Physical Therapy Assistant Practice Exam

In assessing the muscle length of the iliopsoas in a male with low back pain, what is the most appropriate position for the testing?

1. Patient standing with weight evenly distributed

2. Patient lying prone with legs extended

3. Patient lying supine with the right hip flexed to the chest and the left leg extended

4. Patient seated with knees at 90 degrees

The correct answer is: Patient lying supine with the right hip flexed to the chest and the left leg extended

The best choice for assessing the muscle length of the iliopsoas in this scenario is for the patient to lie supine with one hip flexed to the chest while the opposite leg is extended. This position is particularly effective because it allows for isolation of the iliopsoas muscle, which is the primary hip flexor. When the hip is flexed to the chest on one side, it puts the iliopsoas on a stretch on the extended leg side, allowing for a clear assessment of its length. This positioning minimizes any potential compensatory movements from other muscle groups, providing a more accurate reflection of the iliopsoas muscle's flexibility and length. It also facilitates measurement techniques, such as the Thomas test, which specifically evaluates hip flexor tightness. Other positions, such as standing or lying prone, do not effectively isolate the iliopsoas and can involve other muscles, potentially leading to misleading results. The seated position with knees at 90 degrees does not accurately assess iliopsoas length either, as it keeps the hip flexors in a shortened position, thus not allowing for a proper length assessment. Each of these alternative positions may yield unreliable data regarding the muscle's length or tightness, making the supine position