National Physical Therapy Examination (NPTE) Practice Exam

During neurodynamic mobility exercises, if a patient reports increased neural symptoms, how should the therapist respond?

1. Explain that this sensation is normal and continue working in the same range

2. Refer the patient back to the orthopedic physician

3. Explain that this sensation is abnormal and decrease the range used

4. Re-evaluate and determine if there is a different source of their pain

The correct answer is: Explain that this sensation is abnormal and decrease the range used

When a patient reports increased neural symptoms during neurodynamic mobility exercises, responding by explaining that this sensation is abnormal and decreasing the range used is appropriate. Increased neural symptoms, such as tingling, numbness, or sharp pain, typically indicate that the neural tissues are being irritated or stressed beyond their current tolerance level. By explaining that the sensation is abnormal, the therapist acknowledges the patient's experience, reinforcing the importance of listening to and monitoring their body's responses. Decreasing the range of motion used allows the therapist to adjust the exercise to a more tolerable level for the patient, aiming to avoid exacerbation of symptoms. This approach prioritizes patient safety and comfort, ensuring the therapeutic environment remains conducive to healing while still allowing for progress in mobility exercises. In this context, continuing to work in the same range could risk further irritation of the neural tissues, which is not advisable. Referring the patient back to the orthopedic physician or considering a different source of pain may also be appropriate actions, but they do not directly address the immediate concern of increased symptoms during the exercises. Thus, adjusting the exercise by reducing the range and reinforcing that the sensations experienced are not typical contributes to a more effective and patient-centered therapeutic approach.