National Physical Therapy Examination (NPTE) Practice Exam

Post CVA, which therapeutic position would be most challenging for a patient with right hemiplegia to maintain?

1. Half-kneel with involved leg anterior

2. Half-kneel with involved leg posterior

3. Bilateral tall kneeling

4. Bilateral lower extremity bridge

The correct answer is: Half-kneel with involved leg posterior

In this scenario, the most challenging position for a patient with right hemiplegia to maintain is half-kneel with the involved leg positioned posterior. When a patient has right hemiplegia, it means that the right side of their body is significantly affected, including the right leg. Placing the involved leg in a posterior position during half-kneeling demands considerable stability and strength in the involved leg to maintain balance. This position may create difficulty as the body weight shifts onto the right leg, which may not have sufficient strength or control due to the effects of the CVA (cerebrovascular accident). The posterior placement introduces a greater challenge, as it requires the patient to stabilize themselves using the weaker side while potentially leaning away from it for balance. The ability to maintain an upright posture can be compromised, leading to instability and the potential for falls. On the other hand, half-kneeling with the involved leg in an anterior position tends to offer more support since the stronger leg bears more weight. Bilateral tall kneeling and bilateral lower extremity bridge positions also provide a more stable base of support as they engage both legs equally, allowing for better balance and control compared to the posterior half-kneeling position.