National Physical Therapy Examination (NPTE) Practice Exam

Which exercise is most appropriate to start for a patient with patellofemoral dysfunction who is to receive only closed-chain kinematic exercises?

1. Short-arc quads

2. Wall slides

3. Isokinetic exercises with extension blocked at minus 10 degrees

4. Knee extensions on an exercise machine

The correct answer is: Wall slides

Beginning with closed-chain kinematic exercises for a patient with patellofemoral dysfunction is essential, as these exercises provide better weight-bearing stability and less abnormal shear force on the knee joint compared to open-chain exercises. Wall slides are particularly beneficial as they emphasize the recruitment of the quadriceps while maintaining an optimal level of knee flexion, which can improve patellar tracking and overall knee function. In wall slides, the patient remains upright against a wall while they slide down into a squat position and then back up. This position encourages proper alignment and loading through the entire kinetic chain, especially beneficial for individuals with patellofemoral pain. It also engages surrounding musculature, like the hip extensors and abductors, which supports the knee during movement. Other options may not be as favorable for addressing patellofemoral dysfunction specifically within the closed-chain framework. For example, short-arc quadriceps exercises are typically an open-chain exercise focused on the terminal knee extension, which might not be as effective for promoting proper patellar glide as closed-chain exercises. Isokinetic exercises with extension blocked at minus 10 degrees could limit the dynamic movement required to facilitate joint stability and loading in a functional range. Knee extensions on an exercise machine are classic examples of