National Physical Therapy Examination (NPTE) Practice Exam

What is the best modification for a patient with gastroesophageal reflux disease who cannot lie on their back during exercises?

1. Modify the supine position to right side-lying

2. Modify exercises to include light jogging and avoid lying down

3. Encouraging the patient to eat a heavy snack before exercise

4. Performing exercise with the patient before eating

The correct answer is: Performing exercise with the patient before eating

For a patient with gastroesophageal reflux disease (GERD) who cannot lie on their back during exercises, performing exercise before eating is the best modification. This approach minimizes the risk of reflux symptoms, as exercising on a full stomach can increase abdominal pressure and exacerbate GERD symptoms. Engaging in physical activity before meals allows the patient to exercise without the concern of discomfort or symptoms that may arise from having food in the stomach while engaging in movement. The other options present considerations that may not be suitable for managing GERD effectively. Modifying the supine position to right side-lying might help alleviate some reflux symptoms compared to lying flat on the back, but might still not eliminate the risk entirely if the patient is still engaging in positions that require lying down. Light jogging avoids lying down, but it is not as beneficial as completing exercises before meals, as jogging could still cause discomfort if the patient has eaten recently. Lastly, encouraging the patient to eat a heavy snack before exercise would likely lead to increased symptoms of reflux, since the act of eating can already predispose individuals to discomfort when exercising. Thus, exercising on an empty stomach prior to meals is the most effective strategy to reduce the likelihood of triggering GERD symptoms during physical activity.