National Physical Therapy Examination (NPTE) Practice Exam

What direction should be applied for joint mobilization in a patient with limited shoulder abduction due to adhesive capsulitis?

1. Anterior glide of the scapula on the humerus

2. Inferior glide of the humerus on the scapula

3. Superior glide of the humerus on the scapula

4. Posterior glide of the humerus on the scapula

The correct answer is: Inferior glide of the humerus on the scapula

The choice of inferior glide of the humerus on the scapula as the direction to facilitate shoulder abduction in a patient with adhesive capsulitis is based on the anatomy and biomechanics of the shoulder joint. In adhesive capsulitis, or frozen shoulder, there is a stiffness and limitation in the shoulder’s range of motion, particularly in abduction and external rotation due to the fibrosis of the shoulder capsule. When the arm is raised into abduction, the humeral head must move upward and outward. An inferior glide helps to create more room for the humeral head to move in the glenohumeral joint, allowing for an increase in the range of motion during abduction. This mobilization technique assists in decreasing the impingement that can occur due to the tight capsule and helps restore functional movement. Other options either do not facilitate the necessary movement or may not address the limitations caused by adhesive capsulitis effectively. Understanding the specific mechanics of the shoulder with regards to joint mobilization is crucial in providing appropriate treatment strategies.