PRC Treatment Planning & Manual Techniques 3 — Questions and Answers
Question 1: In PRI, what is the primary reason alternating reciprocal activity is emphasized over bilateral symmetrical strengthening?
- It reduces cardiovascular demand during rehabilitation
- It restores the neurological alternating pattern needed for gait and breathing (Correct answer)
- It isolates individual muscle groups more effectively
- It decreases the risk of delayed onset muscle soreness
Correct answer: It restores the neurological alternating pattern needed for gait and breathing
PRI emphasizes alternating reciprocal activity because human locomotion and breathing rely on asymmetrical, alternating neurological patterns that bilateral symmetrical exercise cannot restore.
Question 2: Which reference center of control (RCC) must be established before addressing a patient's left AIC pattern in PRI?
- Left acetabular-femoral joint
- Right acetabular-femoral joint (Correct answer)
- Left glenohumeral joint
- Right sternoclavicular joint
Correct answer: Right acetabular-femoral joint
The right acetabular-femoral joint RCC must be established first because it provides the stable reference point from which the left AIC pattern can be unwound.
Question 3: During PRI treatment, a patient demonstrates inability to sense the right glute max during a right hip extension activity. What is the most likely compensatory pattern?
- Left hamstring over-recruitment
- Right hamstring over-recruitment (Correct answer)
- Right thoracic extensor over-recruitment
- Left quadratus lumborum over-recruitment
Correct answer: Right hamstring over-recruitment
When right glute max is inhibited during right hip extension, the right hamstrings typically over-recruit as a synergistic compensator.
Question 4: In PRI manual therapy, what is the significance of assessing the position of the right shoulder when treating left AIC patterns?
- The right shoulder indicates thoracic rotation direction independent of pelvis
- Right shoulder protraction typically accompanies right BC pattern co-existing with left AIC (Correct answer)
- Right shoulder elevation confirms sacral nutation on the right
- Right shoulder position determines cervical lordosis depth
Correct answer: Right shoulder protraction typically accompanies right BC pattern co-existing with left AIC
Right shoulder protraction and depression typically co-exist with right BC and left AIC patterns, indicating the full polyarticular chain involvement that must be addressed.
Question 5: When applying manual resistance during a PRI zone of apposition (ZOA) exercise, where should the clinician place resistance to facilitate diaphragm repositioning?
- Anteriorly over the sternum to resist chest expansion
- Laterally over the lower ribs to resist bucket-handle motion (Correct answer)
- Posteriorly over the thoracic spine to resist extension
- Superiorly over the clavicles to resist shoulder elevation
Correct answer: Laterally over the lower ribs to resist bucket-handle motion
Lateral resistance over the lower ribs during exhalation resists bucket-handle rib motion and facilitates proper ZOA repositioning by encouraging internal oblique-driven rib depression.
Question 6: In PRI, which finding on physical examination suggests a patient has lost left stance phase during gait?
- Increased left hip internal rotation in standing
- Reduced right knee flexion during terminal swing
- Left hip remaining in external rotation during weight acceptance (Correct answer)
- Right shoulder hiking during left arm swing
Correct answer: Left hip remaining in external rotation during weight acceptance
When the left hip remains externally rotated during weight acceptance, it indicates failure to achieve the internal rotation needed for proper left stance phase.
Question 7: Which PRI technique involves using the wall to provide feedback for proper scapular positioning during a left serratus anterior facilitation exercise?
- Wall press with right arm push and left arm reach forward
- Bilateral wall press with chin tuck
- Left arm wall slide with shoulder protraction at end range (Correct answer)
- Right arm wall angel with thoracic extension
Correct answer: Left arm wall slide with shoulder protraction at end range
A left arm wall slide with shoulder protraction at end range uses the wall as proprioceptive feedback to facilitate left serratus anterior and restore left scapular anterior tipping.
PRC Treatment Planning & Manual Techniques 3
In PRI, what is the primary reason alternating reciprocal activity is emphasized over bilateral symmetrical strengthening?