy billing requirements and has no clinical value
  3. SOAP notes are required only for Medicare patients and not for other payers
  4. Documentation timing has no bearing on legal or billing considerations

Explanation

SOAP note documentation supports clinical reasoning, continuity of care across providers, legal/regulatory accountability, and billing/reimbursement, making timely and accurate documentation an essential professional responsibility.

Question 15Functional anatomy, movement and localization

In biomechanics, the human elbow flexion performed by the biceps brachii muscle operating against a handheld load represents which class of mechanical lever?

  1. Third-class lever (第3类杠杆 / 速度杠杆) Correct answer.
  2. First-class lever (第1类杠杆 / 平衡杠杆)
  3. Second-class lever (第2类杠杆 / 省力杠杆)
  4. Fourth-class lever (第4类杠杆)

Explanation

In elbow flexion, the fulcrum is at the humeroulnar joint, the effort force is applied at the radial tuberosity (insertion of biceps brachii), and the load is in the hand. Because the effort force lies between the fulcrum and the load, it is a third-class lever (第3类杠杆), designed for speed and range of motion at the expense of mechanical force advantage.

Question 16Functional anatomy, movement and localization

A neonate with traction injury to the upper trunk of the brachial plexus (C5-C6 roots / Erb-Duchenne palsy 臂丛上干损伤) typically displays which classic posture of the affected upper limb?

  1. Arm hanging by the side, internally rotated, elbow extended, and forearm pronated ('Waiter's tip' posture / 侍者小费手) Correct answer.
  2. Claw hand deformity with MCP hyperextension and IP flexion (爪形手)
  3. Ape hand deformity with thenar atrophy and thumb adduction (猿手)
  4. Wrist drop with inability to extend MCP joints (垂腕)

Explanation

Upper brachial plexus injury (Erb-Duchenne palsy, C5-C6 roots) paralyzes the deltoid, supraspinatus, infraspinatus, biceps brachii, and brachioradialis. Loss of abduction, external rotation, flexion, and supination leaves the arm hanging internally rotated, elbow extended, and forearm pronated-the classic 'waiter's tip' posture (侍者小费样体位).

Question 17Functional anatomy, movement and localization

During short-duration, maximal-intensity sprint exercise lasting less than 10 seconds, which energy metabolism system serves as the primary immediate source of ATP resynthesis?

  1. Anaerobic lactic glycolytic system (乳酸能系统 / 糖酵解系统)
  2. ATP-CP phosphagen system (磷酸原系统 / 磷酸肌酸系统) Correct answer.
  3. Aerobic oxidative system (有氧氧化系统)
  4. Beta-oxidation of free fatty acids (脂肪酸β氧化)

Explanation

The ATP-CP phosphagen system (磷酸原系统) provides immediate energy without oxygen by utilizing intramuscular ATP and stored creatine phosphate (CP). It produces energy at the fastest rate but is depleted within 6 to 10 seconds of maximal exertion.

Question 18Functional anatomy, movement and localization

In a patient presenting with Brown-Séquard syndrome (脊髓半切综合征) resulting from a right-sided hemisection of the thoracic spinal cord at T8, which sensory deficits will be observed below the level of the lesion?

  1. Bilateral loss of pain and temperature sensation with preserved proprioception (双侧痛温觉丧失而深感觉保留)
  2. Ipsilateral loss of pain/temperature and contralateral loss of proprioception/vibration (同侧痛温觉及对侧深感觉丧失)
  3. Ipsilateral loss of proprioception/vibration and contralateral loss of pain/temperature sensation (同侧深感觉及对侧痛温觉丧失) Correct answer.
  4. Contralateral loss of all sensory modalities including touch, vibration, and temperature (对侧所有感觉完全丧失)

Explanation

The classical hemicord pattern combines ipsilateral weakness and impaired vibration or position sense below the lesion with contralateral pain and temperature impairment beginning somewhat below it. Crossing pathways and lesion extent explain the pattern. Real injuries can be incomplete or mixed, so the syndrome is not an exact map of every clinical finding.

Question 19Functional anatomy, movement and localization

During single-leg stance on the right lower extremity, the patient's left pelvis drops downward. This positive Trendelenburg sign (杜氏征阳性) indicates weakness or paralysis of which muscle on the stance side?

  1. Left gluteus medius (左侧臀中肌)
  2. Right gluteus maximus (右侧臀大肌)
  3. Left iliopsoas (左侧髂腰肌)
  4. Right gluteus medius (右侧臀中肌) Correct answer.

Explanation

During single-limb stance, the stance-side gluteus medius and minimus (臀中肌、臀小肌) contract to abduct the hip and keep the contralateral unsupported pelvis level. Weakness of the right gluteus medius causes the contralateral (left) pelvis to drop downward, termed a positive right Trendelenburg sign.

Question 20Functional anatomy, movement and localization

Carpal tunnel syndrome (腕管综合征) is caused by compression of which neural structure beneath the flexor retinaculum (屈肌支持带 / 腕横韧带)?

  1. Median nerve (正中神经) Correct answer.
  2. Ulnar nerve (尺神经)
  3. Radial nerve superficial branch (桡神经浅支)
  4. Musculocutaneous nerve (肌皮神经)

Explanation

The carpal tunnel is an inelastic fibro-osseous canal bounded by the carpal bones and flexor retinaculum. It contains nine flexor tendons (4 FDS, 4 FDP, 1 FPL) and the median nerve (正中神经). Compression of the median nerve produces numbness in the thumb, index, middle, and radial half of the ring finger and thenar muscle atrophy.

Question 21Functional anatomy, movement and localization

Which of the following physiological characteristics is correct regarding Type I skeletal muscle fibers (慢肌纤维 / 红肌纤维)?

  1. High glycolytic enzyme content, rapid contraction velocity, and low fatigue resistance (高糖酵解酶活性、快速收缩、易疲劳)
  2. High mitochondrial density, rich capillary supply, and high fatigue resistance (高线粒体密度、丰富毛细血管、高抗疲劳性) Correct answer.
  3. Low myoglobin content and primary dependence on anaerobic phosphagen metabolism (低肌红蛋白含量、依赖无氧代谢)
  4. Fast myosin ATPase activity designed specifically for high-velocity explosive power (高肌球蛋白ATP酶活性、专用于爆发力)

Explanation

Type I slow-twitch muscle fibers (慢肌纤维 / 慢氧化型) are rich in myoglobin, mitochondria, and oxidative enzymes, surrounded by dense capillary networks. They contract relatively slowly with low peak force but possess exceptionally high fatigue resistance, making them ideal for postural control and endurance.

Question 22Functional anatomy, movement and localization

In the kinesiological 'screw-home mechanism' (膝关节扣锁机制) of the knee joint during the terminal 30° of open-chain extension, what kinematic motion occurs at the tibia, and which muscle initiates unlocking into flexion?

  1. Tibia internally rotates on the femur; Biceps femoris unlocks the joint by externally rotating the tibia
  2. Tibia slides anteriorly without rotation; Rectus femoris initiates unlocking
  3. Tibia externally rotates on the femur; Popliteus muscle (腘肌) unlocks the joint by internally rotating the tibia Correct answer.
  4. Femur externally rotates on the tibia; Semitendinosus muscle unlocks the joint

Explanation

In the conventional open-chain terminal knee-extension model, the tibia rotates externally relative to the femur, contributing to the screw-home mechanism. Popliteus assists the reverse movement during unlocking. The precise angular range and coupled movement vary with loading and anatomy rather than obeying one fixed threshold.

Question 23Functional anatomy, movement and localization

According to the Henneman Size Principle (亨尼曼大小原则 / 运动单位募集原则) in motor control physiology, in what order are motor units recruited during progressive muscular contraction?

  1. Large soma motor units (Type II fast-twitch) are recruited first to generate initial baseline force, followed by Type I units
  2. All motor units are recruited simultaneously regardless of force requirements
  3. Motor unit recruitment is completely random depending solely on joint angle
  4. Small soma motor units (Type I slow-twitch) are recruited first, followed by larger motor units (Type II fast-twitch) as force demand increases Correct answer.

Explanation

Henneman's size principle states that motor neurons with smaller cell bodies (innervating Type I slow-twitch fibers with low threshold) are recruited first at low force levels. As force demand increases, progressively larger motor units (Type IIa, then Type IIx fast-twitch) are recruited.

Question 24Functional anatomy, movement and localization

Compression or fracture at the fibular head / neck (腓骨小头/颈) is most likely to injure which nerve, resulting in foot drop and a 'steppage gait' (跨阈步态)?

  1. Tibial nerve (胫神经)
  2. Common fibular / peroneal nerve (腓总神经) Correct answer.
  3. Femoral nerve (股神经)
  4. Obturator nerve (闭孔神经)

Explanation

The common fibular (peroneal) nerve winds around the lateral aspect of the fibular neck, where it is superficial and vulnerable to compression or fracture. Damage paralyzes the anterior and lateral compartment leg muscles (tibialis anterior, extensor digitorum longus, peroneus longus/brevis), causing foot drop, loss of eversion, and compensatory steppage gait (跨阈步态).

Question 25Functional anatomy, movement and localization

What is the primary physiological sensory receptor responsible for detecting changes in muscle tension (rather than length) and mediating the autogenic inhibition reflex (自源性抑制 / 腱器官反张反射)?

  1. Muscle spindle primary annulospiral ending (肌梭初级末梢 / Ia类纤维)
  2. Pacinian corpuscle (环层小体)
  3. Golgi tendon organ (腱器官 / 高尔基腱器官) Correct answer.
  4. Ruffini ending (鲁菲尼小体)

Explanation

Golgi tendon organs (腱器官) are encapsulated sensory receptors arranged in series with skeletal muscle fibers at the myotendinous junction. They are sensitive to active muscle tension and transmit via Ib afferents to inhibitory interneurons in the spinal cord, causing autogenic inhibition (自源性抑制) to protect the muscle from excessive force.

Question 26Functional anatomy, movement and localization

A posterolateral intervertebral disc herniation between the C5 and C6 vertebrae is most likely to compress which spinal nerve root, and what neurological deficit is expected?

  1. C5 nerve root; weakness of shoulder abduction and absent triceps reflex (C5神经根受压，肩外展无力，肱三头肌反射消失)
  2. C7 nerve root; weakness of triceps and numbness of the index and middle fingers (C7神经根受压，伸肘无力，食指中指麻木)
  3. C8 nerve root; weakness of intrinsic hand muscles and numbness of the fifth digit (C8神经根受压，手内在肌无力，小指麻木)
  4. C6 nerve root; weakness of wrist extensors and biceps, with hypoactive biceps/brachioradialis reflexes (C6神经根受压，伸腕肌力减弱，肱二头肌及肱桡肌反射减弱) Correct answer.

Explanation

In the cervical spine, spinal nerves exit above their corresponding vertebrae (C1-C7 exit above C1-C7; C8 exits below C7). Therefore, a C5-C6 disc herniation compresses the exiting C6 nerve root. C6 radiculopathy causes weakness in wrist extensors (extensor carpi radialis) and biceps, diminished biceps and brachioradialis reflexes, and sensory loss over the thumb and radial forearm.

Question 27Functional anatomy, movement and localization

Which of the following deep abdominal stabilizing muscles is known to activate in a feedforward / anticipatory manner (前馈控制) prior to limb movements to stabilize the lumbar spine?

  1. Transversus abdominis (腹横肌) Correct answer.
  2. Rectus abdominis (腹直肌)
  3. External oblique (腹外斜肌)
  4. Iliopsoas (髂腰肌)

Explanation

Transversus abdominis can participate in anticipatory trunk stabilization in relevant movements, together with other muscles and control strategies. It is not the only stabilizer or guaranteed to activate in an identical sequence in every person. The concept does not establish one universally superior low-back exercise programme.

Question 28Functional anatomy, movement and localization

Compared to concentric muscle contractions, eccentric muscle contractions (离心收缩) produce which of the following physiological characteristics?

  1. Lower maximal force generation with significantly higher oxygen consumption per unit tension
  2. Higher maximal force generation with lower metabolic energy / oxygen cost, but greater susceptibility to delayed onset muscle soreness (DOMS / 迟发性肌肉酸痛) Correct answer.
  3. Zero mechanical work generation and no microtrauma to sarcomeres
  4. Decreased passive tension and lower risk of tendon remodeling

Explanation

Eccentric contraction (lengthening under tension) produces greater peak force than concentric contraction at lower metabolic/oxygen cost due to cross-bridge mechanics and non-contractile titin stiffness. However, high mechanical strain on sarcomeres makes eccentric exercise the primary cause of delayed onset muscle soreness (DOMS / 迟发性肌肉酸痛).

Question 29Functional anatomy, movement and localization

According to the Frank-Starling mechanism (斯塔林机制 / 心脏异长自身调节) in exercise physiology, an increase in end-diastolic ventricular volume leads to which hemodynamic response?

  1. Decreased stroke volume due to acute cardiac overstretching and compliance failure
  2. Reflex decrease in heart rate mediated exclusively by carotid sinus baroreceptors
  3. Increased myocardial sarcomere stretch resulting in increased force of contraction and increased stroke volume (心肌初长度增加使心肌收缩力增强，搏出量增加) Correct answer.
  4. Immediate reduction in venous return to protect pulmonary capillary integrity

Explanation

Within the physiological operating range, greater ventricular filling can increase myocardial fiber stretch and stroke volume through the Frank-Starling relationship. This is not unlimited: disease, contractility, afterload and excessive distension can change the response. It is a physiological principle rather than an exercise-clearance decision.

Question 30Functional anatomy, movement and localization

A patient sustained a distal laceration of the ulnar nerve at the wrist (尺神经低位损伤). Which characteristic clinical presentation is expected?

  1. Ape hand deformity with loss of thumb opposition and sensory loss over the radial three digits
  2. Wrist drop with inability to extend thumb and fingers
  3. Loss of elbow flexion and forearm supination with intact sensation
  4. Claw hand deformity primarily affecting the 4th and 5th digits, with positive Froment sign (爪形手，以第4、5指为主，Froment征阳性) Correct answer.

Explanation

Low ulnar nerve lesion at the wrist paralyzes the interossei, 3rd/4th lumbricals, and adductor pollicis. The loss of MCP flexion and IP extension causes the classic 'claw hand' (爪形手) in the 4th and 5th digits. Froment sign is positive because the patient compensates for weak adductor pollicis during key pinch by hyperflexing the thumb IP joint via the median-innervated flexor pollicis longus.

Question 31Assessment, measurement and functional goals

When measuring knee joint flexion Range of Motion (ROM / 关节活动度) with a universal goniometer, where should the fulcrum (axis) of the goniometer be aligned?

  1. Patellar center (髌骨中心)
  2. Tibial tuberosity (胫骨结节)
  3. Lateral epicondyle of the femur (股骨外侧髁) Correct answer.
  4. Lateral malleolus (外踝)

Explanation

For knee flexion/extension goniometry, the fulcrum is aligned over the lateral epicondyle of the femur (股骨外侧髁). The stationary arm aligns with the lateral midline of the femur (directed toward greater trochanter), and the movable arm aligns with the lateral midline of the fibula (directed toward lateral malleolus).

Question 32Assessment, measurement and functional goals

In normal human gait cycle analysis (步态周期分析), what approximate percentages of a single stride cycle are occupied by the Stance Phase (支撑相) and Swing Phase (摆动相), respectively?

  1. Stance phase ~50%, Swing phase ~50% (支撑相约50%，摆动相约50%)
  2. Stance phase ~60%, Swing phase ~40% (支撑相约60%，摆动相约40%) Correct answer.
  3. Stance phase ~40%, Swing phase ~60% (支撑相约40%，摆动相约60%)
  4. Stance phase ~75%, Swing phase ~25% (支撑相约75%，摆动相约25%)

Explanation

In normal level walking, one gait cycle consists of the stance phase (支撑相, from initial heel contact to toe-off, ~60% of the cycle) and the swing phase (摆动相, from toe-off to next heel contact, ~40% of the cycle). Double limb support occurs during two periods totaling approximately 20% of the cycle.

Question 33Assessment, measurement and functional goals

During passive range of motion assessment, the therapist encounters an abrupt, hard, unyielding stop when the olecranon process contacts the olecranon fossa at terminal elbow extension. How is this normal end-feel (关节终末感) classified?

  1. Soft / Tissue approximation end-feel (软终末感 / 软组织逼近)
  2. Firm / Capsular-ligamentous end-feel (坚韧终末感 / 关节囊韧带张力)
  3. Hard / Bone-to-bone end-feel (硬终末感 / 骨性终末感) Correct answer.
  4. Empty end-feel (空虚终末感)

Explanation

A hard (bone-to-bone 骨性) end-feel is a painless, abrupt, hard stop resulting from bone contacting bone, normal in terminal elbow extension. Soft end-feel occurs in elbow flexion (muscle bulk approximation); firm end-feel occurs in ankle dorsiflexion or wrist extension (capsule/ligament stretch); empty end-feel is always abnormal and occurs when severe pain prevents reaching mechanical resistance.

Question 34Assessment, measurement and functional goals

A patient with Parkinson's disease demonstrates a gait characterized by short, accelerating, shuffling steps with forward trunk stooping and difficulty stopping. What is the clinical term for this gait deviation?

  1. Festinating gait (慌张步态 / 前冲步态) Correct answer.
  2. Circumduction gait (划圈步态 / 偏瘫步态)
  3. Ataxic gait (共济失调步态 / 醉汉步态)
  4. Scissor gait (剪刀步态 / 痉挛性截瘫步态)

Explanation

Festinating gait (慌张步态 / 前冲步态) is classic in Parkinson's disease. The patient displays flexed posture, loss of arm swing, progressive shortening of stride length, and involuntary acceleration (festination) as the center of gravity falls ahead of the base of support.

Question 35Assessment, measurement and functional goals

Which of the following sensory testing modalities evaluates deep sensation (深感觉 / 本体感觉) rather than superficial sensation?

  1. Pinprick pain sensation (针刺痛觉)
  2. Temperature discrimination (温度觉)
  3. Joint position sense and kinesthesia (关节位置觉与运动觉) Correct answer.
  4. Light touch sensation using cotton wisp (棉签轻触觉)

Explanation

Sensory examination categorizes sensations into: (1) Superficial sensation (浅感觉: pain, temperature, light touch); (2) Deep sensation (深感觉/本体感觉: position sense, kinesthesia/movement sense, vibration sense); (3) Combined/cortical sensation (复合感觉: stereognosis, two-point discrimination, graphesthesia).

Question 36Assessment, measurement and functional goals

In the Fugl-Meyer Motor Assessment (FMA / Fugl-Meyer运动功能评定), what is the maximum achievable motor score for the Upper Extremity and Lower Extremity combined?

  1. 126 points (Upper extremity 70 points, Lower extremity 56 points)
  2. 56 points (Upper extremity 28 points, Lower extremity 28 points)
  3. 100 points (Upper extremity 50 points, Lower extremity 50 points)
  4. 100 points (Upper extremity 66 points, Lower extremity 34 points / 上肢66分，下肢34分，总分100分) Correct answer.

Explanation

The Fugl-Meyer Assessment (FMA) Motor Domain has a total possible score of 100 points: 66 points for the upper extremity (testing reflex, synergy, isolated movement, wrist, hand grasp, coordination) and 34 points for the lower extremity (reflex, synergy, isolated motion, coordination).

Question 37Assessment, measurement and functional goals

On needle electromyography (EMG / 针电极肌电图), the appearance of spontaneous fibrillation potentials (纤颤电位) and positive sharp waves (正尖相) at rest 2 to 3 weeks after peripheral nerve injury indicates which pathophysiology?

  1. Active lower motor neuron denervation of muscle fibers (失神经支配电位 / 下运动神经元去神经变性) Correct answer.
  2. Upper motor neuron hyperreflexia and spasticity (上运动神经元痉挛)
  3. Normal motor unit action potential recruitment (正常运动单位募集)
  4. Myasthenia gravis postsynaptic junctional block (重症肌无力突触传递阻滞)

Explanation

Fibrillation potentials and positive sharp waves can support active denervation in the appropriate nerve-injury setting. Their appearance depends on timing, anatomy and the underlying process, and they are not unique to a single disease. Interpret them with the complete qualified electrodiagnostic examination rather than a universal post-injury date.

Question 38Assessment, measurement and functional goals

A patient with cerebellar ataxia (小脑性共济失调) demonstrates inability to rapidly perform alternating pronation and supination movements of the forearms. What is the precise clinical neurological term for this sign?

  1. Dysmetria (辨距不良)
  2. Dysdiadochokinesia (轮替运动障碍) Correct answer.
  3. Intention tremor (意向性震颤)
  4. Asthenia (肌无力)

Explanation

Dysdiadochokinesia (轮替运动障碍 / 轮替动作障碍) is the inability to perform rapid, alternating antagonist movements (e.g., rapid forearm pronation/supination or palm-tapping). It is a classic sign of cerebellar hemisphere dysfunction.

Question 39Assessment, measurement and functional goals

On the standard 10-cm Visual Analogue Scale (VAS / 视觉模拟评分法) for pain intensity assessment, how is the score measured?

  1. The patient selects one of five descriptive verbal words representing pain intensity
  2. The therapist assigns a score based on facial grimace expressions observed during joint mobilization
  3. The distance in centimeters or millimeters from the 'no pain' (0) anchor to the patient's mark along a 100-mm uncalibrated line Correct answer.
  4. The number of pain-free hours recorded by the patient in a 24-hour log

Explanation

The standard Visual Analogue Scale (VAS) consists of a horizontal line exactly 10 cm (100 mm) in length, anchored by 'No pain' (无痛, 0 cm) on the left and 'Worst imaginable pain' (最剧烈疼痛, 10 cm) on the right. The score is determined by measuring the distance from the left anchor to the patient's mark.

Question 40Assessment, measurement and functional goals

In a supplied conventional exercise-testing teaching model, which listed concept describes a transition associated with increasing lactate and ventilatory responses, recognizing that these thresholds are not always identical and do not mean all metabolism suddenly becomes anaerobic?

  1. The exercise intensity at which blood lactate begins to accumulate and pulmonary ventilation increases disproportionately relative to oxygen consumption (通气量相对摄氧量非线性增加，血乳酸开始蓄积) Correct answer.
  2. The point at which heart rate reaches 100% of age-predicted maximum
  3. The moment myocardial ischemia produces ST-segment depression ≥ 1 mm
  4. The cessation of exercise due to voluntary subject exhaustion

Explanation

The anaerobic-threshold label is used in teaching for an exercise transition associated with lactate and ventilatory responses. Different measurement definitions need not identify exactly the same point, and oxidative metabolism continues. Actual exercise prescription requires the measured response and qualified interpretation rather than a sharp universal switch.

Question 41Assessment, measurement and functional goals

In the Functional Independence Measure (FIM / 功能独立性评定) 7-level scoring system, what score is assigned when a patient requires a helper to provide up to 25% of the effort to complete a task (Minimal Contact Assistance / 最小辅助)?

  1. Level 5 (Supervision / 5分: 仅需监护/提示)
  2. Level 4 (Minimal Assistance / 4分: 需触碰辅助，患者付出≥75%力量) Correct answer.
  3. Level 3 (Moderate Assistance / 3分: 患者付出50%-74%力量)
  4. Level 2 (Maximal Assistance / 2分: 患者付出25%-49%力量)

Explanation

The FIM scale grades independence from 1 to 7: Level 7 = Complete Independence; Level 6 = Modified Independence; Level 5 = Supervision/Setup; Level 4 = Minimal Assistance (helper provides <25% effort, patient ≥75%); Level 3 = Moderate Assistance (patient 50%-74%); Level 2 = Maximal Assistance (patient 25%-49%); Level 1 = Total Assistance (patient <25%).

Question 42Assessment, measurement and functional goals

In an adult neurological examination, extension of the great toe with fanning after plantar stimulation is classically associated with which listed pathway finding?

  1. Lower motor neuron in anterior horn (脊髓前角下运动神经元)
  2. Peripheral sensory nerve fibers (周围感觉神经纤维)
  3. Pyramidal / Corticospinal tract (锥体束 / 皮质脊髓束上运动神经元损伤) Correct answer.
  4. Cerebellar vermis (小脑蚓部)

Explanation

The Babinski sign is a classic pathological reflex indicating an upper motor neuron (pyramidal tract / corticospinal tract 锥体束) lesion in individuals older than 18-24 months. Loss of descending corticospinal inhibition unmasks primitive spinal withdrawal extension of the great toe.

Question 43Assessment, measurement and functional goals

When measuring hip joint extension Range of Motion (ROM) with a goniometer, what is the standard patient testing position, and what movement compensation must be strictly prevented?

  1. Prone position; prevent anterior pelvic tilt and lumbar hyperextension (俯卧位；防止骨盆前倾与腰椎过伸代偿) Correct answer.
  2. Supine position; prevent lateral pelvic tilt
  3. Side-lying position; prevent knee flexion
  4. Sitting position; prevent thoracic flexion

Explanation

Standard hip extension goniometry is performed in the prone position (俯卧位). The therapist stabilizes the pelvis to prevent anterior pelvic tilt and compensatory lumbar spine hyperextension, which falsely exaggerates true hip extension ROM (normal: 0°–15°/30°).

Question 44Assessment, measurement and functional goals

The 6-Minute Walk Test (6MWT / 6分钟步行试验) is a widely utilized clinical assessment tool primarily designed to evaluate which functional parameter?

  1. Maximal sprinting anaerobic capacity and peak power
  2. Isolated lower extremity joint range of motion
  3. Submaximal functional exercise capacity and cardiopulmonary endurance (亚极量运动功能与心肺耐力) Correct answer.
  4. Static balance and fall risk in stroke patients

Explanation

The 6-Minute Walk Test (6MWT) measures the maximum distance a patient can walk along a flat, hard 30-meter corridor in 6 minutes. It reflects submaximal functional exercise capacity and daily activity endurance in cardiopulmonary, geriatric, and neurological rehabilitation.

Question 45Assessment, measurement and functional goals

In a patient with complete C6 tetraplegia (C6脊髓损伤), passive finger flexion occurs automatically when the wrist is actively extended. What is the clinical term for this functional grasp mechanism?

  1. Spastic flexion synergy (痉挛性屈曲模式)
  2. Babinski grasp reflex (强握反射)
  3. Intrinsic plus grasp (手内在肌强化抓握)
  4. Tenodesis grasp (腱固定效应 / 腱固定抓握) Correct answer.

Explanation

Patients with C6 complete SCI preserve wrist extensor function (extensor carpi radialis longus/brevis) but lack active finger flexors. When they actively dorsiflex the wrist, the passive tension in the unlengthened finger flexor tendons (FDP/FDS) pulls the fingers into flexion, producing a functional 'tenodesis grasp' (腱固定抓握).

Question 46Assessment, measurement and functional goals

During the Thomas test (托马斯试验), the patient lies supine and fully flexes one hip and knee to the chest to flatten lumbar lordosis. The contralateral test thigh lifts off the examination table. What does this positive finding indicate?

  1. Hip flexion contracture / Iliopsoas tightness on the test side (测试侧髂腰肌紧张 / 髋关节屈曲挛缩) Correct answer.
  2. Gluteus maximus weakness on the test side
  3. Hamstring muscle tightness on the test side
  4. Sciatic nerve root irritation on the flexed side

Explanation

The Thomas test (托马斯试验) evaluates hip flexion contracture. When the contralateral hip is maximally flexed to flatten the lumbar spine, if the test thigh lifts off the examination surface, it indicates tightness or contracture of the hip flexors (iliopsoas / rectus femoris).

Question 47Exercise, motor learning and physical interventions

When applying Neuromuscular Electrical Stimulation (NMES) to stimulate a completely denervated skeletal muscle (失神经支配肌肉), which electrical current waveform parameter is required to elicit a contraction?

  1. Short-duration pulse (< 0.1 ms) high-frequency biphasic symmetrical current
  2. Medium-frequency sinusoidal interference current at 4000 Hz
  3. Long-duration pulse (> 100 ms) triangular / exponential current (长脉冲、指数渐增电流) Correct answer.
  4. Microcurrent electrical therapy at sub-sensory threshold (< 100 µA)

Explanation

Denervated muscle loses the low-threshold nerve axon and exhibits accommodation loss and reduced electrical excitability (chronaxie increases from <1 ms to >10-100 ms). It requires a long pulse duration (>100 ms) triangular or exponential pulse current (指数渐增电流) to depolarize the sarcolemma directly while avoiding excitation of adjacent normal innervated structures.

Question 48Exercise, motor learning and physical interventions

In Progressive Resistance Exercise (PRE / 渐进抗阻训练), what is the classic DeLorme protocol structure based on the patient's 10-Repetition Maximum (10 RM)?

  1. Set 1 at 100% 10 RM, Set 2 at 75% 10 RM, Set 3 at 50% 10 RM (Oxford regression protocol)
  2. Set 1 at 30% 10 RM, Set 2 at 60% 10 RM, Set 3 at 90% 10 RM (30 repetitions each)
  3. Single set of 100 repetitions at 20% 10 RM for endurance
  4. Set 1 at 50% 10 RM, Set 2 at 75% 10 RM, Set 3 at 100% 10 RM (10 repetitions each / 50%-75%-100%递增) Correct answer.

Explanation

The DeLorme Progressive Resistance Exercise (PRE) protocol consists of 3 sets of 10 repetitions with progressive load: Set 1 = 10 reps at 50% of 10 RM; Set 2 = 10 reps at 75% of 10 RM; Set 3 = 10 reps at 100% of 10 RM.

Question 49Exercise, motor learning and physical interventions

According to the Maitland Joint Mobilization (Maitland关节松动术) grading system (Grades I to V), which grade is defined as a large-amplitude passive movement performed up to the limit of available joint range, used specifically to treat joint stiffness and capsular adhesions?

  1. Grade III (3级松动: 大幅度手法，达到关节活动受限端，用于治疗僵硬) Correct answer.
  2. Grade I (1级松动: 小幅度手法，在关节活动起始端，用于止痛)
  3. Grade II (2级松动: 大幅度手法，在关节可用范围内，用于止痛)
  4. Grade V (5级松动: 高速度、小幅度冲压手法，即关节调整术)

Explanation

Maitland grading: Grade I = Small amplitude at the beginning of range (for pain); Grade II = Large amplitude within resistance-free range (for pain); Grade III = Large amplitude moving up to the pathological resistance limit (for stiffness/hypomobility); Grade IV = Small amplitude at the pathological resistance limit (for stiffness/hypomobility); Grade V = High-velocity, low-amplitude thrust at the anatomical limit (manipulation).

Question 50Exercise, motor learning and physical interventions

The Motor Relearning Program (MRP / 运动再学习方案) for stroke rehabilitation developed by Carr and Shepherd emphasizes which fundamental sequence of clinical intervention steps?

  1. 1. Reflex elicitation; 2. Resistive overload; 3. Static posturing; 4. Passive stretching
  2. 1. Analysis of task; 2. Practice of missing components; 3. Practice of the whole task; 4. Transference of training to real environments (任务分析、缺失成分练习、任务练习、训练迁移) Correct answer.
  3. 1. Key point handling; 2. Electrical stimulation; 3. Orthotic immobilization; 4. Discharge
  4. 1. Sensory brushing; 2. Mass synergy training; 3. Bed rest; 4. Independent walking

Explanation

Carr and Shepherd's Motor Relearning Program (MRP / 运动再学习) is a cognitive, task-oriented approach consisting of 4 distinct steps: 1. Analysis of the task (observing biomechanical deviations); 2. Practice of missing components (relearning isolated components); 3. Practice of the whole task (performing task with feedback); 4. Transference of training (generalizing into everyday home and community environments).