ART Upper Extremity Treatment Protocols 3 — Questions and Answers
Question 1: During ART treatment of the subscapularis, the practitioner applies tension while the patient moves the shoulder from internal rotation to which position?
- Extension
- External rotation (Correct answer)
- Horizontal adduction
- Elevation
Correct answer: External rotation
Subscapularis ART protocol moves the arm from internal rotation to external rotation, lengthening the muscle against the applied tension.
Question 2: Which structure is targeted when treating Guyon's canal syndrome using ART at the wrist?
- Median nerve
- Radial nerve
- Ulnar nerve (Correct answer)
- Anterior interosseous nerve
Correct answer: Ulnar nerve
Guyon's canal syndrome involves compression of the ulnar nerve as it passes through the canal at the wrist.
Question 3: In ART, the 'pin and stretch' technique for the infraspinatus involves contacting the muscle belly and moving the arm from external rotation into which motion?
- Abduction
- Internal rotation (Correct answer)
- Flexion
- Extension
Correct answer: Internal rotation
Infraspinatus ART uses internal rotation to lengthen the muscle as the practitioner pins the tissue, releasing adhesions.
Question 4: When treating thoracic outlet syndrome with ART, which scalene muscle is typically addressed when symptoms follow the C8-T1 distribution?
- Anterior scalene (Correct answer)
- Middle scalene
- Posterior scalene
- All scalenes equally
Correct answer: Anterior scalene
The anterior scalene compresses the lower brachial plexus trunk (C8-T1) and subclavian vein, making it the primary ART target for lower TOS.
Question 5: Which position best isolates the flexor digitorum superficialis for ART treatment of finger flexor adhesions?
- Wrist extended, MCP flexed, PIP passively extended (Correct answer)
- Wrist flexed, all fingers in fist
- Wrist neutral, fingers fully extended
- Wrist extended, fingers in hook fist
Correct answer: Wrist extended, MCP flexed, PIP passively extended
Extending the wrist while flexing the MCP and extending the PIP isolates the FDS by differentiating it from the FDP.
Question 6: ART treatment of the pectoralis minor for shoulder impingement syndrome primarily addresses which secondary effect of the shortened muscle?
- Decreased acromioclavicular joint mobility
- Anterior tilting and downward rotation of the scapula (Correct answer)
- Glenohumeral internal rotation deficit
- Increased thoracic kyphosis
Correct answer: Anterior tilting and downward rotation of the scapula
A shortened pectoralis minor anteriorly tilts and downwardly rotates the scapula, reducing subacromial space and contributing to impingement.
Question 7: Which ART protocol is specifically indicated for intersection syndrome, a condition affecting rowers and paddlers at the dorsal forearm?
- Treating the APL and EPB at their crossing with ECRL and ECRB (Correct answer)
- Treating FCU and FCR at the wrist crease
- Releasing the extensor retinaculum only
- Treating the supinator at the radial head
Correct answer: Treating the APL and EPB at their crossing with ECRL and ECRB
Intersection syndrome occurs where the APL/EPB cross over the ECRL/ECRB, creating friction and adhesions treatable with ART.
ART Upper Extremity Treatment Protocols 3
During ART treatment of the subscapularis, the practitioner applies tension while the patient moves the shoulder from internal rotation to which position?