When evaluating a patient with an active nasoenteric tube, which activity should be AVOIDED?

• A. Gait assessment in the hallway
• B. Sensation testing with the bed raised to improve ergonomic positioning for the therapist
• C. Manual muscle testing with the head of the bed at 0°
• D. Gait assessment using axillary crutches

Answer: (C)

When a patient has an active nasoenteric tube, the priority is movements and positions that keep the tube secure and avoid dislodgement or aspiration. The neck and abdomen are sensitive to strain, coughing, or heavy bearing down, which can accidentally pull on the tube or increase pressure that could affect its course.

Manual muscle testing with the head of the bed at 0 degrees should be avoided because it prompts maximal effort and potential Valsalva-like bracing in a flat position. That combination can increase intra-abdominal and intrathoracic pressures and encourage tube movement or dislodgement, along with patient discomfort. Keeping the bed properly elevated and avoiding strenuous trunk or abdominal maneuvers reduces these risks.

Other activities can be performed with appropriate precautions—ensure the tube is well secured, monitor for discomfort, and avoid pulling on the tube during any activity. This includes gait assessment with secure tubing or gait using assistive devices, and sensation testing with attention to tube management and patient safety.