National Physical Therapy Examination (NPTE) Practice Exam

What information would be MOST helpful in determining the source of a patient's shoulder pain with decreased AROM?

1. Date of onset of the problems

2. Passive shoulder range of motion measures

3. Upper extremity deep tendon reflex measures

4. Manual muscle testing scores for the rotator cuff

The correct answer is: Passive shoulder range of motion measures

To determine the source of a patient's shoulder pain, especially when accompanied by decreased active range of motion (AROM), assessing passive shoulder range of motion (ROM) is particularly insightful. Passive ROM evaluates the joint's movement when the examiner moves the limb without the patient’s muscle effort, allowing for an assessment of the joint's integrity separate from the patient's ability to actively move due to pain or weakness. If passive motion is relatively normal, it may indicate that the primary issue resides within the muscle itself, rather than structural pathologies of the joint or surrounding tissues. Conversely, if both active and passive ROM are restricted, this may suggest a more significant issue, such as adhesive capsulitis or intra-articular pathology. In this context, while knowing the date of onset can provide background on the progression of the condition, it does not directly inform the clinician about the mechanics of the pain or movement restriction. Reflex measures can shed light on neurological involvement, but they don’t specifically address the shoulder's biomechanical function. Similarly, manual muscle testing provides insight into strength but does not directly help differentiate whether the problem is muscular, neurological, or related to joint structures. Therefore, assessing passive shoulder range of motion measures stands out as the most beneficial in pinpointing the source