CSRS ACTUAL 2026 STUDY GUIDE QUESTIONS AND
SOLUTIONS RATED A+
✔✔Awareness Training: Neglect - ✔✔Grading or shaping the patient awareness of non-
intact perceptual field (start big /end small) and have person work across the midline
GOAL: Build INSIGHT into deficits
- (lighthouse sweep across) scanning
-flash cards
-cueing grading (min, mod, max)
-create a map of the room
-anchors (stickers/ paper scan space and find)
2nd strategy TENS 15 min electrodes placed on the posterolateral aspect of neck
(lateral to spine) and upper trapezius on neglect side
✔✔Apraxia
(Lesson 6)
2 types of Apraxia
-Ideational Apraxia
-Ideomotor Apraxia
Damage to the praxis system: The network of structures underlying praxis is thought to
include the frontal and parietal cortex, basal ganglia, and white matter tracts containing
projections between these areas - ✔✔A neurological disorder characterized by the
inability to perform learned (familiar) movements on command, even though the
command is understood and there is a willingness to perform the movement. Both the
desire and the capacity to move are present but the person simply cannot execute the
act.
-the inability to carry out learned, skilled motor acts despite preserved motor and
sensory systems, coordination, comprehension, and cooperation
- difficulty in executing learned movements sequences beyond limitations that could be
explained be weakness, lack of coordination, sensory deficits/loss, comprehension of
deficits, memory and/or motivation
✔✔Ideational Apraxia
Conceptual Apraxia - ✔✔inability to formulate an initial motor plan and sequence tasks
where the proprioceptive input necessary for movement is impaired
-A breakdown of knowledge of "what" is to be done
-Loss of mental representation about the concept required for performance
-Lack of knowledge regarding object use
-Breakdown in sequencing of an activity steps or use of objects in relation to each other
-a condition in which an individual is unable to plan movements related to interaction
with objects, because they have lost the perception of the object's purpose.
Characteristics of this disorder include a disturbance in the concept of the sequential
organization of voluntary actions
ex. dressing apraxia, tool apraxia
,✔✔Ideomotor Apraxia
Motor Apraxia - ✔✔a condition where a person plans a movement or task, but cannot
volitionally perform it. Automatic movement may occur, however, a person cannot
impose additional movement on command
-breakdown in knowledge of "how" a task is to be done
-Loss of access to kinetic memory patterns so that purposeful movements cannot be
produced or achieved because of defective planning and sequencing of movements,
even though the purpose of task is understood
-Difficulty with motor planning in general (awkward or clumsy movements/ poor foot
placement)
-Difficulty with planning movements to cross bodies midline (difficulty adjusting grasp on
hair brush when moving to other side)
- Difficulty using correct grip to conform to objects
(Using pinch grip to pick up a bottle when you should be using a cylinder grip on base)
✔✔Ideomotor Apraxia Clinical Presentation
Evaluation - ✔✔-Static and inflexible hand positions with fine motor
a. the patient is unable to manipulate coins out of hand to put into vending machine
(Translation)
-Difficulty sequencing movements
b. unable to sequencing turning, during transfers, propel w/c, pick-up phone and bring to
ear, negotiating stairs
-Difficulty coordinating two or more joints
c. coupling the shoulder & elbow during reach
d. poor foot placement during gait and transfers
e. the more joints involved in the task, the more motor planning is impaired
-Difficulty timing movements
f. delay in initiation of movement, pauses or incorrect speed of movement (fast/slow)
g. poor gesture production on demand, particularly when gesturing the use of objects
Evaluation: Diagnosis impairments of apraxia: research
Effects of apraxia of everyday living skills: rehab
Strategy Training : teach compensatory strategies depending on which of the 3 stages
the patient has deficits through different methods: Instruction/ideational
Assistance/ideomotor
Feedback ideational & ideomotor
✔✔Evaluation of Apraxia
Functional Test Evaluation - ✔✔Standardized Test
-Florida Apraxia Screening Test (revised)
-Cambridge Apraxia Battery
-Kaufman Hand Movement Test
-Limb Apraxia Test
-Movement Imitation Test
-Diagnostic Test for Apraxia
-TULIA
, Functional Task Evaluation
-Structured observation of the errors that people make during functional activities is a
valid method of assessing apraxia: Apraxia results in an observable problem related to
functional. allowing person to make safe errors during task, analyzing the errors to
classify them based on type of apraxia and error type
Tasked Based Training
-Performing functional task in appropriate settings
Intervention: select an appropriate task, high repetition to reinforce learning provide
feedback
✔✔Shoulder Introduction
(Lesson 7) - ✔✔Note: Start with alignment of the TRUNK
-Alignment is "key": keep the patient in alignment throughout the examination of the
shoulder
-weak CERVICAL FLEXORS and weak RHOMBOIDS and LOWER TRAPS
-tight SUBOCCIPITAL, UPPER TRAPS and LEVATOR along with tight PECS
NOTE: Look at the ribcage, trunk, and spine alignment
-after the trunk always assess the extremities while simultaneously working with the
trunk
-once trunk assessment is complete the scapula must be assessed before any upper
extremity activity can be started
✔✔Shoulder Assessment (PSSP)
Shoulder Assessment (TIS) - ✔✔Observation: posture, arm placement any movement
during function
Pain-> ask about this first then note throughout movement -> AROM/PROM
Subluxation->integrity of the capsule-> type of subluxation
Scapula-> what is the position of the scapula-> if elevated start with stretching
PROM-> what is PROM of the external rotators-> remember 100 degrees of shoulder
flexion is functional (lateral rotation before any shoulder moevement
Tone ->how do you describe-> note when the catch if in external rotators
Isolated Movements ->ability to isolate active movement without synergy-> The Fugi-
Meyer can help you here
Sensation-> light touch proprioception-> how does it present in function
✔✔Shoulder Joint
Shoulder muscles - ✔✔Ball & Socket:
-Glenohumeral (most mobile joint)/multiaxial ball & socket
-Acromioclavicular: junction between clavicle & acromion
SOLUTIONS RATED A+
✔✔Awareness Training: Neglect - ✔✔Grading or shaping the patient awareness of non-
intact perceptual field (start big /end small) and have person work across the midline
GOAL: Build INSIGHT into deficits
- (lighthouse sweep across) scanning
-flash cards
-cueing grading (min, mod, max)
-create a map of the room
-anchors (stickers/ paper scan space and find)
2nd strategy TENS 15 min electrodes placed on the posterolateral aspect of neck
(lateral to spine) and upper trapezius on neglect side
✔✔Apraxia
(Lesson 6)
2 types of Apraxia
-Ideational Apraxia
-Ideomotor Apraxia
Damage to the praxis system: The network of structures underlying praxis is thought to
include the frontal and parietal cortex, basal ganglia, and white matter tracts containing
projections between these areas - ✔✔A neurological disorder characterized by the
inability to perform learned (familiar) movements on command, even though the
command is understood and there is a willingness to perform the movement. Both the
desire and the capacity to move are present but the person simply cannot execute the
act.
-the inability to carry out learned, skilled motor acts despite preserved motor and
sensory systems, coordination, comprehension, and cooperation
- difficulty in executing learned movements sequences beyond limitations that could be
explained be weakness, lack of coordination, sensory deficits/loss, comprehension of
deficits, memory and/or motivation
✔✔Ideational Apraxia
Conceptual Apraxia - ✔✔inability to formulate an initial motor plan and sequence tasks
where the proprioceptive input necessary for movement is impaired
-A breakdown of knowledge of "what" is to be done
-Loss of mental representation about the concept required for performance
-Lack of knowledge regarding object use
-Breakdown in sequencing of an activity steps or use of objects in relation to each other
-a condition in which an individual is unable to plan movements related to interaction
with objects, because they have lost the perception of the object's purpose.
Characteristics of this disorder include a disturbance in the concept of the sequential
organization of voluntary actions
ex. dressing apraxia, tool apraxia
,✔✔Ideomotor Apraxia
Motor Apraxia - ✔✔a condition where a person plans a movement or task, but cannot
volitionally perform it. Automatic movement may occur, however, a person cannot
impose additional movement on command
-breakdown in knowledge of "how" a task is to be done
-Loss of access to kinetic memory patterns so that purposeful movements cannot be
produced or achieved because of defective planning and sequencing of movements,
even though the purpose of task is understood
-Difficulty with motor planning in general (awkward or clumsy movements/ poor foot
placement)
-Difficulty with planning movements to cross bodies midline (difficulty adjusting grasp on
hair brush when moving to other side)
- Difficulty using correct grip to conform to objects
(Using pinch grip to pick up a bottle when you should be using a cylinder grip on base)
✔✔Ideomotor Apraxia Clinical Presentation
Evaluation - ✔✔-Static and inflexible hand positions with fine motor
a. the patient is unable to manipulate coins out of hand to put into vending machine
(Translation)
-Difficulty sequencing movements
b. unable to sequencing turning, during transfers, propel w/c, pick-up phone and bring to
ear, negotiating stairs
-Difficulty coordinating two or more joints
c. coupling the shoulder & elbow during reach
d. poor foot placement during gait and transfers
e. the more joints involved in the task, the more motor planning is impaired
-Difficulty timing movements
f. delay in initiation of movement, pauses or incorrect speed of movement (fast/slow)
g. poor gesture production on demand, particularly when gesturing the use of objects
Evaluation: Diagnosis impairments of apraxia: research
Effects of apraxia of everyday living skills: rehab
Strategy Training : teach compensatory strategies depending on which of the 3 stages
the patient has deficits through different methods: Instruction/ideational
Assistance/ideomotor
Feedback ideational & ideomotor
✔✔Evaluation of Apraxia
Functional Test Evaluation - ✔✔Standardized Test
-Florida Apraxia Screening Test (revised)
-Cambridge Apraxia Battery
-Kaufman Hand Movement Test
-Limb Apraxia Test
-Movement Imitation Test
-Diagnostic Test for Apraxia
-TULIA
, Functional Task Evaluation
-Structured observation of the errors that people make during functional activities is a
valid method of assessing apraxia: Apraxia results in an observable problem related to
functional. allowing person to make safe errors during task, analyzing the errors to
classify them based on type of apraxia and error type
Tasked Based Training
-Performing functional task in appropriate settings
Intervention: select an appropriate task, high repetition to reinforce learning provide
feedback
✔✔Shoulder Introduction
(Lesson 7) - ✔✔Note: Start with alignment of the TRUNK
-Alignment is "key": keep the patient in alignment throughout the examination of the
shoulder
-weak CERVICAL FLEXORS and weak RHOMBOIDS and LOWER TRAPS
-tight SUBOCCIPITAL, UPPER TRAPS and LEVATOR along with tight PECS
NOTE: Look at the ribcage, trunk, and spine alignment
-after the trunk always assess the extremities while simultaneously working with the
trunk
-once trunk assessment is complete the scapula must be assessed before any upper
extremity activity can be started
✔✔Shoulder Assessment (PSSP)
Shoulder Assessment (TIS) - ✔✔Observation: posture, arm placement any movement
during function
Pain-> ask about this first then note throughout movement -> AROM/PROM
Subluxation->integrity of the capsule-> type of subluxation
Scapula-> what is the position of the scapula-> if elevated start with stretching
PROM-> what is PROM of the external rotators-> remember 100 degrees of shoulder
flexion is functional (lateral rotation before any shoulder moevement
Tone ->how do you describe-> note when the catch if in external rotators
Isolated Movements ->ability to isolate active movement without synergy-> The Fugi-
Meyer can help you here
Sensation-> light touch proprioception-> how does it present in function
✔✔Shoulder Joint
Shoulder muscles - ✔✔Ball & Socket:
-Glenohumeral (most mobile joint)/multiaxial ball & socket
-Acromioclavicular: junction between clavicle & acromion
