CMT Patient Evaluation & Treatment Planning 2 — Questions and Answers
Question 1: During a cervical spine assessment, a patient reports pain radiating into the ipsilateral arm with neck compression and rotation. Which test would best confirm cervical radiculopathy?
- Spurling's compression test (Correct answer)
- Adson's maneuver
- Vertebral artery test
- Distraction test
Correct answer: Spurling's compression test
Spurling's compression test reproduces radicular symptoms by compressing the neural foramina on the affected side via lateral flexion, rotation, and axial compression.
Question 2: A manual therapist performing a lumbar assessment notes that active trunk flexion is limited and painful but passive extension is full and pain-free. This pattern most likely indicates:
- Facet joint dysfunction
- Disc herniation with anterior compression
- Muscle guarding with flexion bias (Correct answer)
- Sacroiliac joint dysfunction
Correct answer: Muscle guarding with flexion bias
Pain and limitation with active flexion but full pain-free passive extension suggests anterior muscle guarding or flexion-loaded tissue involvement rather than a structural lesion.
Question 3: When documenting a patient's pain using the SOAP format, information about the patient's occupation and daily activities belongs in which section?
- Subjective (Correct answer)
- Objective
- Assessment
- Plan
Correct answer: Subjective
Subjective information includes the patient's self-reported history, symptoms, occupation, and functional activities that are not directly measured by the clinician.
Question 4: A 45-year-old patient presents with unilateral shoulder pain and limited internal rotation. The posterior capsule is most likely involved if which test is positive?
- Posterior capsule stretch (sleeper stretch) reproduces pain (Correct answer)
- Speed's test reproduces pain at the bicipital groove
- Hawkins-Kennedy test causes anterior shoulder pain
- Empty can test produces mid-arc weakness
Correct answer: Posterior capsule stretch (sleeper stretch) reproduces pain
Pain or tightness reproduced by the sleeper stretch (horizontal adduction with internal rotation) directly implicates posterior capsule restriction.
Question 5: Which outcome measure is most appropriate for tracking functional disability in patients with non-specific low back pain?
- Visual Analog Scale (VAS)
- Oswestry Disability Index (ODI) (Correct answer)
- Fear-Avoidance Beliefs Questionnaire (FABQ)
- Pittsburgh Sleep Quality Index
Correct answer: Oswestry Disability Index (ODI)
The Oswestry Disability Index is specifically designed to measure functional disability related to low back pain across ten activity categories.
Question 6: During gait analysis, a manual therapist observes the patient's pelvis dropping on the swing-phase side. This Trendelenburg sign indicates weakness of which muscle?
- Stance-side hip abductors (Correct answer)
- Swing-side hip flexors
- Bilateral gluteus maximus
- Stance-side hip adductors
Correct answer: Stance-side hip abductors
A positive Trendelenburg sign indicates weakness of the stance-side gluteus medius, which normally maintains pelvic level during single-leg support.
Question 7: A patient with suspected thoracic outlet syndrome reports arm symptoms with overhead activity. Which special test assesses vascular compromise by checking for a radial pulse change?
- Roos stress test
- Wright's hyperabduction test
- Adson's maneuver (Correct answer)
- ULTT-1
Correct answer: Adson's maneuver
Adson's maneuver assesses the scalene triangle by having the patient rotate and extend the neck while the examiner monitors the radial pulse for diminishment.
CMT Patient Evaluation & Treatment Planning 2
During a cervical spine assessment, a patient reports pain radiating into the ipsilateral arm with neck compression and rotation.
Which test would best confirm cervical radiculopathy?