National Physical Therapy Examination (NPTE) Practice Exam

After one round of serial casting, what is the MOST likely expected increase in range of motion for a patient lacking 40 degrees of elbow extension post tendon repair?

1. 5 degrees

2. 15 degrees

3. 25 degrees

4. 35 degrees

The correct answer is: 5 degrees

Following one round of serial casting, an increase in range of motion is typically observed, but the amount varies based on several factors, including the severity of the contracture and the duration and consistency of the casting. In cases where a patient is significantly limited in elbow extension, as indicated by the 40 degrees deficit post tendon repair, a modest gain is expected for the initial phase of treatment. The correct answer reflects a conservative expectation of improvement, which is often the case in rehabilitation. With proper casting, it is common to see around a 5-degree increase in range of motion following the first application. This gradual approach allows for gradual tissue remodeling and minimizes the risk of further damage to softened tissues. The selected option aligns with clinical observations indicating that while significant gains might be anticipated in subsequent rounds of casting, the first increment tends to be limited due to the need for caution as the tissues begin to adapt. In contrast, the other options suggest larger increases in range of motion, which may not be realistic for just one round of serial casting. Patients often achieve more substantial improvements over time, but the acute phase, influenced by factors such as inflammation and tissue quality, typically results in smaller increments of motion.