A postal worker complains of numbness and tingling in the right hand. Examination reveals a median nerve distribution.  When the PT evaluates the patient’s work tasks, the therapist notes that the patient is required to key in zip codes at about 58 letters/min.  Which of the following would be an appropriate administrative control to decrease this patient’s injury risk?

Question #44    The patient case is repeated here for your convenience.  Mary is a 55-year-old female with CC of 3-month history of left sided neck and central – left upper back/scapula pain. SH: married with twin 10 year old children; she is trained as a research lab. technician but is currently a homemaker. CLOF: Mary reports she is having a “hard time keeping with her husband and children” and increasing difficulty managing her home. Even minor activities such as reaching to upper cabinets/closets, lifting and carrying groceries or laundry result in significant pain. As a result she has been very sedentary lately and feels that she fatigues easily. PLOF: Independent in all BADLs and IADLs, worked full time  PMH:  hypercholestemia (210mg/dL) SH: current smoker – 1 pack per day x 35 years MEDS: takes Tylenol for current pain; started taking over the counter allergy medicine, Zyrtec, by mouth 3 weeks ago because of recent nasal congestion and cough. She is self referred to PT with goals to decrease pain, return to regular activities and exercise, and to feel good enough to be able to start part-time work. PHYSICAL EXAMINATION: Posture and Observation: Posterior pelvic tilt, increased thoracic kyphosis, Mod forward head, C – spine in L side bend.   Height:  1.75 meters  (69 in)    Weight: 55 kg  (121 lbs)       BMI: 18.28 VSs at rest: HR 84 bpm, reg ;  RR 22,  upper chest breathing pattern  BP  120/75 Active Range of Motion: Cervical spine: flexion 0 to 30 degrees; extension 0 to 25 degrees; rotation (R) 0 to 40 degrees, (L) 0 to 15 degrees; sidebending (R) 0 to 30 degrees, (L) 0 to 20 degrees MMT Strength Testing: Upper trapezius (B) 5/5; middle trapezius (R) 3/5, (L) 2/5; lower trapezius (B) 2/5; sternocleidomastoid (B) 2/5; trunk curl 3/5; bilat leg lowering (abdominals)  2/5; Palpation: Tender to light pressure in suboccipital region, medial upper and mid trapezius, SCM origin & insertion L > R Function: sitting tol. 20 mins, standing tol. 15 mins, can lift 5lbs from knee to waist and waist to shoulder level with mild increase in discomfort; unable to lift heavier loads due to significant increase in pain, unable to lift loads from floor level, unable to reach/lift overhead due to pain.  Amb. independently indoor and outdoors w/o assistive device, up to ½ mile on level surfaces with reports of fatigue and increased discomfort/pain; Amb. elevations independently w/o AD but uses 1 rail on stairs for stability.   Question #44 Explain how the results from the aerobic capacity test you selected /described above combined with the other information you have on this client eg age and HR, can be used to establish appropriate exercise parameters for aerobic activity including intensity and target HR. (1.5pts).

While exercising on a treadmill a patient reports a rate of perceived exertion of 15 on the 6 – 20 Borg RPE Scale. Assuming the patient’s response appropriately reflects their effort, which of the following correctly estimates their expected hear rate and perceived level of work?

A patient with a history of low back pain has been receiving PT for 2 weeks.  The patient is employed as a loading dockworker and performs repetitive lifting and carrying of boxes weighing between 15 and 30lb. Which of the following would be an appropriate engineering control to reduce the ergonomic stresses of lifting and carrying?

Given the LTG you developed in the previous question,  write an appropriate and related activity level STG for this patient including all required elements. (1)

Which of the following statements about the Body Mass Index (BMI) is FALSE? 

An elderly patient has been hospitalized for the past 3 days with pneumonia. The MD and patient are hoping for a home discharge tomorrow. The patient lives with their sister in a first floor apartment.  The PT has determined that ambulation status is independent with rolling walker up to 15ft. which is not enough to allow the patient to get from the bed to the bathroom (30 feet). Which of the following is the most appropriate PT recommendation?

In normal balance function for a young to middle aged adult, what are the relative contributions of each of the 3 systems under usual conditions? 

As you learned in Chapter 13, the 4P’s of a Marketing Mix are Product, Price, Place (aka Distribution channels), Promotion. Please see the article below on Nestle.   PRODUCT (6 points), Please QUOTE, including “—“s, FROM the article, 3 references to Nestle’s PRODUCT offering or strategy. Any quotes AND/OR any generic ideas that are NOT from the article, or are without “s WILL be graded 0. PRICE (PRICING STRATEGY) (6 points). Please QUOTE, including “—“s, FROM the article, 3 references to the PRICING strategy. Any quotes AND/OR any generic ideas that are NOT from the article, or are without “s WILL be graded 0. PLACE (4 points). Please QUOTE, including “—“s, FROM the article, 2 references to the PLACE (Distribution / Channels) strategy. Any quotes AND/OR any generic ideas that are NOT from the article, or are without “s WILL be graded 0. PROMOTION (2 Points). Please QUOTE, including “—“s, FROM the article, 1 reference to the PROMOTION strategy. Any quotes AND/OR any generic ideas that are NOT from the article, or bare without “s WILL be graded 0. Any repetition of a quote in more than 1 place will be counted as 0 for that quote.

An elderly community dwelling patient with persistent balance difficulty and a history of recent falls (2 in the last 3 months) is referred for PT exam and evaluation.  Which of the following is crucial to examine during the initial session?