Watch the video version of this episode on YouTube - https://youtu.be/H9AckItGTNw

A patient performs an exercise using a foam roller as depicted in the image. This exercise would MOST likely be used to improve a patient’s performance with which of the following functional activities?

1. Reaching to wash the opposite shoulder
2. Reaching overhead into a high cupboard
3. Reaching down to tie one’s shoes
4. Looking upward to shave one’s neck

Transcript

Welcome back to the Scorebuilders’ Question and Answer Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

Ready? Let’s go!

A patient performs an exercise using a foam roller as depicted in the image. This exercise would MOST likely be used to improve a patient’s performance with which of the following functional activities?

1. Reaching to wash the opposite shoulder
2. Reaching overhead into a high cupboard
3. Reaching down to tie one’s shoes
4. Looking upward to shave one’s neck

I would anticipate many questions like this on the NPTE, meaning an intervention is described using words, imagery or video and the therapist is then asked to identify the likely purpose or therapeutic objective. There are literally thousands of possible scenarios that could be encountered and therefore these questions tend to require decision making and careful analysis rather than memorization. 

In this particular case, the patient is incorporating the use of a foam roller.

Foam Rollers
Foam rollers are often employed to assist with self-stretching or self-mobilization techniques. In the depicted exercise, the foam roller is placed across the patient’s thoracic spine and the patient is performing thoracic extension against the foam roller.

Let’s explore each of the options.

Option 1 - Reaching to wash the opposite shoulder 
To reach the opposite shoulder, a patient would need adequate shoulder horizontal adduction range of motion. The depicted exercise using the foam roller is primarily used to improve thoracic extension range of motion and would therefore not assist a patient in trying to wash their opposite shoulder.

Option 2 - Reaching overhead into a high cupboard 
To reach overhead, a patient would need adequate shoulder flexion range of motion. However, having adequate thoracic extension range of motion would also be necessary since the thoracic spine extends as the patient reaches into end-range shoulder flexion. The depicted exercise which is used to improve thoracic extension mobility, would be beneficial in assisting a patient when reaching into a high cupboard.

Option 3 - Reaching down to tie one’s shoes
To reach down to tie one’s shoes, a patient would need adequate spinal flexion range of motion (thoracic and lumbar), as well as hip flexion range of motion. The depicted exercise using the foam roller would be used to improve spinal extension mobility, not flexion mobility.

Option 4 - Looking upward to shave one’s neck
To look upward, a patient would need adequate cervical extension range of motion. 

The depicted exercise shows a foam roller positioned across the thoracic spine and therefore it would primarily be used to improve thoracic extension range of motion, not cervical range of motion. Though some thoracic extension mobility may be necessary when extending the cervical spine, it would be relatively minor compared to the extent of thoracic extension needed when reaching overhead.

The correct answer is Option 2

Let’s explore the all student data:
4% of students selected Option 1, Reaching to wash the opposite shoulder
71% of students selected Option 2, Reaching overhead into a high cupboard, the correct response
4% of students selected Option 3, Reaching down to tie one’s shoes
21% of students selected Option 4, Looking upward to shave one’s neck

System Classification
This question is a Musculoskeletal Systems question which represents approximately 27% of all exam items.

Content Outline Classification
This question is an Interventions question which represents approximately 29% of all exam items.

Level Classification
This question is a Level 3 question since the question requires candidates to systematically analyze and often interpret information to determine an appropriate course of action. The questions tend to have some degree of subjectivity and candidates are required to assign varying degrees of importance to different variables.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!