NPTE Clinical Files | Physical Therapy

Orion is a 12-year-old with spastic diplegic cerebral palsy and is evaluated for gait abnormalities. The therapist observes excessive hip flexion, knee flexion, and ankle dorsiflexion throughout the gait cycle. Which of the following gait patterns BEST describes these findings? A) Crouch gait B) Scissoring gait C) Ataxic gait D) Steppage gait TEXT OUR TEAM:

Kai is a 65-year-old male who presents with deep groin pain, morning stiffness lasting 30 minutes, and a positive scour test. Which gait deviation is MOST likely to be observed? A) Uneven cadence B) Decreased step length on the unaffected limb C) Lateral trunk lean toward the unaffected limb D) Marked hip internal rotation on the affected side DOWNLOAD THIS EPISODE'S CHEATSHEET: www.nptecheatsheet.com/osteo-arthritis

Harper presents with neck pain and tingling radiating into the right hand. Symptoms worsen with overhead activities and improve with the arm at rest. Examination reveals weakness in elbow flexion, diminished biceps reflex, and reduced sensation over the lateral forearm. Which of the following tests is the MOST effective to assess this condition? A) Spurling’s test B) Cervical distraction test C) Upper limb tension test (ULTT) for the median nerve D) Adson’s test Join the FREE Facebook Group: www.nptegroup.com

DeShawn is assessing a 12-month-old child during a developmental screening. The child can pull to stand, cruise along furniture, and grasp small objects using a pincer grip, but has not yet started walking independently. Which of the following findings is MOST concerning? A) Inability to walk independently B) Absence of babbling or single words C) Persistence of the Moro reflex D) Lack of interest in grasping toys TEXT OUR TEAM:

Diego is six weeks post-rotator cuff repair and reports stiffness and a pulling sensation near the surgical incision during overhead movement. Examination reveals restricted shoulder range of motion and palpable adhesions. Which technique is MOST appropriate to address the patient’s symptoms? A) Effleurage B) Transverse friction massage C) Myofascial release D) Joint mobilization DOWNLOAD THIS EPISODE'S CHEATSHEET: www.nptecheatsheet.com/soft-tissue

Luca is a 68 year old male with moderate COPD who is referred for physical therapy to improve exercise tolerance. He reports dyspnea with minimal exertion and has a 6-minute walk test distance of 250 meters. His resting oxygen saturation is 92% on room air. Which of the following is the MOST appropriate initial exercise approach? A) Interval training with short work and rest periods at moderate intensity B) Continuous training at 75% of peak work rate to build endurance C) Resisted walking with a weighted vest to strengthen lower extremities D) Breathing retraining combined with unsupported upper extremity exercises Join the FREE Facebook Group: www.nptegroup.com

Amara presents with mild to moderate Alzheimer’s disease and has impaired gait and balance. She becomes disoriented in new environments and struggles with multi-step instructions. Which intervention is MOST appropriate for this patient?A) High-intensity balance exercises on uneven surfacesB) Dual-task training to improve cognitive functionC) Structured gait training in a familiar environmentD) Community ambulation to enhance adaptabilityTEXT OUR TEAM:

Helga is two days post-total knee arthroplasty (TKA) and reports moderate knee pain and stiffness. Her knee range of motion is 0–45 degrees, and her incision is well-approximated with mild edema. Which intervention is MOST appropriate to prioritize during this session? A) Full weight bearing on the surgical leg B) Low-intensity range of motion exercises to increase knee flexion C) Ambulation with a rollator walker for at least 200 feet D) Manual lymphatic drainage to reduce swelling DOWNLOAD THIS EPISODE'S CHEATSHEET: www.nptecheatsheet.com/tka

Freda presents with persistent shoulder pain following rotator cuff repair surgery. The therapist considers using electrical stimulation for pain management. The patient has a history of mild hypertension controlled with medication and reports occasional muscle spasms in the surgical area. Which of the following would MOST likely require avoidance of electrical stimulation? A) Metal anchors used during surgical fixation B) Recent use of anti-hypertensive medication C) Active muscle spasms near the surgical site D) Impaired sensation over the affected shoulder Join the FREE Facebook Group: www.nptegroup.com

Mohammad is documenting outcomes for a patient who has been treated for a venous ulcer. Which of the following improvements is the MOST significant to report? A) The patient reports a decrease in pain from 6/10 to 2/10 B) The patient's walking distance has increased from 100 meters to 300 meters C) The wound size has decreased from 6 cm² to 3 cm² D) The patient's lower leg swelling has reduced by 50% TEXT OUR TEAM:

Sweeney recently underwent a hysterectomy and requests to sit after ambulating a few feet. The patient reports dizziness and right lower extremity pain. On examination, her resting heart rate is 102 bpm, and she has significant swelling in her right lower leg. Which of the following should be assessed FIRST: A) Walking distance before stopping B) Pulse pressure C) Deep calf tenderness D) Dorsal pedal integrity DOWNLOAD THIS EPISODE'S CHEATSHEET: www.nptecheatsheet.com/dvt-implications

Azaria is a 22-year-old swimmer with intermittent right shoulder pain who complains of a slipping sensation during overhead activities. Which of the following tests should be performed FIRST? A) Apprehension test B) Speed's test C) Drop arm test D) Load and shift test Join the FREE Facebook Group: www.nptegroup.com

John reports dizziness and unsteadiness when walking, especially in busy environments or when turning his head quickly. He denies positional dizziness but struggles to read signs while walking. Examination reveals normal balance in static postures and no spontaneous nystagmus. Which test is MOST appropriate to assess the suspected deficit? A) Dix-Hallpike maneuver B) Head thrust test C) Snellen Chart Reading while walking D) Romberg test DOWNLOAD THIS EPISODE'S CHEATSHEET: www.nptecheatsheet.com/vestibular-patho

Before an evaluation, Arial is reviewing the patient's MRI report that describes sequestration at the L4 – L5 level. The intake form reveals sensory changes along the lateral calf, and dorsum of the foot. Which clinical finding is the most consistent with the medical record? A) Impaired heel walking B) Gastrocnemius and soleus atrophy C) Extensor hallicus longus weakness D) Saddle paraesthesia TEXT OUR TEAM:

Samantha is an office worker who presents with pain and numbness in the right hand, particularly at night. On examination, there is decreased sensation along the palmar aspect of the thumb, index, and middle fingers. Which the of the following is the LEAST likely impaired: A) Abductor pollicus brevis B) Flexor pollicus longus C) Opponens pollicus D) 2nd Lumbrical DOWNLOAD THIS EPISODE'S CHEATSHEET: www.nptecheatsheet.com/hand-wrist

Denise is six days post-abdominal surgery with a midline incision. The incision is well-approximated with slight redness but no drainage or dehiscence. She is concerned about safely participating in physical therapy. Which recommendation is MOST appropriate for this patient? A) Avoid core exercises until 6 weeks post-op B) Continue light activities and monitor for redness, swelling, or drainage C) Apply heat to the incision before exercise to promote healing D) Use high-compression abdominal binders during therapy Join the FREE Facebook Group: www.nptegroup.com

Kelly is referred to physical therapy six days after coronary artery bypass graft (CABG) surgery. She reports mild fatigue but denies chest pain or shortness of breath. Her resting heart rate is 85 bpm, and her blood pressure is 125/80 mmHg. The therapist plans to begin light aerobic exercise as part of her cardiac rehabilitation. Which of the following is the MOST appropriate guideline to follow during this session? A) Monitor for a target heart rate of 70–80% of her age-predicted maximum B) Avoid upper extremity exercises to minimize sternal stress C) Limit aerobic exercise to a maximum of 1–2 METs during this phase D) Emphasize light aerobic exercise with an intensity below 13 on the Borg RPE scale TEXT OUR TEAM:

Ollie reports progressive weakness in his legs and tingling sensations in his hands and feet after a recent upper respiratory infection. On examination, he has moderate dorsiflexor weakness, and mild gait instability. Which of the following is the MOST anticipated finding? A) Hyperreflexia with distal weakness B) Loss of tactile sensation C) Severe gross hip muscle weakness D) Limb contractures DOWNLOAD THIS EPISODE'S CHEATSHEET: www.nptecheatsheet.com/gbs25

Rella presents with a diagnosis of adhesive capsulitis in the freezing phase. She reports persistent, deep shoulder pain at rest and significant discomfort with attempted movement. Passive range of motion reveals capsular end-feel in all directions, particularly with external rotation. Which intervention is MOST appropriate to address the patient’s symptoms at this stage? A) Low-load prolonged passive stretching with gradual increases in intensity B) Submaximal isometric exercises to reduce pain and maintain muscle activation C) Low-grade joint mobilizations to minimize discomfort and maintain joint mechanics D) Dynamic strengthening exercises to improve shoulder function Join the FREE Facebook Group: www.nptegroup.com

Bailey presents with a history of osteoarthritis and hypertension and is referred to physical therapy for knee pain management. She reports taking over-the-counter medication daily for pain relief. During the session, she mentions experiencing mild stomach discomfort and occasional dizziness. Her blood pressure is 138/86 mmHg. Which medication is MOST likely contributing to the patient’s symptoms? A) Acetaminophen B) Ibuprofen C) Calcium-channel blocker D) Glucosamine supplement DOWNLOAD THIS EPISODE'S CHEATSHEET: www.nptecheatsheet.com/common-med