Your patient sustained a traumatic brain injury (TBI) 9 months ago. They are ambulatory with a FWW and supervision, but fatigue after about 10 minutes of walking due to an inefficient, hemiparetic gait pattern. They would like to eventually walk without the walker. According to the 2020 Locomotor Clinical Practice Guideline, which of the following approaches would be most highly recommended?  

Connections between neurons which are rarely used are gradually eliminated to improve organization and efficiency of nueral relationships.  This process is called Synaptic Pruning.  

Temperament is biologically based and there is no evidence that “nurture” (environmental) factors has any influence on behavioral patterns related to temperament.

If the results from this study indicate significant differences between the groups, can Dr. Furrie make cause and effect conclusions about his findings?

True/False: The efficacy of spinal epidural stimulation to improve function following SCI requires intense, task-specific physical therapy.

Kalima is a 26 y/o female (she/her) who was admitted to ICU where you work from the ER. She sustained a closed head injury yesterday when her dog accidentally tripped her as she was walking down outdoor concrete stairs. Your interdisciplinary team is going over her case, and nursing reports that Kalima’s vitals have been stable and she is engaging with staff appropriately.  They are wondering if it would be appropriate for PT to see her or if it’s too soon. Based on the research about early mobilization for people with TBI, which statement is most appropriate? 

You are working with Theo (they/them), who has had a stroke and is working on bed mobility, sitting, and standing activities with assistance. They have not yet progressed to walking. You want to perform an objective measure that best captures their current level of function. Which of the following measures would be the best choice? 

Ten-month-old Natalia says 3 words (dada, mama and hi), however it is most likely she understands many more words than she can produce.  

Rick’s Movement Analysis: Gait: Rick walks short distances with a forearm crutch, but struggles significantly to advance his left leg forward due to excess knee extension and ankle plantarflexion. He hikes and circumducts his left leg to help clear the floor, but is not effective and needs Mod A. Stance phase of gait: He has adequate stance stability in his left knee, but has excessive hip flexion and forward trunk collapse and relies heavily on the crutch.  His LUE remains a little flexed while he is walking, but he is developing control out of synergy. Sensation: Intact RUE/LE for light touch, sharp/dull, and proprioception. LUE: impaired light touch and sharp/dull: upper arm 8/10 stimuli correct, forearm 8/10 stimuli correct, hand 6/10 stimuli correct. Proprioception intact at shoulder and elbow, impaired at wrist. LLE: impaired light touch and sharp/dull: 7/10 stimuli correct throughout entire leg. Proprioception intact. Motor control: Movement combining synergies in the LUE (flexion pattern) and LLE (extension pattern) Spasticity: MAS 1 in left biceps, MAS 2 in left quadriceps, MAS 3 in left plantarflexors.   MMT: R UE/LE: 5/5 throughout.  LUE: shoulder flexion and abduction 4/5, biceps 4/5, triceps 2/5, wrist flex/ext 2+/5, weak grasp. LLE: hip flexors 2-/5, hip extensors and abductors 2/5, hamstrings 2+/5, quads 4/5, ankle DF 3/5, ankle PF influenced by spasticity – unable to get clear test. Cognition/Behavior: RLOCF VI. He can currently attend for 30-45 minutes at a time, depending on how well he slept the night before. What is one intervention you could do to address Rick’s spasticity or motor control? Describe which you are choosing to address and provide enough detail so that another therapist can replicate it. (2 points):

Anat says that she had a scan done of her head yesterday and that it was negative. She does not understand why she is still having problems. Explain the pathophysiology of a concussion to Anat, avoiding medical terminology/jargon. (1 point)