You are the lead PT on a rehab floor today. Three patients are waiting. A college soccer player two weeks out from ACL reconstruction. An office worker recovering from a rotator cuff repair. An older adult relearning to walk after a stroke. Each has a different diagnosis, different precautions, and a different finish line — and they're all on your caseload.
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Patient A
Dx: ACL Reconstruction · Post-op Week 2 Age: 19 · College soccer Goal: Return to sport
Dx: CVA with L Hemiparesis · Week 6 Age: 71 · Lives with spouse Goal: Walk household distances
BRIEFING
This capstone draws from Labs 1 and 2. You'll evaluate, dose interventions, track progress, and clear each patient through the right phase of rehab. Hit START LAB when you're ready — the timer will run for 30 minutes.
📖 HOW TO USE THIS LAB (read before starting)
Part 1 — Foundations: Read the passage, then study the vocabulary cards (one at a time, 8-second auto-flip). Click each card as many times as you need. Finish the matching game for 10 points.
Part 2 — Reading the Goniometer: Learn the parts of a goniometer, then take 3 practice measurements and 9 quick questions. Worth 18 points and unlocks the patient simulations.
Patients A, B, C: You are the PT. For each patient, work through 3 sessions: 📐 Measure with the goniometer + clinical scales, 📋 Plan the exercises + gait equipment + modalities, then ▶ Implement & Advance to the next session. A good plan = good progression. A risky plan = setback. Each patient ends with 5 quiz questions.
Data Analysis: Read the chart of all 3 patients, answer 5 questions.
Battle Boss: Five categories × five values × 25 questions. Worth 25 points.
Summary + Print: Auto-graded final score. Print to PDF and submit.
🔒 Your work is auto-saved. If the browser closes or the period ends, just sign back in with the same name and period and click "Resume."
PART 1 — Foundations of Phased Rehab READING + VOCAB
Reading: How a PT Thinks in Phases
Physical therapy after surgery or a neurological event is almost never one workout repeated for weeks. It is a phased progression — protect the healing tissue first, restore range of motion, rebuild strength, then layer in the demands of real life. A PT who moves too fast can rupture a graft. A PT who moves too slow leaves a patient stiff, weak, and frustrated. The skill is reading the patient in front of you and choosing the next dose: not too much, not too little.
Every patient — whether they tore an ACL, had a shoulder repaired, or survived a stroke — passes through phases. The acute phase protects the injury, controls swelling, and manages pain. The subacute phase restores motion and gentle strength. The strengthening phase rebuilds capacity. The return-to-function phase tests whether the patient can do what their life requires — sprint, lift overhead, climb stairs, walk the dog. The names change between diagnoses, but the logic is the same.
Two more ideas thread through everything. Contraindications are things you must not do — like resisted external rotation in the first six weeks after a rotator cuff repair. Precautions are things you must do carefully — like avoiding deep knee flexion under load early after ACL reconstruction. Knowing the precaution list for a diagnosis is half of being a safe PT.
Vocabulary — Tap one card at a time (8-second auto-flip back, but you can re-open any card)
Matching Practice — Click a term, then click its definition
Matching score: 0 / 10
PART 2 — Reading the Goniometer TUTORIAL · 18 PTS
What is a Goniometer?
A goniometer is the most-used tool in a PT's pocket. It looks like a protractor with two arms, and it measures how far a joint can move. Before you can plan rehab for Marcus, Diane, or Mr. Ortega, you have to be able to measure them — and that means knowing how to read a goniometer.
A goniometer has three parts: a fulcrum (the round center, placed over the joint axis), a stationary arm (lined up with one body segment that doesn't move), and a moving arm (lined up with the body segment that does move). The angle between them — read off the protractor face — is the joint's range of motion at that instant.
The number you read is relative to anatomical zero. Knee at 0° means fully straight. Knee at 90° means bent at a right angle (like sitting in a chair). Knee at 135° is deeply bent (like a deep squat). PTs typically measure to the nearest 5°. Two PTs measuring the same patient should land within about ±5° of each other — that's the standard for "good agreement."
Anatomy of the Tool — Click LOCK after Aligning
HOW TO READ
Place the fulcrum over the joint axis.
Line up the stationary arm with the body segment that does not move (for the knee, this is the femur/thigh).
Line up the moving arm with the segment that does move (for the knee, this is the tibia/shin).
Read where the moving arm crosses the degree scale.
Record to the nearest 5° (good agreement is ±5°).
This image is an example — the moving arm is at ~45°. Try the practice goniometers below.
Practice 1 — Beginner: Knee at a small angle 3 PTS
The patient's knee is bent. Drag the green handle to align the moving arm with the gray "shin" line, then click LOCK. You get 3 pts for ±3°, 2 pts for ±5°, 1 pt for ±10°.
DIAL: 0°
⏱ Not recorded yet
JOINT: Knee · Stationary arm = thigh · Moving arm = shin
Practice 2 — Intermediate: Knee bent further 3 PTS
Same procedure — align the moving arm to the patient's shin, then lock.
DIAL: 0°
⏱ Not recorded yet
JOINT: Knee · Stationary arm = thigh · Moving arm = shin
Practice 3 — Advanced: Shoulder flexion 3 PTS
Now you're measuring a different joint. The procedure is identical — align stationary arm to torso, moving arm to upper arm/humerus.
DIAL: 0°
⏱ Not recorded yet
JOINT: Shoulder · Stationary arm = torso · Moving arm = upper arm
Practice Score: 0 / 9
Knowledge Check 9 QUESTIONS · 1 PT EACH
Answer all 9 questions about reading and using a goniometer.
Quiz Score: 0 / 9
PATIENT A — ACL Reconstruction POST-OP WEEK 2
⚽
Marcus, 19
Dx: R ACL reconstruction (BTB autograft), 14 days post-op HPI: Non-contact pivot injury during preseason soccer Precautions: No open-chain knee extension 30°→0° under load × 12 weeks. Brace locked 0° for ambulation. Goal: Return to soccer at 9 months Today's exam: Knee ROM 5°–95°, quad lag present, effusion 2+, gait with crutches PWB
Reading: The First 12 Weeks After ACL Reconstruction
The graft is at its weakest between weeks 4 and 8 — it has to remodel. Early rehab prioritizes swelling control, restoring full knee extension (a stiff knee is harder to fix than a weak one), and waking up a quadriceps muscle that the brain has essentially turned off. As effusion drops and ROM returns, we add closed-chain strengthening — squats, leg press, step-ups — because closed-chain loading is graft-protective. Late phase introduces plyometrics and sport-specific cutting once strength and proprioception meet benchmarks (typically ≥90% limb symmetry index on hop tests).
🎯 TODAY'S OBJECTIVE FOR PATIENT A
You are Marcus's PT for the next 12 weeks. Across 3 sessions (Weeks 2, 6, 12) you will:
📐 EVALUATE — Use the goniometer to measure his knee flexion, then record effusion, pain, strength, and a functional test.
📋 PLAN — Choose appropriate exercises, gait equipment, and modalities for this phase of his rehab.
▶ IMPLEMENT — Click "Advance" and see how Marcus responds at the next session. A bad plan = limited progress. A good plan = expected recovery.
Answer 5 clinical reasoning questions about his case.
Interactive Treatment Tracker — 3 Sessions
How to measure: The goniometer's green moveable arm starts horizontal. The patient's actual knee position is shown in gray on the protractor. Drag the green handle until it aligns with the gray line, read the angle, and click LOCK FLEXION to record it. Then complete the rest of the evaluation, choose a plan, and advance.
Plan Quality: 0 / 5Measurement Accuracy: 0 / 4
Clinical Reasoning 5 QUESTIONS
Score: 0 / 5
PATIENT B — Rotator Cuff Repair POST-OP WEEK 4
💼
Diane, 52
Dx: R supraspinatus repair (small tear), 4 weeks post-op HPI: Insidious onset shoulder pain × 9 months, MRI confirmed full-thickness tear Precautions: Sling × 6 weeks. No active shoulder elevation × 6 weeks. No resisted ER × 12 weeks. Goal: Pain-free overhead reach (job is desk-based but she lifts grandkids) Today's exam: PROM flex 110°, PROM ER 30°, no active elevation cleared yet
Reading: The Healing Curve of a Repaired Cuff
A rotator cuff repair is held together by sutures and biology. For the first six weeks, the tendon-to-bone interface is the slowest tissue in the body to heal — and the easiest to disrupt. PTs use a sling, avoid active elevation, and start with pendulums and passive range only. As healing progresses we layer in AAROM (active-assisted range of motion — the patient does some of the work, gravity or a pulley helps), then isolated isometrics, then resisted strengthening. External rotation against resistance is contraindicated early because it directly loads the repaired tendon. Patients who push too hard re-tear; patients who don't push enough get a stiff shoulder. The art is choosing the next step at the right week.
🎯 TODAY'S OBJECTIVE FOR PATIENT B
You are Diane's PT for the next 12 weeks. Across 3 sessions (Weeks 4, 8, 12) you will:
📐 EVALUATE — Use the goniometer to measure her shoulder PROM flexion, then record AROM, pain, and functional reach.
📋 PLAN — Choose phase-appropriate exercises, sling/support status, and modalities. Resisted external rotation is contraindicated until Week 12.
▶ IMPLEMENT — Advance to the next session. Inappropriate plans = re-tear risk.
Answer 5 clinical reasoning questions about her case.
Interactive Treatment Tracker — 3 Sessions
How to measure shoulder flexion: The static cyan arm represents Diane's torso. The gray line shows where her upper arm currently is. Drag the green moving arm to align with the gray arm, read the angle, and LOCK.
Plan Quality: 0 / 5Measurement Accuracy: 0 / 4
Clinical Reasoning 5 QUESTIONS
Score: 0 / 5
PATIENT C — CVA with Left Hemiparesis WEEK 6 POST-STROKE
🚶
Mr. Ortega, 71
Dx: R MCA ischemic stroke, 6 weeks ago. L hemiparesis. HPI: Found by wife with L-sided weakness. tPA within window. Now home with home health PT. Exam: L UE: Brunnstrom Stage 3 · L LE: Stage 4 · Gait: hemi-walker, foot-drop on L FIM: Mobility 4/7 (modified independent) · Functional goals: walk to mailbox, transfer toilet without help Goal: Household ambulation 50 ft with single-point cane, no falls
Reading: Relearning to Move After a Stroke
A stroke isn't a muscle problem — it's a brain problem that looks like a muscle problem. The muscles work; the brain has forgotten how to recruit them. PT for a stroke patient relies on neuroplasticity: the brain rewires when it is challenged with the right task, the right number of times. We call this task-specific training. If the goal is walking, you walk — repeatedly, with feedback, in increasing complexity. Hemiparesis (one-sided weakness) often comes with foot drop, which a PT addresses with an AFO (ankle-foot orthosis), and with a spastic tone pattern that has to be managed rather than ignored. Balance training and gait training with assistive devices reduce fall risk. Neuromuscular re-education retrains how the brain talks to the limb. The FIM score (Functional Independence Measure) tracks how much help the patient still needs.
🎯 TODAY'S OBJECTIVE FOR PATIENT C
You are Mr. Ortega's home-health PT for the next 18 weeks. Across 3 sessions (Weeks 6, 10, 16) you will:
📐 EVALUATE — Use the goniometer to measure his L ankle dorsiflexion (the joint that drives foot drop), then record FIM, walk time, Berg balance, and falls.
📋 PLAN — Choose neuroplasticity-driving exercises, the right gait equipment for his current ability, and adjuncts like an AFO. Plyometrics is a fall risk — don't.
▶ IMPLEMENT — Advance to the next session.
Answer 5 clinical reasoning questions about his case.
Interactive Treatment Tracker — 3 Sessions
How to measure ankle dorsiflexion: Static cyan arm = the tibia (lower leg). Gray line = where his foot currently is. Normal dorsiflexion is ~20°. Foot drop = 0° or less. Drag the green arm to align with the gray foot line, then LOCK.
Plan Quality: 0 / 5Measurement Accuracy: 0 / 4
Clinical Reasoning 5 QUESTIONS
Score: 0 / 5
PART 7 — Data Analysis Across Patients CHART + 5 QUESTIONS
Below is a comparison of each patient's primary functional score across rehab. Use it to answer the questions.
Score: 0 / 5
BATTLE BOSS — Jeopardy of the PT Labs 25 QUESTIONS · 25 PTS
Five categories. Five questions per category. Tap a value to play it. Each correct = 1 point added to your final score.
Battle Boss Score: 0 / 25
CATEGORY
$100
LAB SUMMARY GRADE REPORT
0%FINAL GRADE · 0 / 100
Have your teacher initial your printout if required.