NPTE-PT Musculoskeletal System Interventions 5 — Questions and Answers
Question 1: A patient with a hip labral tear presents with anterior hip pain and clicking. Which therapeutic exercise should be AVOIDED early in rehabilitation?
- Gluteal isometric exercises
- Hip flexion past 90° with external load (Correct answer)
- Aquatic walking
- Supine hip abduction
Correct answer: Hip flexion past 90° with external load
Hip flexion beyond 90° under load compresses the anterior labrum and should be avoided early in rehabilitation for anterior hip labral tears.
Question 2: Which outcome measure is MOST appropriate to assess functional mobility and fall risk in an older patient with hip OA?
- Visual Analog Scale (VAS)
- Timed Up and Go (TUG) test (Correct answer)
- Oswestry Disability Index
- QuickDASH questionnaire
Correct answer: Timed Up and Go (TUG) test
The TUG test is a validated functional mobility assessment that measures fall risk and is appropriate for older patients with lower extremity conditions like hip OA.
Question 3: A patient has weakness in the serratus anterior. Which movement pattern will be MOST impaired?
- Glenohumeral internal rotation
- Scapular upward rotation and protraction during overhead reach (Correct answer)
- Elbow flexion strength
- Glenohumeral horizontal adduction
Correct answer: Scapular upward rotation and protraction during overhead reach
Serratus anterior is the primary scapular protractor and contributes to upward rotation; weakness impairs overhead reaching and causes scapular winging.
Question 4: Which intervention is indicated for a patient with thoracic outlet syndrome caused by a tight anterior scalene?
- Cervical flexion strengthening
- Scalene and pectoral muscle stretching with postural correction (Correct answer)
- Strengthening of the upper trapezius only
- Cervical manipulation at C1-C2
Correct answer: Scalene and pectoral muscle stretching with postural correction
TOS due to tight anterior scalene is treated with scalene and pectoral stretching combined with postural correction to open the thoracic outlet.
Question 5: During gait analysis, a patient demonstrates contralateral pelvic drop (Trendelenburg gait). Which muscle is MOST likely weak?
- Hip adductors on the stance limb side
- Hip abductors on the stance limb side (Correct answer)
- Hip flexors on the swing limb side
- Quadriceps on the stance limb side
Correct answer: Hip abductors on the stance limb side
Contralateral pelvic drop during stance indicates weakness of the hip abductors (primarily gluteus medius) on the weight-bearing side, resulting in Trendelenburg gait.
Question 6: A therapist performs a Maitland Grade III mobilization. Which description BEST defines this technique?
- Small amplitude at the beginning of range
- Large amplitude at the beginning of range
- Large amplitude into resistance, not reaching end range (Correct answer)
- Small amplitude at the end of range
Correct answer: Large amplitude into resistance, not reaching end range
Maitland Grade III is a large-amplitude oscillatory mobilization that moves into the resistance barrier but does not reach the absolute end of range.
Question 7: Which plyometric exercise progression is the CORRECT order from least to most demanding for lower extremity rehabilitation?
- Depth jump → bilateral squat jump → single-leg hop
- Bilateral squat jump → single-leg hop → depth jump (Correct answer)
- Single-leg hop → bilateral squat jump → depth jump
- Depth jump → single-leg hop → bilateral squat jump
Correct answer: Bilateral squat jump → single-leg hop → depth jump
Plyometric progression moves from bilateral to unilateral and from lower to higher intensity: bilateral squat jumps → single-leg hops → depth jumps (highest reactive demand).
NPTE-PT Musculoskeletal System Interventions 5
A patient with a hip labral tear presents with anterior hip pain and clicking.
Which therapeutic exercise should be AVOIDED early in rehabilitation?