College of Massage Therapists of British Columbia (CMTBC) Practice Exam

During the assessment of a patient with acute rheumatoid arthritis, how can the therapist safely evaluate functional limitations in the hands?

1. Perform a paper pinch test

2. Ask about ability to button clothing and handwrite

3. Perform ligamentous stress tests on fingers

4. Assess passive range of motion with overpressure

The correct answer is: Ask about ability to button clothing and handwrite

Evaluating functional limitations in the hands of a patient with acute rheumatoid arthritis should prioritize the patient's comfort and safety, especially considering the pain and swelling often associated with this condition. Asking about the ability to perform everyday tasks, such as buttoning clothing and handwriting, provides valuable insight into the patient's functional capabilities without exerting undue pressure on their joints or causing additional pain. This approach is effective because it focuses on the patient's self-reported abilities, which are often affected during an acute phase of rheumatoid arthritis. An inquiry into these specific activities can reveal the extent of functional limitation while also considering the patient's experience of pain and overall joint status. In contrast, other methods, such as performing stress tests or assessing range of motion with overpressure, may cause discomfort and exacerbate the inflammatory condition of the joints, making them less suitable for this scenario.