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1. PFP can arise from any innervated patellofemoral joint structure and a combination of innervated tissues may be involved concurrently. These structures include which of the following?
A. Subchondral bone
B. Infrapatellar fat pad
C. Quadriceps tendon
D. Patellar tendon
E. All of the above
2. During weight-bearing exercises, the quadriceps force increases as the knee extends into terminal extension, whereas the opposite occurs for non-weight-bearing exercises.
A. True
B. False
3. A systematic review of 24 case-control studies found that individuals with PFP tend to exhibit all of the following, EXCEPT?
A. Delayed peak rearfoot eversion
B. A greater amount of rearfoot eversion at heel strike during walking and running
C. Profound pronation while standing
D. Less rearfoot eversion range during running
4. Static measures of foot postures appear to be an adequate representation of dynamic foot function
A. True
B. False
5. In foot interventions for PFP, all of the following have been shown to be beneficial reasons to use foot orthoses EXCEPT?
A. Improves functional performance immediately
B. Improves functional performance in the medium term (12 weeks)
C. Improves functional performance in the long term (greater than 12 weeks)
D. Has similar effects in patellofemoral joint osteoarthritis
6. Findings from the current literature suggest that females with PFP demonstrate altered hip kinematics during tasks such as:
A. Running
B. Jumping
C. Landing
D. All of the above
7. The following muscles have been found to be weak in females with PFP compared to healthy females EXCEPT?
A. Gastrocnemius & soleus
B. Hip abductors
C. Hip external rotators
D. All of the above
8. Higher patellofemoral stress in the PFP group was the result of diminished contact area as opposed to an increase in joint reaction force.
A. True
B. False
9. Using a subject-specific 3D model to quantify patellofemoral joint reaction forces, and finite-element methods to quantify stress, researchers were able to show that females with PFP exhibit elevated hydrostatic and shear stress in the articular cartilage.
A. True
B. False
10. Excessive internal rotation of the femur can result in?
A. Abnormal patellofemoral joint kinematics
B. Decreased patellofemoral contact
C. Increased joint stress
D. All of the above
11. Compared to abnormal foot supination, altered hip kinematics (i.e. excessive hip adduction and internal rotation) appear to have the greatest influence on the dynamic Q-angle.
A. True
B. False
12. In the study performed by Hodges et al, when a painful electric shock is randomly and intermittently applied to the knee of asymptomatic individuals (i.e. mimicking the fear-of-pain state experienced by patients with PFP), the following muscle activity decreased:
A. Vastus Lateralis
B. Vastus Medialis
C. Both decreased
D. Neither decreased
13. The fat pad performs the following functions:
A. Facilitates the distributes synovial fluid
B. Stabilizes the patella in the extremes of knee motion (i.e, less than 20 degress and greater than 100 degrees of knee flexion)
C. Increases tibial external rotation
D. All of the above
14. In the study performed analyzing increased patella cartilage stress with internal rotation of the femur, what degrees of femoral internal rotation resulted in significant increases in peak and average hydrostatic pressure when compared to the neutral position?
A. 5 degrees
B. 10 degrees
C. 15 degrees
D. A and B
15. The results from a study analyzing forward trunk lean during running found that a slight decrease in trunk flexion can lead to a significant reduction of peak patellofemoral joint stress.
A. True
B. False
16. In the study comparing female runners with patellofemoral pain syndrome, the control group had greater shift in hip adduction at the end of the run as compared to the PFPS group.
A. True
B. False
17. In the study analyzing kinematics and muscle activity during single and double leg squats, subjects with PFPS had increased gluteus maximus (GMax) activity which may be due to all of the following EXCEPT?
A. An adaptive strategy to decelerate hip flexion during descent
B. Compensation for decreased hamstring activity
C. Facilitate extension during ascent of a single-leg squat
D. Improve lower extremity joint ROM
18. In the study comparing males and females with a history of PFPS, the following was observed:
A. Males with PFPS have similar hip weakness as females
B. Females generated significantly less hip extensor output than males
C. Males demonstrated increased anterior, but similar lateral and posterior core endurance compared to females
D. All of the above
19. In the study determining if hip muscle weakness is a predisposing factor for PFPS in female novice runners, the authors of the study concluded that weak isometric strength of the hip muscles predisposes people to the development of PFPS.
A. True
B. False
20. The cross sectional area of what quadriceps muscles was found to be significantly smaller in the PFPS group than in the control group?
A. Vastus lateralis
B. Vastus Medialis
C. Vastus Intermedius
D. Rectus Femoris
21. Loss of vastus medialis (VM) function can lead to:
A. Increased lateral patellofemoral shift
B. External tibiofemoral rotation
C. Both A & B
D. None of the above
22. A higher -riding patella and a shallower trochlear groove lessen the ability of the osseous structures of the distal femur to resist the lateral pull of the quadriceps and the iliotibial band.
A. True
B. False
23. Compared to pain-free controls, subjects with PFPS demonstrated all of the following EXCEPT?
A. Equal amounts of patella water fraction prior to running
B. Increases in pain after running
C. Elevated patella water fraction after running
D. Increased volume of local bone marrow lesions after running
24. Rearfoot inversion (peak and angle at toe-off) was significantly greater in runners with a previous history of PFPS compared to healthy controls.
A. True
B. False
25. Females are 20 times more likely to develop PFPS compared to their male counterparts.
A. True
B. False
26. In analyzing the effectiveness of a SERF brace on treatment of PFPS, the authors of the study conclude:
A. Application of the SERF brace would appear to improve knee valgus angle and reduce pain in females with PFPS during unilateral functional loading
B. Caution must be applied when interpreting these results
C. Differences between the prebracing and postbracing values, in knee valgus, are more likely to be due to measurement error than an actual effect of the brace itself
D. All of the above
27. A program of isolated hip abductor and external rotator strengthening was effective in improving pain and health status in females with patellofemoral pain when compared to a no-exercise control group.
A. True
B. False
28. 28. Females with patellofemoral pain tend to experience less knee pain during the menstrual phase of their cycle.
A. True
B. False
29. Which of the following were noted in the PFPS group compared to Nonspecific Knee Complaint group:
A. Showed a shorter duration of complaints
B. Had a lower proportion of bilateral complaints
C. Showed less pain at patella edge
D. Had less pain on knee extension
30. Findings suggest that long patellofemoral pain duration is the most consistent predictor of poor short-and long-term outcome on measures of pain, function, and perceived recovery.
A. True
B. False
31. Study outcomes indicate that only custom made foot orthoses & not prefabricated inserts, can produce immediate and significant reduction in perceived pain irrespective of baseline symptoms and lower-limb posture.
A. True
B. False
32. Which of the following is thought to be true regarding Rearfoot strike (RFS) pattern in runners?
A. Seventy-five percent of runners strike the ground with a RFS pattern
B. RFS results in a very distinct vertical impact peak that is associated with high rates of loading
C. RFS impacts have shown to be related to stress fractures in runners
D. All of the above
33. What degree of Q-angle is considered abnormally high and regarded as an anatomical risk factor in the etiology of overuse injuries of the knee?
A. 5 degrees for males and 10 degrees for females
B. 10 degrees for males and 15 degrees for females
C. 15 degrees for males and 20 degrees for females
D. 20 degrees for males and 25 degrees for females
34. In the study comparing muscle flexibility, which muscles were tighter in patients with patellofemoral pain syndrome?
A. Psoas and hamstring
B. Psoas and quadriceps
C. Hamstring and calf
D. Quadriceps and calf
35. In the study using EMG decomposition, the results from the normal subjects support previous findings of Vastus Medialis (VM) and Vastus Lateralis (VL) EMG decomposition with approximately equal firing rates of VM and VL.
A. True
B. False
36. In the 6 functional measures investigated for patellofemoral pain, which test was the most responsive to change over a 12-month period?
A. Functional Index Questionnaire (FIQ)
B. Lower Extremity Functional Scale (LEFS)
C. Patient-Specific Functional Scale (PSFS)
D. All of the above
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