Physical Therapy Practice Examination 2026–2027
Physical Therapy Practice Examination 2026–2027
Musculoskeletal, Neurological & Rehabilitation Systems
Section 1: Musculoskeletal System
Question 1
A 52-year-old male presents with right shoulder pain and limited active abduction. Passive range of
motion reveals pain at 110° of abduction, and the Hawkins-Kennedy test reproduces his symptoms.
Which diagnosis is MOST consistent with this presentation?
A. Glenohumeral osteoarthritis
B. Adhesive capsulitis
C. Subacromial impingement syndrome
D. Full-thickness rotator cuff tear
Correct Answer: C
Detailed Rationale:
The classic presentation of subacromial impingement includes a painful arc during mid-range abduction
(typically 60°–120°) and a positive Hawkins-Kennedy test, which compresses the supraspinatus tendon
beneath the coracoacromial arch. The positive impingement sign specifically reproduces pain by
narrowing the subacromial space.
Why the Other Options Are Incorrect:
A. Glenohumeral osteoarthritis: This condition typically presents with global stiffness, crepitus, and
radiographic joint space narrowing. A focal painful arc with a positive impingement sign is not characteristic.
B. Adhesive capsulitis: This condition produces global restriction of both active and passive motion, especially
external rotation. The described patient has preserved passive motion except at the painful arc, arguing
against capsular restriction.
D. Full-thickness rotator cuff tear: This would typically present with significant weakness in abduction or
external rotation, often with a positive drop arm test. The scenario describes pain-limited motion without
marked weakness.
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Question 2
A 28-year-old soccer player sustains a knee injury during a cutting maneuver. The Lachman test
demonstrates increased anterior translation with a soft end-feel. Which structure is MOST likely
injured?
A. Posterior cruciate ligament
B. Anterior cruciate ligament
C. Medial collateral ligament
D. Lateral meniscus
Correct Answer: B
Detailed Rationale:
The Lachman test assesses anterior translation of the tibia relative to the femur and is highly sensitive
and specific for anterior cruciate ligament (ACL) disruption. A soft end-feel indicates loss of ligamentous
integrity.
Why the Other Options Are Incorrect:
Musculoskeletal, Neurological & Rehabilitation Systems
, Physical Therapy Practice Examination 2026–2027
A. Posterior cruciate ligament: PCL integrity is assessed via the posterior drawer test or posterior sag sign,
which evaluate posterior tibial translation.
C. Medial collateral ligament: MCL integrity is assessed via valgus stress testing at 20°–30° of knee flexion.
D. Lateral meniscus: Meniscal pathology is assessed via McMurray or Thessaly tests, which provoke
mechanical symptoms rather than ligamentous laxity.
───────────────────────────────────────────────────────────────────────────────────────────────
Question 3
A patient is 6 weeks status post anterior cruciate ligament reconstruction. Which consideration is MOST
critical during this phase of rehabilitation?
A. The graft is at its weakest point due to remodeling
B. Aggressive plyometric training should be initiated
C. Return to full competitive sport is appropriate
D. Deep squatting should be performed daily
Correct Answer: A
Detailed Rationale:
The 6-week postoperative period corresponds to the early remodeling phase of graft healing, during
which the graft undergoes revascularization and structural reorganization, making it biomechanically
weakest. Rehabilitation must balance controlled loading with protection of the graft.
Why the Other Options Are Incorrect:
B. Aggressive plyometric training: Plyometrics impose high tensile and shear loads inappropriate during the
graft remodeling phase; they are introduced much later (typically 4–6 months).
C. Return to full competitive sport: Return to sport typically requires 9–12 months and depends on strength,
functional, and psychological readiness criteria.
D. Deep squatting: Deep knee flexion creates high anterior shear forces on the ACL graft and is generally
restricted during early remodeling.
───────────────────────────────────────────────────────────────────────────────────────────────
Question 4
A 45-year-old female presents with insidious onset of right lateral hip pain that worsens when lying on
the affected side and when climbing stairs. Palpation reveals tenderness over the greater trochanter.
Which condition is MOST likely?
A. Femoroacetabular impingement
B. Greater trochanteric pain syndrome
C. Lumbar radiculopathy
D. Adductor strain
Correct Answer: B
Detailed Rationale:
Greater trochanteric pain syndrome encompasses gluteal tendinopathy and trochanteric bursitis. The
hallmark features are point tenderness over the greater trochanter and pain exacerbated by side-lying
and weight-bearing activities such as stair climbing.
Why the Other Options Are Incorrect:
A. Femoroacetabular impingement: This typically presents with anterior groin pain, pain with deep hip flexion
and internal rotation, and a positive FADIR test.
Musculoskeletal, Neurological & Rehabilitation Systems
, Physical Therapy Practice Examination 2026–2027
C. Lumbar radiculopathy: This would present with radiating symptoms in a dermatomal pattern, often below
the knee, with positive neural tension signs.
D. Adductor strain: This presents with medial thigh/groin pain and tenderness at the adductor origin,
worsened by resisted adduction.
───────────────────────────────────────────────────────────────────────────────────────────────
Question 5
Which gait deviation is MOST commonly associated with weakness of the gluteus medius?
A. Steppage gait
B. Trendelenburg gait
C. Festinating gait
D. Antalgic gait
Correct Answer: B
Detailed Rationale:
The gluteus medius stabilizes the pelvis during single-leg stance. Weakness results in a Trendelenburg
sign—the pelvis drops on the contralateral, unsupported side—and a compensatory ipsilateral trunk
lean during ambulation.
Why the Other Options Are Incorrect:
A. Steppage gait: Results from dorsiflexor weakness (e.g., peroneal nerve injury), causing excessive hip and
knee flexion to clear the toes.
C. Festinating gait: Characteristic of Parkinson’s disease, with small, shuffling steps and progressive
acceleration.
D. Antalgic gait: Results from pain, with decreased stance time on the affected limb; it is not specific to
gluteus medius weakness.
Section 2: Neurological System
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Section 2: Neurological System
───────────────────────────────────────────────────────────────────────────────────────────────
Question 6
A patient presents with right-sided hemiparesis following a middle cerebral artery stroke. During
examination, the patient exhibits flaccidity with no voluntary movement in the right upper extremity.
According to the Brunnstrom Stages of Motor Recovery, which stage is this patient in?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV
Correct Answer: A
Detailed Rationale:
Brunnstrom Stage I is characterized by flaccidity and absence of voluntary movement following the
initial shock phase of stroke. This is the starting point of the motor recovery continuum.
Why the Other Options Are Incorrect:
B. Stage II: Presence of spasticity and emerging synergies, with minimal voluntary movement.
C. Stage III: Spasticity peaks, and voluntary movement occurs primarily within flexor or extensor synergies.
Musculoskeletal, Neurological & Rehabilitation Systems
, Physical Therapy Practice Examination 2026–2027
D. Stage IV: Spasticity begins to decline, and some movement combinations outside of synergy patterns
emerge.
───────────────────────────────────────────────────────────────────────────────────────────────
Question 7
A patient with a C6 spinal cord injury retains which functional movement?
A. Independent ankle dorsiflexion
B. Functional elbow flexion
C. Intrinsic hand muscle function
D. Independent hip extension
Correct Answer: B
Detailed Rationale:
The C6 myotome includes the biceps brachii, allowing for functional elbow flexion and the ability to
perform a tenodesis grasp. This is a key functional milestone for individuals with C6 tetraplegia.
Why the Other Options Are Incorrect:
A. Independent ankle dorsiflexion: Ankle dorsiflexion is innervated by L4–L5 and is not present in a C6 injury.
C. Intrinsic hand muscle function: Intrinsic hand muscles are innervated by C8–T1; at C6, hand function is
limited to tenodesis.
D. Independent hip extension: Hip extension is innervated by L5–S1 and is not available at the C6 level.
───────────────────────────────────────────────────────────────────────────────────────────────
Question 8
During a gait assessment, a patient with Parkinson’s disease demonstrates small, shuffling steps that
progressively increase in speed. This pattern is BEST described as:
A. Hemiplegic gait
B. Festinating gait
C. Ataxic gait
D. Dystrophic gait
Correct Answer: B
Detailed Rationale:
Festinating gait is a hallmark of Parkinson’s disease and is characterized by short, shuffling steps with
involuntary acceleration, often accompanied by reduced arm swing and difficulty initiating movement.
Why the Other Options Are Incorrect:
A. Hemiplegic gait: Associated with stroke, featuring extension synergy in the lower extremity with
circumduction of the affected limb.
C. Ataxic gait: Characterized by a wide-based, unsteady pattern, often due to cerebellar dysfunction or
sensory ataxia.
D. Dystrophic gait: Not a standard gait classification; dystonia may cause abnormal postures but not the
festinating pattern described.
───────────────────────────────────────────────────────────────────────────────────────────────
Question 9
A patient with a traumatic brain injury is classified as Level III on the Rancho Los Amigos Levels of
Cognitive Functioning. Which behavioral presentation is MOST consistent with this level?
A. No response to any stimulation
Musculoskeletal, Neurological & Rehabilitation Systems
Physical Therapy Practice Examination 2026–2027
Musculoskeletal, Neurological & Rehabilitation Systems
Section 1: Musculoskeletal System
Question 1
A 52-year-old male presents with right shoulder pain and limited active abduction. Passive range of
motion reveals pain at 110° of abduction, and the Hawkins-Kennedy test reproduces his symptoms.
Which diagnosis is MOST consistent with this presentation?
A. Glenohumeral osteoarthritis
B. Adhesive capsulitis
C. Subacromial impingement syndrome
D. Full-thickness rotator cuff tear
Correct Answer: C
Detailed Rationale:
The classic presentation of subacromial impingement includes a painful arc during mid-range abduction
(typically 60°–120°) and a positive Hawkins-Kennedy test, which compresses the supraspinatus tendon
beneath the coracoacromial arch. The positive impingement sign specifically reproduces pain by
narrowing the subacromial space.
Why the Other Options Are Incorrect:
A. Glenohumeral osteoarthritis: This condition typically presents with global stiffness, crepitus, and
radiographic joint space narrowing. A focal painful arc with a positive impingement sign is not characteristic.
B. Adhesive capsulitis: This condition produces global restriction of both active and passive motion, especially
external rotation. The described patient has preserved passive motion except at the painful arc, arguing
against capsular restriction.
D. Full-thickness rotator cuff tear: This would typically present with significant weakness in abduction or
external rotation, often with a positive drop arm test. The scenario describes pain-limited motion without
marked weakness.
───────────────────────────────────────────────────────────────────────────────────────────────
Question 2
A 28-year-old soccer player sustains a knee injury during a cutting maneuver. The Lachman test
demonstrates increased anterior translation with a soft end-feel. Which structure is MOST likely
injured?
A. Posterior cruciate ligament
B. Anterior cruciate ligament
C. Medial collateral ligament
D. Lateral meniscus
Correct Answer: B
Detailed Rationale:
The Lachman test assesses anterior translation of the tibia relative to the femur and is highly sensitive
and specific for anterior cruciate ligament (ACL) disruption. A soft end-feel indicates loss of ligamentous
integrity.
Why the Other Options Are Incorrect:
Musculoskeletal, Neurological & Rehabilitation Systems
, Physical Therapy Practice Examination 2026–2027
A. Posterior cruciate ligament: PCL integrity is assessed via the posterior drawer test or posterior sag sign,
which evaluate posterior tibial translation.
C. Medial collateral ligament: MCL integrity is assessed via valgus stress testing at 20°–30° of knee flexion.
D. Lateral meniscus: Meniscal pathology is assessed via McMurray or Thessaly tests, which provoke
mechanical symptoms rather than ligamentous laxity.
───────────────────────────────────────────────────────────────────────────────────────────────
Question 3
A patient is 6 weeks status post anterior cruciate ligament reconstruction. Which consideration is MOST
critical during this phase of rehabilitation?
A. The graft is at its weakest point due to remodeling
B. Aggressive plyometric training should be initiated
C. Return to full competitive sport is appropriate
D. Deep squatting should be performed daily
Correct Answer: A
Detailed Rationale:
The 6-week postoperative period corresponds to the early remodeling phase of graft healing, during
which the graft undergoes revascularization and structural reorganization, making it biomechanically
weakest. Rehabilitation must balance controlled loading with protection of the graft.
Why the Other Options Are Incorrect:
B. Aggressive plyometric training: Plyometrics impose high tensile and shear loads inappropriate during the
graft remodeling phase; they are introduced much later (typically 4–6 months).
C. Return to full competitive sport: Return to sport typically requires 9–12 months and depends on strength,
functional, and psychological readiness criteria.
D. Deep squatting: Deep knee flexion creates high anterior shear forces on the ACL graft and is generally
restricted during early remodeling.
───────────────────────────────────────────────────────────────────────────────────────────────
Question 4
A 45-year-old female presents with insidious onset of right lateral hip pain that worsens when lying on
the affected side and when climbing stairs. Palpation reveals tenderness over the greater trochanter.
Which condition is MOST likely?
A. Femoroacetabular impingement
B. Greater trochanteric pain syndrome
C. Lumbar radiculopathy
D. Adductor strain
Correct Answer: B
Detailed Rationale:
Greater trochanteric pain syndrome encompasses gluteal tendinopathy and trochanteric bursitis. The
hallmark features are point tenderness over the greater trochanter and pain exacerbated by side-lying
and weight-bearing activities such as stair climbing.
Why the Other Options Are Incorrect:
A. Femoroacetabular impingement: This typically presents with anterior groin pain, pain with deep hip flexion
and internal rotation, and a positive FADIR test.
Musculoskeletal, Neurological & Rehabilitation Systems
, Physical Therapy Practice Examination 2026–2027
C. Lumbar radiculopathy: This would present with radiating symptoms in a dermatomal pattern, often below
the knee, with positive neural tension signs.
D. Adductor strain: This presents with medial thigh/groin pain and tenderness at the adductor origin,
worsened by resisted adduction.
───────────────────────────────────────────────────────────────────────────────────────────────
Question 5
Which gait deviation is MOST commonly associated with weakness of the gluteus medius?
A. Steppage gait
B. Trendelenburg gait
C. Festinating gait
D. Antalgic gait
Correct Answer: B
Detailed Rationale:
The gluteus medius stabilizes the pelvis during single-leg stance. Weakness results in a Trendelenburg
sign—the pelvis drops on the contralateral, unsupported side—and a compensatory ipsilateral trunk
lean during ambulation.
Why the Other Options Are Incorrect:
A. Steppage gait: Results from dorsiflexor weakness (e.g., peroneal nerve injury), causing excessive hip and
knee flexion to clear the toes.
C. Festinating gait: Characteristic of Parkinson’s disease, with small, shuffling steps and progressive
acceleration.
D. Antalgic gait: Results from pain, with decreased stance time on the affected limb; it is not specific to
gluteus medius weakness.
Section 2: Neurological System
───────────────────────────────────────────────────────────────────────────────────────────────
Section 2: Neurological System
───────────────────────────────────────────────────────────────────────────────────────────────
Question 6
A patient presents with right-sided hemiparesis following a middle cerebral artery stroke. During
examination, the patient exhibits flaccidity with no voluntary movement in the right upper extremity.
According to the Brunnstrom Stages of Motor Recovery, which stage is this patient in?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV
Correct Answer: A
Detailed Rationale:
Brunnstrom Stage I is characterized by flaccidity and absence of voluntary movement following the
initial shock phase of stroke. This is the starting point of the motor recovery continuum.
Why the Other Options Are Incorrect:
B. Stage II: Presence of spasticity and emerging synergies, with minimal voluntary movement.
C. Stage III: Spasticity peaks, and voluntary movement occurs primarily within flexor or extensor synergies.
Musculoskeletal, Neurological & Rehabilitation Systems
, Physical Therapy Practice Examination 2026–2027
D. Stage IV: Spasticity begins to decline, and some movement combinations outside of synergy patterns
emerge.
───────────────────────────────────────────────────────────────────────────────────────────────
Question 7
A patient with a C6 spinal cord injury retains which functional movement?
A. Independent ankle dorsiflexion
B. Functional elbow flexion
C. Intrinsic hand muscle function
D. Independent hip extension
Correct Answer: B
Detailed Rationale:
The C6 myotome includes the biceps brachii, allowing for functional elbow flexion and the ability to
perform a tenodesis grasp. This is a key functional milestone for individuals with C6 tetraplegia.
Why the Other Options Are Incorrect:
A. Independent ankle dorsiflexion: Ankle dorsiflexion is innervated by L4–L5 and is not present in a C6 injury.
C. Intrinsic hand muscle function: Intrinsic hand muscles are innervated by C8–T1; at C6, hand function is
limited to tenodesis.
D. Independent hip extension: Hip extension is innervated by L5–S1 and is not available at the C6 level.
───────────────────────────────────────────────────────────────────────────────────────────────
Question 8
During a gait assessment, a patient with Parkinson’s disease demonstrates small, shuffling steps that
progressively increase in speed. This pattern is BEST described as:
A. Hemiplegic gait
B. Festinating gait
C. Ataxic gait
D. Dystrophic gait
Correct Answer: B
Detailed Rationale:
Festinating gait is a hallmark of Parkinson’s disease and is characterized by short, shuffling steps with
involuntary acceleration, often accompanied by reduced arm swing and difficulty initiating movement.
Why the Other Options Are Incorrect:
A. Hemiplegic gait: Associated with stroke, featuring extension synergy in the lower extremity with
circumduction of the affected limb.
C. Ataxic gait: Characterized by a wide-based, unsteady pattern, often due to cerebellar dysfunction or
sensory ataxia.
D. Dystrophic gait: Not a standard gait classification; dystonia may cause abnormal postures but not the
festinating pattern described.
───────────────────────────────────────────────────────────────────────────────────────────────
Question 9
A patient with a traumatic brain injury is classified as Level III on the Rancho Los Amigos Levels of
Cognitive Functioning. Which behavioral presentation is MOST consistent with this level?
A. No response to any stimulation
Musculoskeletal, Neurological & Rehabilitation Systems
