A pitcher is exercising in a clinic with a sports cord mounted behind and above his head. The pitcher simulates pitching motion using the sports cord as resistance. Which proprioceptive neuromuscular facilitation (PNF) diagonal is the pitcher using to strengthen the muscles involved in pitching a baseball?

A therapist is mobilizing a patient’s right shoulder. The movement taking place at the joint capsule is not completely to end range. It is a large amplitude movement from near the beginning of available range to near the end of available range. What grade of mobilization according to Maitland, is being performed?

A therapist has been treating a patient who received a rotator cuff surgical repair with sessions consisting only of passive range of motion (for an extended period). The patient has just returned from a follow-up doctor’s visit with an additional order to continue with passive range of motion only. Which of the following is the best course of action for the therapist?

The therapist is treating a male patient for a second-degree acromioclavicular sprain. The patient has just finished the doctor’s prescription of 3 sessions/week for 4 weeks. The therapist is treating the patient with iontophoresis (driving dexamethasone), deltoid-strengthening exercises, pectoral strengthening exercises, and ice. The patient reports no decline in pain level since the initial evaluation. Which of the following is the best course of action for the therapist?

A therapist working in an outpatient physical therapy clinic evaluates a patient with a diagnosis of rotator cuff bursitis. The physician’s order is to evaluate and treat. During the evaluation the following facts are revealed: Active shoulder flexion = 85o with pain; Passive shoulder flexion = 177 o ; Active shoulder abduction = 93 o with pain; Passive shoulder abduction = 181 o ; Active external rotation = 13 o ; Passive external rotation = 87 o ; Drop arm test = positive; Impingement test = negative; Biceps tendon subluxation test = negative; Sulcus sign = negative. Of the following, which is the best course of action?

What is the closed-packed position of the shoulder?

A patient with a diagnosis of a rotator cuff tear has just begun active range of motion. The therapist is strengthening the rotator cuff muscles to increase joint stability and oppose the superior shear of the deltoid. Which of the rotator cuff muscles participate least in opposing the superior shear force of the deltoid?

A 14-year-old girl with right thoracic scoliosis is referred to physical therapy. The therapist should expect which of the following findings?

A 67-year-old woman presents to an outpatient facility with a diagnosis of right adhesive capsulitis. The therapist plans to focus mostly on gaining abduction range of motion. In which direction should the therapist mobilize the shoulder to gain abduction range of motion?

A patient presents to an outpatient clinic with complaints of shoulder pain. The therapist observes a painful arc between 70o and 120o of active abduction in the involved shoulder. This finding is most indicative of what shoulder pathology?

A patient is positioned in the supine position. The involved left upper extremity is positioned by the therapist in 90o of shoulder flexion. The therapist applies resistance into shoulder flexion, then extension. No movement takes place. The therapist instructs the patient to “hold” when resistance is applied in both directions. Which of the following proprioceptive neuromuscular facilitation techniques is being used?

The therapist is treating a patient who received an above elbow amputation 2 years ago. The prosthesis has a split cable that controls the elbow and the terminal device. With this type of prosthesis, the patient must first lock the elbow to allow the cable to activate the terminal device. This is accomplished with what movements?

A 32-year-old construction worker fell off a ladder. In his effort to prevent the fall, the worker reached for a beam with his right arm. This motion stretched the brachial plexus, resulting in decreased function in the right arm. Full function returned after 2 ½ weeks. What is the most likely type of injury?

A therapist is attempting to gain external rotation range of motion in a patient’s right shoulder. The therapist decides to use contract-relax-contract antagonist. In what order should the following rotator cuff muscles contract to perform this movement successfully?

The therapist is assessing a patient’s strength in the right shoulder. The patient has 0o of active shoulder abduction in the standing position. In the supine position, the patient has 42o of active shoulder abduction and 175o pain-free passive shoulder abduction. What is the correct manual muscle testing grade for the patient’s shoulder abduction?

A therapist is assessing a patient in an attempt to discover the source of her pain. She positions the patient’s cervical spine in different directions in an attempt to elicit the patient’s symptoms. In one such direction, the patient reports return of symptoms, including pain located at the right posterior scapular region, which extends down the posterior side of the right upper extremity to the ends of the fingers, and tingling in the second, third, and fourth digits. The patient also indicates that she often has decrease in sensation on the dorsal side of the second and third digits. She also has noticeable weakness in the right triceps. Which nerve root is most likely involved?

An outpatient physical therapist notices that a large number of patients with impingement of the rotator cuff have been treated in the past 6 months. The clinic finds that most patients are employed at a new auto manufacturing plant. The therapist is invited to the plant to perform an ergonomic assessment and finds that a certain number of the employees must work with their shoulders at 120o of elevation and internal rotation. Which of the following recommendation would decrease the occurrence of impingement?

A 48-year-old woman is being evaluated by a physical therapist. Her diagnosis is right rotator cuff tendinitis. She reports right shoulder weakness and pain for the past 2 months. The patient describes “pins and needles”, over the lateral right shoulder and upper extremity, extending into the thumb. She also reports no causative trauma. Manual muscle testing reveals in the right upper extremity: flexion = 4/5, extension = 3+/5, abduction = 3+/5, adduction = 4/5, internal rotation = 3+/5, and external rotation = 3+/5. Manual muscle testing reveals in the left upper extremity: flexion = 4+/5, extension = 5/5, abduction = 5/5, adduction = 4+/5, internal rotation = 4+/5, and external rotation = 4+/5. Active and passive shoulder range of motion is within normal limits and equal bilaterally. All thoracic outlet tests are negative. All shoulder special tests are negative. Which of the following steps would most likely assess the source of the patient’s problems?

A physical therapist is performing an isokinetic test on a 16-year-old boy’s shoulder. This particular test compares the right shoulder with the left shoulder. The patient’s father asks the physical therapist, “What is the purpose of this test?” How should the therapist respond?

A physical therapist is scheduled to evaluate the shoulder of a patient with hepatitis B. The therapist notices no open wounds or abrasions and also notices that the patient has good hygiene. The physician has ordered passive range of motion to the right shoulder because of adhesive capsulitis. Which of the following precautions is absolutely necessary to prevent the therapist from being infected?

A therapist is screening a patient complaining of pain at the anterior left shoulder region. The pain is increased when the examiner instructs the patient to position the left arm by his side with the elbow flexed at 90o and to actively supinate the forearm against resistance (provided by the examiner). What test is being performed?

A patient is in prone position with his head rotated to the left side. The left upper extremity is placed at his side and fully internally rotated. The left shoulder is then shrugged toward the chin. The therapist then grasps the midshaft of the patient’s left forearm. The patient is then instructed to “try to reach your feet using just your left arm.” This movement is resisted by the therapist. The test is assessing the strength of what muscle?

An 81-year-old woman with right-side hemiparesis due to stroke is being treated by a physical therapist through home health services. The therapist is attempting to increase the functional reach of the right upper extremity. The patient currently has 120o of active flexion. The therapist decides to use trunk mobility/stability facilitation techniques to help achieve the patient’s functional goals. Which of the following skills need to be mastered by the patient to attain the ability to reach 2 feet in front of her wheelchair and 2 feet to the right of midline at 125o of shoulder flexion with the right upper extremity?

A physical therapist is performing passive range of motion on the shoulder of a 43-year-old woman who received rotator cuff repair 5 weeks ago. During passive range of motion, the therapist notes a capsular end feel at 95o of shoulder flexion. What should the therapist do?

A physical therapist is treating an automobile mechanic. The patient asks for tips on preventing upper extremity repetitive motion injuries. Which of the following is incorrect advice?

A 43-year-old man with right biceps brachii rupture presents to physical therapy after a surgical repair. According to the surgeon, the rupture was at the musculotendinous junction. Which of the following has most likely been compromised?