PRC Case Analysis & Practical Application 2 — Questions and Answers
Question 1: A patient presents with right hip flexion limitation and left thoracic rotation restriction. Which PRI pattern does this most likely represent?
- Left AIC with Right BC (Correct answer)
- Right AIC with Left BC
- Bilateral BC pattern
- Right TMCC pattern
Correct answer: Left AIC with Right BC
Left AIC pattern typically presents with right hip flexion limitation combined with right thoracic and left lumbar rotation restrictions, often paired with Right BC.
Question 2: During a patient evaluation, you find the left diaphragm is positioned higher than the right at rest. What is the most likely contributing factor?
- Right diaphragm dominance due to liver position (Correct answer)
- Left diaphragm overactivity from spleen
- Bilateral diaphragm weakness
- Elevated left rib cage from scoliosis
Correct answer: Right diaphragm dominance due to liver position
The liver's mass positions the right diaphragm lower, making right diaphragm dominance and left hemidiaphragm elevation a common asymmetric finding in PRI.
Question 3: A patient with a Right BC pattern will most likely show restricted cervical rotation to which direction?
- Right
- Left (Correct answer)
- Bilateral equally
- No cervical restriction
Correct answer: Left
Right BC pattern involves right rib cage expansion and thoracic rotation to the right, which limits left cervical rotation through coupled motion.
Question 4: Which test finding confirms a patient has achieved a neutral position after PRI treatment?
- Equal hip abduction strength bilaterally
- Negative Adduction Drop and Hruska Abduction tests bilaterally (Correct answer)
- Symmetric passive hip internal rotation
- Neutral lumbar lordosis on visual inspection
Correct answer: Negative Adduction Drop and Hruska Abduction tests bilaterally
Bilateral negative Adduction Drop (ADD) and Hruska Abduction (HA) tests indicate the pelvis has achieved a neutral, non-patterned position.
Question 5: A 45-year-old runner presents with chronic right IT band syndrome unresponsive to stretching. PRI evaluation reveals a Left AIC pattern. Which muscle is most likely over-facilitated on the right?
- Right TFL and right glute max (Correct answer)
- Right hamstring and right adductor
- Right psoas and right iliacus
- Right piriformis and right obturator internus
Correct answer: Right TFL and right glute max
In Left AIC, the right TFL and right glute max become over-facilitated as the right innominate anteriorly rotates, placing stress on the IT band.
Question 6: When applying the 90-90 Hip Lift technique, the patient reports inability to feel posterior pelvic tilt. What is the most appropriate modification?
- Add a balloon to facilitate exhalation and increase intra-abdominal pressure (Correct answer)
- Have the patient perform active hip flexion against resistance
- Place a pillow under the lumbar spine for support
- Ask the patient to contract their glutes maximally
Correct answer: Add a balloon to facilitate exhalation and increase intra-abdominal pressure
Adding balloon blowing facilitates full exhalation, ZOA establishment, and posterior pelvic tilt through diaphragmatic repositioning.
Question 7: A patient with TMCC pattern presents with jaw pain and cervical headaches. Which PRI chain is most directly implicated?
- Temporal Mandibular Cervical Chain (Correct answer)
- Anterior Interior Chain
- Brachial Chain
- Posterior Exterior Chain
Correct answer: Temporal Mandibular Cervical Chain
The Temporal Mandibular Cervical Chain (TMCC) directly links jaw mechanics to cervical and cranial position, making it the primary chain in TMJ-cervical presentations.
PRC Case Analysis & Practical Application 2
A patient presents with right hip flexion limitation and left thoracic rotation restriction.
Which PRI pattern does this most likely represent?