A physical therapist is beginning desensitization treatment for a patient with significant tactile hypersensitivity in the palm following carpal tunnel surgery. The patient describes light touch as irritating and has started avoiding hand use. Which of the following textures would be the MOST appropriate to use when initiating treatment?

1. A soft cotton T-shirt

2. A silk scarf

3. A bath towel

4. A paper towel

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.

Ready? Let's go!

A physical therapist is beginning desensitization treatment for a patient with significant tactile hypersensitivity in the palm following carpal tunnel surgery. The patient describes light touch as irritating and has started avoiding hand use. Which of the following textures would be the MOST appropriate to use when initiating treatment?

1. A soft cotton T-shirt

2. A silk scarf

3. A bath towel

4. A paper towel

Desensitization training

Desensitization training is a therapeutic approach used to alleviate hypersensitivity following peripheral nerve injuries, surgeries, or trauma. The goal is to gradually reintroduce sensory stimuli to help normalize the patient's sensory processing and reduce pain responses.

This question is asking you to identify the most appropriate texture to BEGIN desensitization treatment for someone with significant hypersensitivity. The key word here is "beginning" - we need to start with the least provocative stimulus and gradually progress to more challenging textures.

Let's explore each of the options:

Option 1 - A soft cotton T-shirt

Using a soft cotton T-shirt would be a good option for the early stages of desensitization training. However, while cotton T-shirts are relatively soft, they do have a distinct texture. If you run your fingers across a cotton T-shirt, you can feel the weave pattern. For someone with significant hypersensitivity who finds even light touch irritating, this might be too much stimulation to start with.

Option 2 - A silk scarf

Silk provides the smoothest and least irritating tactile input. It has minimal friction against the skin and provides a very gentle tactile input. This makes it an ideal starting point for someone with severe hypersensitivity.

Option 3 - A bath towel

Have you ever dried off with a new bath towel? Even the softest ones have a relatively rough texture compared to clothing fabrics. A bath towel would be too coarse of a stimulus for initial use with desensitization training. Its thicker fibers and rougher surface may cause discomfort at this early stage of therapy. 

Option 4 - A paper towel

Though not as rough as a bath towel, paper towels can have an abrasive, scratchy texture that may trigger discomfort in sensitive areas. They also tend to break down or crumble, which can further irritate the skin. Like the bath towel, this would be too intense for the initial stages of treatment. 

Remember, with desensitization, we always want to start with the least provocative stimulus and gradually progress to more challenging ones. We want the patient to experience success, not more pain!

The correct answer is Option 2.

Let's explore the all student data:
20% of students selected Option 1 - A soft cotton T-shirt
 70% of students selected Option 2 - A silk scarf 
 5% of students selected Option 3 - A bath towel
 5% of students selected Option 4 - A paper towel

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 an Intervention question which represents approximately 28% of all exam items.

Level Classification
This question is a Level 2 question since the question requires students to integrate numerous pieces of information or to apply knowledge in a given clinical scenario. Remediation of Level 2 questions occurs by increasing flexibility with academic content and by carefully analyzing decision making processes when answering applied examination questions.

Academic Focus Area
Looking to review related academic content? Check out page 527 in PTEXAM: The Complete Study Guide.

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