National Physical Therapy Examination (NPTE) Practice Exam

A patient is encouraged to perform shoulder active range of motion (AROM) in a pain-free range while avoiding flexion greater than 90 degrees. Which of the following surgeries associates most with this prescribed exercise regimen?

1. Coronary artery bypass graft

2. Angiogram

3. J-tube insertion

4. Thoracotomy

The correct answer is: Coronary artery bypass graft

The prescribed exercise regimen of performing shoulder active range of motion (AROM) while avoiding flexion greater than 90 degrees is most closely associated with post-operative recovery following a thoracotomy. This type of surgery involves the opening of the chest wall to access the lungs or heart, which can lead to significant restrictions in upper body movement, particularly shoulder flexion. Patients who have undergone a thoracotomy often experience shoulder stiffness and discomfort due to the surgical approach and the positioning during the procedure. Rehabilitative strategies typically emphasize maintaining range of motion while avoiding extreme positions that could strain the surgical site or surrounding musculature. Therefore, encouraging AROM in a pain-free range while limiting flexion avoids exacerbating any post-surgical pain and promotes safe recovery. In contrast, the other options listed do not typically involve similar restrictions on shoulder movement or are not directly related to shoulder mobility protocols following surgery. For example, coronary artery bypass grafts focus on cardiac rehabilitation rather than shoulder motion, while angiograms and J-tube insertions do not involve extensive upper body manipulation or movement restrictions post-procedure.