Movement Pattern Analysis - National Physical Therapy Examination NPTE

1. Identify the likely impairment if a squat shows dynamic knee valgus and hip adduction.

   hip abductor/external rotator weakness and poor motor control. These deficits allow uncontrolled medial collapse; valgus indicates poor neuromuscular control in weight-bearing tasks like squats.

2. What is the primary purpose of movement-pattern analysis in PT examination?

   Identify impairments and their system-specific contributors. This approach enables physical therapists to detect deviations in tasks like gait or squats, linking them to underlying dysfunctions in specific body systems.

3. Which impairment is most consistent with a Trendelenburg sign during single-leg stance?

   hip abductor weakness (gluteus medius/minimus). Hip abductors stabilize the pelvis; weakness causes contralateral pelvic drop during weight-bearing, evident in single-leg tasks.

4. What is the most appropriate first step when a movement pattern is limited by pain?

   Modify the task to reduce pain and reassess movement. Reducing pain allows for a clearer assessment of underlying movement patterns without compensatory distortions from nociceptive responses.

5. Which system is most suggested by spastic patterning with velocity-dependent resistance?

   neurologic system (upper motor neuron). Spasticity from upper motor neuron lesions causes velocity-dependent hypertonia, leading to rigid, patterned movements observable in functional tasks.

6. Identify the likely contributor if cueing "keep knees over toes" immediately corrects knee valgus in squat.

   motor control/coordination deficit rather than fixed structural limit. Immediate correction with cues implies a trainable deficit in neuromuscular patterning rather than an unchangeable anatomical restriction.

7. Which system is most suggested by limited ROM with firm capsular end-feel and stiffness?

   musculoskeletal system (joint mobility restriction). Capsular end-feel and stiffness suggest joint capsule or ligament restrictions, limiting mobility in a system-specific manner during movement evaluation.

8. Identify the likely impairment if sit-to-stand shows excessive forward trunk lean and slow rise.

   hip extensor weakness and/or limited ankle dorsiflexion. These impairments disrupt posterior weight shift and propulsion, causing compensatory trunk lean to maintain balance during rising.

9. Identify the likely impairment if gait shows contralateral hip hike during swing.

   insufficient swing-phase limb clearance (DF or knee flexion deficit). Hip hiking elevates the pelvis on the swing side to compensate for poor clearance, often due to dorsiflexion or knee flexion limitations in gait.

10. Which system is most suggested by rapid fatigue and dyspnea limiting task performance?

    cardiopulmonary system. Fatigue and dyspnea reflect reduced aerobic capacity or respiratory efficiency, impacting endurance and performance in sustained movement tasks.

11. Which system is most suggested by movement limited primarily by fear, guarding, or avoidance?

    psychosocial/behavioral factors affecting movement. Fear or avoidance behaviors can restrict movement without physical impairment, highlighting the role of psychological factors in functional analysis.

12. Identify the likely impairment if gait shows vaulting on the stance limb to clear swing limb.

    limited swing-limb clearance (often dorsiflexion deficit). Vaulting increases height on the stance side to aid swing-limb advancement, compensating for clearance deficits in gait patterns.

13. What impairment is most consistent with a positive Gower sign during floor-to-stand?

    proximal hip and trunk extensor weakness. Weak extensors impair upright rising; Gower sign involves using hands to 'climb' the body for mechanical advantage in floor-to-stand.

14. Identify the likely impairment if sit-to-stand requires pushing off armrests with both hands.

    lower-extremity strength deficit (hip/knee extensors). Pushing off armrests compensates for inadequate lower-extremity power generation needed for vertical lift in sit-to-stand transitions.

15. Identify the likely impairment if gait shows foot slap at initial contact to loading response.

    ankle dorsiflexor weakness (tibialis anterior). Dorsiflexors control foot descent; weakness results in uncontrolled plantarflexion at heel strike, producing a slap in gait analysis.

16. Which system is most suggested by ataxic, dysmetric, poorly coordinated movement?

    neurologic system (cerebellar control). Ataxia and dysmetria indicate cerebellar dysfunction, impairing coordination and precision in voluntary movements during task analysis.

17. Identify the likely impairment if a squat shows heels rising early in descent.

    limited ankle dorsiflexion (gastroc-soleus tightness). Tight plantarflexors restrict dorsiflexion, forcing early heel rise to maintain forward progression during squat descent.

18. Which observation best distinguishes a compensation from a fixed impairment during a task?

    Compensation changes with cueing; fixed impairment persists. Compensations are adaptable behaviors that can improve with verbal or tactile guidance, whereas fixed impairments remain unchanged due to structural limitations.

19. What is the most likely impairment when a patient cannot eccentrically control descent in sit-to-stand?

    lower-extremity eccentric weakness (often quadriceps). Eccentric control is crucial for controlled lowering; quadriceps weakness leads to uncontrolled descent in functional tasks like stand-to-sit transitions.

20. What term describes movement deviation caused by a pain response during a task?

    painful compensation. Pain triggers adaptive deviations to avoid discomfort, distinguishing it from other compensations or primary impairments in movement analysis.

21. Identify the likely impairment if gait shows knee hyperextension in midstance.

    quadriceps weakness or plantarflexor tightness/proprioceptive deficit. These factors lead to thrust into hyperextension to stabilize the knee passively during weight-bearing in stance phase of gait.

22. Identify the likely impairment if gait shows circumduction of the swing limb.

    reduced knee flexion and/or ankle dorsiflexion in swing. Limited flexion reduces ground clearance; circumduction provides an alternative path to advance the limb without dragging in swing phase.

23. What term describes a movement strategy that reduces demand on an impaired structure?

    compensation. It represents an adaptive strategy to maintain function despite underlying dysfunction, often modifiable with cues or interventions in physical therapy.

24. Which quick test best differentiates strength deficit versus balance deficit in single-leg stance?

    Add fingertip support; improved time suggests balance limitation. Minimal support reduces balance demands; improvement isolates balance as the limiting factor over pure strength in stance duration.

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