National Physical Therapy Examination (NPTE) Practice Exam

What classification stage is indicated by flexion synergy patterns and excessive spasticity in a patient post-CVA?

1. Shoulder ER, ABD, elbow and wrist flexed, and forearm supinated; Stage III

2. Shoulder IR, ADD, elbow and wrist flexed, and forearm supinated; Stage III

3. Shoulder ER, ABD, elbow and wrist extended, and forearm pronated; Stage IV

4. Shoulder IR, ABD, elbow and wrist flexed and forearm pronated; Stage V

The correct answer is: Shoulder ER, ABD, elbow and wrist flexed, and forearm supinated; Stage III

The indicated classification stage characterized by flexion synergy patterns and excessive spasticity in a patient post-cerebrovascular accident (CVA) corresponds with the description showing shoulder external rotation (ER), abduction (ABD), elbow and wrist flexed, and forearm supinated. This presentation aligns with stage III of the Brunnstrom stages of motor recovery. In this stage, patients typically demonstrate significant spasticity and are beginning to exhibit more complex movement patterns. The shoulder's external rotation and abduction suggest that the limb is in a more functional position, yet the presence of flexion synergy indicates that the movement patterns are still influenced by spasticity and lack of voluntary control. Understanding the relationship between these clinical presentations and Brunnstrom's stages is critical in guiding rehabilitation strategies and establishing recovery expectations for patients post-CVA. The other options describe different positions or stages that do not adequately represent the flexion synergy and spasticity noted in the scenario, thus confirming the validity of the selected stage.