Certified Hand Therapist (CHT) Practice Exam

Paradoxical extension occurs when what action is performed?

1. Making a fist and experiencing finger extension

2. Extending the fingers with resistance at the wrist

3. Flexing at the PIP while attempting to make a fist

4. Opening the hand rapidly

The correct answer is: Making a fist and experiencing finger extension

Paradoxical extension refers to a phenomenon where an action intended to promote flexion of the fingers instead results in unintended extension. This typically occurs due to the complex interplay of musculotendinous and neural control over the hand’s muscles and joints. In the case of making a fist, the expectation is that the fingers should flex; however, due to issues such as nerve injuries or muscle imbalances, the fingers may instead extend. This can happen when the intrinsic muscles of the hand are compromised, causing the extrinsic extensors to dominate the movement when an attempt is made to flex. Such a scenario can be observed in certain pathologies or conditions affecting hand function. The other options presented involve actions that either do not specifically result in paradoxical extension or do not align with the physiological principles governing this particular phenomenon.