A physical therapist evaluates a pediatric patient using the Modified Ashworth Scale. Which condition would LEAST benefit from the use of this tool?
 
1.      Hypotonia
2.      Hyperreflexia
3.      Spasticity
4.      Rigidity

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 physical therapist evaluates a pediatric patient using the Modified Ashworth Scale. Which condition would LEAST benefit from the use of this tool?
 
1.      Hypotonia
2.      Hyperreflexia
3.      Spasticity
4.      Rigidity

Warning!

The question states “LEAST benefit” meaning, which condition would not benefit from use of the Modified Ashworth Scale.

Modified Ashworth Scale

The Modified Ashworth Scale is a widely used qualitative scale for the assessment of increased tone (e.g., hypertonicity, spasticity). It measures the amount of resistance to passive stretch. Spasticity is not a primary condition, but a secondary effect from central nervous system damage. 

Let’s explore each of the options:

Option 1 – Hypotonia

Hypotonia is defined as a decrease in expected tension within a resting muscle or the amount of resistance to stretch that a resting muscle possesses. The Modified Ashworth Scale does not evaluate diminished tone. A grade of 0 indicates normal tone and a grade of 4 indicates rigidity found in flexion or extension of a body part.

Option 2 – Hyperreflexia

Hyperreflexia refers to hyperactive or clonic reflexes. Patients that exhibit hyperreflexia may also experience an increase in skeletal tone. Clinical assessment of hypertonicity will typically include use of the Modified Ashworth Scale, muscle grading, deep tendon reflexes, and range of motion evaluation.

Option 3 – Spasticity

Spasticity is a component of an upper motor neuron lesion, which is also characterized by exaggerated phasic (tendon jerks) and tonic (spastic) stretch reflexes that can occur after injury to the central nervous system.  The Modified Ashworth Scale is used to assess the degree of spasticity with assigning a grade of 0 to 4 based on resistance to passive motion.

Option 4 – Rigidity

Rigidity is a state of severe hypertonicity where a sustained muscle contraction does not allow for any movement at a specified joint. A patient that presents with rigidity would be evaluated with the Modified Ashworth Scale and receive a grade of 4.

The correct answer is Option 1.

Deductive Reasoning Strategies

If you lacked the necessary academic knowledge to answer this question correctly, you may have been able to increase the probability of identifying the correct option using deductive reasoning strategies. Option 2 hyperreflexia, Option 3 Spasticity, and Option 4 Rigidity all deal with increased tone, while Option 1 Hypotonia is characterized by decreased tone….Voila!

Don’t use deductive reasoning strategies when you possess the necessary academic knowledge to correctly answer a question. However, consider employing this strategy prior to random guessing.

Let’s explore the all student data:

51% of students selected Option 1 – Hypotonia – the correct response
36% of students selected Option 2 - Hyperreflexia
3% of students selected Option 3 - Spasticity
10% of students selected Option 4 - Rigidity
 
System Classification
This question is a Neuromuscular and Nervous Systems question which represents approximately 24% of all exam items.
 
Content Outline Classification
This question is a Physical Therapy Examination question which represents approximately 24% of all exam items.
 
Level Classification
This question is a Level 1 question since the question requires students to possess basic foundational academic knowledge. Remediation of Level 1 questions occurs through academic review of entry-level content using textbooks, review books, Basecamp, and flash cards.
 
Academic Focus Area
Looking to review related academic content? Check out page 274 in PTEXAM: The Complete Study Guide.
 
Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!