COKO Patient Assessment and Evaluation 3 — Questions and Answers
Question 1: When assessing shoulder impingement syndrome, a positive Hawkins-Kennedy test is elicited by which maneuver?
- Full passive abduction with overpressure at end range
- Passive forward flexion to 90° with internal rotation of the humerus (Correct answer)
- Resisted external rotation at 0° abduction
- Active abduction through the painful arc between 60° and 120°
Correct answer: Passive forward flexion to 90° with internal rotation of the humerus
The Hawkins-Kennedy test involves passively flexing the shoulder to 90° and then internally rotating the humerus, which compresses subacromial structures to reproduce impingement pain.
Question 2: In the context of COKO practice standards, informed consent for a kinesiological assessment must include which element?
- A guarantee of specific outcomes from the proposed program
- An explanation of the nature, risks, benefits, and alternatives to the assessment (Correct answer)
- A waiver of all liability for injury during testing
- Documentation that the client has passed a medical fitness examination
Correct answer: An explanation of the nature, risks, benefits, and alternatives to the assessment
Informed consent requires explaining the nature of the assessment, its potential risks and benefits, and available alternatives so the client can make an autonomous decision.
Question 3: A kinesiologist measures a client's ankle dorsiflexion range of motion in non-weight-bearing using a goniometer and obtains 8°. The normal reference range is 15–20°. How should this finding be classified?
- Within normal limits
- Hypermobility
- Hypomobility (Correct answer)
- Normal asymmetry
Correct answer: Hypomobility
A dorsiflexion measurement of 8° falls below the accepted normal range of 15–20°, indicating hypomobility or restricted range of motion at that joint.
Question 4: Which assessment tool is specifically validated to measure health-related quality of life across eight domains including physical functioning, bodily pain, and mental health?
- DASH (Disabilities of the Arm, Shoulder and Hand)
- SF-36 (Short Form-36) (Correct answer)
- WOMAC (Western Ontario McMaster Osteoarthritis Index)
- KOOS (Knee Injury and Osteoarthritis Outcome Score)
Correct answer: SF-36 (Short Form-36)
The SF-36 is a widely validated generic health-related quality of life measure assessing eight domains applicable across diverse patient populations.
Question 5: A kinesiologist observes that a client exhibits forward head posture during a static postural assessment. Which compensatory change in the thoracic and cervical spine typically accompanies this finding?
- Cervical lordosis reduction with thoracic kyphosis decrease
- Increased cervical lordosis with increased thoracic kyphosis (Correct answer)
- Cervical lateral flexion with lumbar hyperlordosis
- Thoracic scoliosis with cervical rotation
Correct answer: Increased cervical lordosis with increased thoracic kyphosis
Forward head posture is coupled with increased upper cervical extension (lordosis) and increased thoracic kyphosis as the spine adapts to the anterior translation of the head.
Question 6: A client reports intermittent numbness and tingling in the fourth and fifth digits of the hand. To differentiate between cubital tunnel syndrome and C8 radiculopathy, which assessment finding would best support cubital tunnel syndrome?
- Positive Spurling test reproducing symptoms
- Positive Tinel sign at the medial elbow (Correct answer)
- Reduced triceps deep tendon reflex
- Weakness of extensor carpi ulnaris
Correct answer: Positive Tinel sign at the medial elbow
A positive Tinel sign at the medial elbow (over the cubital tunnel) supports ulnar nerve entrapment at that level, distinguishing it from a cervical root origin.
Question 7: When recording goniometric measurements for clinical documentation, which practice best ensures reliability and reproducibility?
- Estimating joint angles visually to reduce patient discomfort
- Standardizing bony landmarks, patient position, and goniometer alignment across sessions (Correct answer)
- Using different clinicians to measure the same joint to average results
- Measuring only in the dominant limb to reduce variability
Correct answer: Standardizing bony landmarks, patient position, and goniometer alignment across sessions
Reliability in goniometry is maximized by consistently using the same bony landmarks, patient positioning, and instrument alignment across all measurement sessions.
COKO Patient Assessment and Evaluation 3
When assessing shoulder impingement syndrome, a positive Hawkins-Kennedy test is elicited by which maneuver?