National Physical Therapy Examination (NPTE) Practice Exam

A patient comes to the clinic with tightness of lumbricals. To stretch these muscles, the physical therapist needs to:

1. Flex the wrist

2. Flex the wrist and MCP joints

3. Extend MCP and flex IP joints

4. Flex MCP and extend IP joints

The correct answer is: Extend MCP and flex IP joints

To effectively stretch the lumbrical muscles, flexing the metacarpophalangeal (MCP) joints while extending the interphalangeal (IP) joints is the appropriate approach. The lumbricals originate from the flexor digitorum profundus tendons and insert into the extensor expansion on the dorsal side of the proximal phalanx. Their primary function is to flex the MCP joints while extending the IP joints when the fingers are in a neutral or slightly extended posture. By flexing the MCP joints and extending the IP joints, the lumbricals are placed in a lengthened position, allowing for an effective stretch. This specific positioning facilitates a maximal stretch of the muscle fibers, which is important for improving flexibility and reducing tightness. Other options do not provide the correct alignment for effectively stretching the lumbricals. For example, simply flexing the wrist or both the wrist and MCP joints does not target the lumbricals adequately. Additionally, flexing the MCP joints while extending the IP joints creates a position that could shorten the lumbricals rather than stretch them.