A 21-year-old female patient presents with neck pain and stiffness that has gradually worsened over the last two weeks. Upon examination, the patient is noted to have pain with left side bending with left rotation and reports pain on the left at the C5-6 junction. Hypomobility is also noted with ri...
A 21-year-old female patient presents with neck pain and stiffness that has
gradually worsened over the last two weeks. Upon examination, the patient is
noted to have pain with left side bending with left rotation and reports pain on
the left at the C5-6 junction. Hypomobility is also noted with right side-gliding of
C6. Which of the following techniques will be most appropriate to decrease pain
1) Closing technique for the mid-thoracic spine.
2) Closing manipulation in extension for C5-C6
3) Gapping manipulation in flexion for C5-C6.
4) Flexion/opening manipulation for mid-thoracic spine - ANSWER 2
The hypomobility is noted at C6 with right side-gliding and pain with left SB and
rotation, indicating a closing restriction at the left C5-6 facet joint. Thus,
interventions would require assistance with closing (approximation).
A patient presents to the clinic with right shoulder pain and complains of difficulty
reaching overhead, with pain especially from 60-120 degrees of shoulder flexion.
Which special test would be MOST informative for this set of symptoms?
1) Neer Test
2) Empty Can Test
3) Crossover Test
4) Push Off Test - ANSWER 1
, The Neer Test is a test for subacromial impingement and is typically associated
with the painful arc.
A physical therapist is evaluating a patient with back pain. The patient reports
having pain that has increased steadily over the last 2 months and is constant and
unremitting. The pain radiates into both lower extremities. The patient also feels
marked weakness throughout the right lower extremity. What is the MOST
appropriate initial treatment?
1) Discontinue treatment and refer patient to primary care physician for further
testing.
2) Begin a program of core strengthening, focusing on transversus abdominis
training and progressing toward a long term stabilization program.
3) Instruct the patient in appropriate lower extremity exercises to improve leg
strength, focusing on the right leg.
4) Initiate piriformis stretching as tolerated and instruct the patient in self
mobilization techniques to improve mobility throughout the lumbar spine. -
ANSWER 1
Constant pain without any relation to position is a key indicator of spinal cancer.
While examining a patient's lumbar x-ray films, a physical therapist notices that
the L5 vertebra is displaced anteriorly on sacrum by approximately 50% of the
vertebral body. How will this MOST affect physical therapy if the patient is being
treated for low back pain?
1) Emphasize core strengthening, especially in spine neutral
, 2) Begin progressive gluteal and quad strengthening to assist the lumbopelvic
fascia
3) Avoid extension activities, especially in standing
4) Add progressive external oblique training as tolerated to assist proper spinal
alignment - ANSWER 3
Extension activities will exacerbate any pain from this spondylolisthesis. Hertling
D. Lumbar Spine.
A physical therapist is treating a patient with cervical pain. The patient reports
that the pain occurs with most movements and feels "stiff" with active range of
motion. What is the MOST appropriate course of action?
1) Refer to the primary care physician for further testing.
2) Initiate thoracic spine mobilization.
3) Instruct the patient on cervical spine stabilization exercises and issue a home
exercise program.
4) Initiate an upper extremity exercise routine to improve shoulder internal
rotation range of motion and progress as tolerated. - ANSWER 2
Increasing amounts of the literature suggest that for hypomobility of the neck,
thrust manipulation of the thoracic spine can provide short-term improvements in
patients with mechanical neck pain.
A physical therapist is treating an individual recovering from a total knee
replacement. The therapist desires to make an objective measure regarding the
functional ambulation status of this individual. Which of the following devices
would be MOST useful?
A stopwatch for the TUG or 6 MWT would be MOST useful. These are excellent
tests in determining function in a community ambulator.
A patient is being treated for difficulty with overhead activities and subacromial
bursitis. Which of the following strengthening activities will be MOST helpful?
Shoulder rotation, especially external rotation, is the MOST helpful at
strengthening the rotator cuff, which will be the MOST helpful at treating
subacromial bursitis.
A patient is receiving physical therapy 10 weeks after an elbow fracture and
displays a significant elbow flexion joint contracture. The patient's physician states
the fracture is well-healed. Which of the following is the MOST appropriate initial
intervention to improve elbow range of motion?
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