National Physical Therapy Examination (NPTE) Practice Exam

What activity would be most difficult for a patient with 3/5 strength in the right subscapularis?

1. Extension of the GH joint

2. Elevation of right scapula

3. Flexion of humerus overhead

4. Performing a push-up with both upper extremities

The correct answer is: Flexion of humerus overhead

The difficulty level associated with an activity is primarily determined by the strength and functionality of the muscles involved in performing that activity. In this case, a patient has 3/5 strength in the right subscapularis, indicating that the patient has some strength but can only move against gravity without added resistance. The subscapularis is a key muscle in shoulder function, specifically involved in internal rotation and stabilization of the glenohumeral (GH) joint. When considering the activities listed, flexing the humerus overhead relies heavily on the coordinated activity of several muscles, including the deltoid and the rotator cuff muscles, among which the subscapularis plays a crucial role in stabilizing the joint during this motion. With only 3/5 strength, the patient's ability to perform this overhead activity becomes significantly compromised, as it requires full control and strength to avoid dislocation or excessive strain on the shoulder. In contrast, the extension of the GH joint and elevation of the right scapula are movements that may still be manageable despite the reduced strength of the subscapularis since these do not require as much stabilization from the subscapularis specifically. Additionally, performing a push-up involves the use of multiple