Rehabilitation and Physical Medicine — MCQs

Rehabilitation and Physical Medicine Indian Medical PG Practice Questions and MCQs

Question 21: Iliotibial band contracture in patients of poliomyelitis will lead to

A. Extension at hip, flexion at knee
B. Flexion at hip and knee
C. Flexion at hip, extension at knee (Correct Answer)
D. Extension at hip and knee

Explanation: **Flexion at hip, extension at knee** - A tight **iliotibial band (ITB)**, in the context of poliomyelitis, causes **flexion and abduction of the hip** and **extension of the knee**. - This characteristic posture, sometimes called a **"paradoxical genu recurvatum"**, is due to the ITB's strong attachment to the **Gerdy's tubercle** on the tibia, creating an extensor moment at the knee when the hip is flexed. *Flexion at hip and knee* - While ITB contracture does cause hip flexion, it leads to **knee extension**, not flexion, due to its distal attachments and mechanical leverage. - **Flexion at both hip and knee** is typically seen in conditions like generalized hamstring contracture or crouch gait. *Extension at hip, flexion at knee* - ITB contracture primarily causes **hip flexion**, not extension, because its proximal attachments like the **tensor fasciae latae** and **gluteus maximus** contribute to hip flexion, especially when the hip is already in a flexed position. - Knee flexion with hip extension is characteristic of a 'calcaneal gait' or weakness of quadriceps rather than ITB contracture. *Extension at hip and knee* - The ITB causes **hip flexion**, not hip extension. - While it contributes to knee extension in this specific pathology, the hip response rules this option out.

Question 22: Treatment of choice in Acute myositis ossificans is:

A. Immobilization of the affected area (Correct Answer)
B. Early mobilization and active exercises
C. Immediate surgical excision of ossified tissue
D. High-dose corticosteroids and NSAIDs

Explanation: ***Immobilization of the affected area*** - Initial treatment for **acute myositis ossificans** focuses on conservative measures, primarily **rest and immobilization**. - This helps to **reduce inflammation**, prevent further injury, and minimize the risk of ossification progression. *Early mobilization and active exercises* - **Early mobilization** and aggressive exercises can **aggravate the condition** and promote further heterotopic ossification during the acute inflammatory phase. - While physical therapy is important later, it must be introduced cautiously and gently **after the acute phase** has subsided. *Immediate surgical excision of ossified tissue* - **Surgical excision** during the acute phase is **contraindicated** due to a high risk of **recurrence** and increased bleeding. - Surgery is typically reserved for **mature, symptomatic lesions** causing functional impairment, and is usually performed at least 6 to 12 months after onset. *High-dose corticosteroids and NSAIDs* - While **NSAIDs** might be used to manage pain and inflammation in some cases, **high-dose corticosteroids** are generally not the primary treatment of choice for acute myositis ossificans. - The effectiveness of corticosteroids in preventing or treating myositis ossificans is **not well-established**, and prolonged use carries significant side effects.

Practice by Chapter

Principles of Rehabilitation

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Exercise Prescription

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Physical Modalities in Rehabilitation

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Post-Fracture Rehabilitation

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Post-Surgical Rehabilitation

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Spinal Rehabilitation

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Sports Rehabilitation

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Pain Management in Rehabilitation

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Geriatric Rehabilitation

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Pediatric Rehabilitation

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Amputee Rehabilitation

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Functional Assessment and Outcome Measures

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