National Physical Therapy Examination (NPTE) Practice Exam

During early rehabilitation after a type II SLAP repair, what is the best intervention for the patient?

1. Focus on biceps brachii stretching and strengthening

2. Defer intervention during the maximum protection phase

3. Perform careful range of motion of shoulder internal rotators

4. Perform careful range of motion of shoulder external rotators

The correct answer is: Perform careful range of motion of shoulder internal rotators

In the early rehabilitation phase after a type II SLAP repair, performing careful range of motion of shoulder internal rotators is appropriate, as it helps to protect the surgical repair while promoting mobility. This phase, often referred to as the maximum protection phase, involves protecting the healing tissue and gradually increasing range of motion without overloading the shoulder joint. Focusing on biceps brachii stretching and strengthening could place undue stress on the repaired structure too early in the rehabilitation process. The biceps tendon is closely associated with the labrum, and aggressive strengthening or stretching of this muscle can risk re-injury or complications. Deferring intervention entirely during the maximum protection phase is not beneficial. While it is essential to prioritize protection initially, some form of gentle mobilization should be implemented to prevent stiffness and maintain joint function. Careful range of motion of shoulder external rotators is also involved in shoulder rehabilitation, but in this phase, internal rotation might be more critical as it generally allows for a less stressful movement pattern and better protection of the surgical site while still enabling some degree of motion. In summary, emphasizing controlled range of motion exercises primarily targeting internal rotators after a type II SLAP repair facilitates healing and maintains mobility, setting a solid foundation for subsequent rehabilitation phases.