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Physical Therapy Board Exam Study Notes
Complete Reviewer for the Physical Therapist Licensure Examination (PTLE)
In This Guide
About the PT Board Exam
The Physical Therapist Licensure Examination (PTLE) is administered by the Professional Regulation Commission (PRC) to assess competency for physical therapy practice in the Philippines. It covers theoretical knowledge and clinical applications.
Exam Subjects
- • Anatomy & Physiology
- • Kinesiology & Biomechanics
- • Therapeutic Exercises
- • Physical Agents & Electrotherapy
- • Clinical Sciences
- • Professional Practice
Requirements
- • BS Physical Therapy degree
- • Completion of clinical internship
- • Passing score: 75%
- • No subject below 50%
Part 1: Anatomy & Physiology
Musculoskeletal System
Muscle Types
Skeletal Muscle
- • Voluntary control
- • Striated appearance
- • Attached to bones
- • Multi-nucleated
Cardiac Muscle
- • Involuntary control
- • Striated appearance
- • Heart only
- • Intercalated discs
Smooth Muscle
- • Involuntary control
- • Non-striated
- • Visceral organs
- • Single nucleus
Muscle Fiber Types
Type I (Slow Twitch)
- • Red fibers (high myoglobin)
- • Aerobic metabolism
- • Fatigue-resistant
- • Postural muscles
- • Low force production
Type II (Fast Twitch)
- • White fibers (low myoglobin)
- • Anaerobic metabolism
- • Fatigues quickly
- • Power movements
- • High force production
Nervous System
Neural Control of Movement
- Motor Unit: Alpha motor neuron + all muscle fibers it innervates
- Recruitment: Size principle - smaller units first, then larger
- Upper Motor Neurons: Cortex to spinal cord; lesion = spasticity, hyperreflexia
- Lower Motor Neurons: Spinal cord to muscle; lesion = flaccidity, areflexia
- Reflex Arc: Receptor → Sensory neuron → Integration → Motor neuron → Effector
Cardiovascular & Respiratory
Exercise Physiology Basics
- VO2max: Maximum oxygen consumption; gold standard for aerobic capacity
- Cardiac Output: CO = HR × SV; increases with exercise
- MET (Metabolic Equivalent): 1 MET = 3.5 mL O2/kg/min at rest
- Target Heart Rate: 60-85% of HRmax; HRmax ≈ 220 - age
- RPE Scale: Rate of Perceived Exertion; 6-20 (Borg scale)
Part 2: Kinesiology & Biomechanics
Types of Muscle Contractions
Concentric
Muscle shortens
Overcomes resistance
Example: Bicep curl up
Eccentric
Muscle lengthens
Controls movement
Example: Bicep curl down
Isometric
No length change
Static hold
Example: Wall sit
Joint Movements
Movement Terms
- Flexion: Decreasing joint angle
- Extension: Increasing joint angle
- Abduction: Away from midline
- Adduction: Toward midline
- Rotation: Internal/External
- Pronation: Palm facing down
- Supination: Palm facing up
- Dorsiflexion: Ankle - toes up
- Plantarflexion: Ankle - toes down
- Circumduction: Circular movement
Gait Analysis
Gait Cycle Phases
Stance Phase (60%)
- Initial Contact (Heel Strike)
- Loading Response
- Midstance
- Terminal Stance
- Pre-swing (Toe Off)
Swing Phase (40%)
- Initial Swing
- Mid-swing
- Terminal Swing
Common Gait Deviations:
- • Trendelenburg: Hip abductor weakness
- • Steppage gait: Foot drop (peroneal nerve)
- • Antalgic gait: Pain avoidance
- • Circumduction: Hip flexor weakness
Key Muscles & Actions
Upper Extremity
- Deltoid: Shoulder abduction
- Biceps: Elbow flexion, supination
- Triceps: Elbow extension
- Rotator Cuff: SITS (Supraspinatus, Infraspinatus, Teres minor, Subscapularis)
Lower Extremity
- Iliopsoas: Hip flexion
- Gluteus maximus: Hip extension
- Gluteus medius: Hip abduction
- Quadriceps: Knee extension
- Hamstrings: Knee flexion, hip extension
- Gastrocnemius: Plantarflexion
Part 3: Therapeutic Exercises
Range of Motion Exercises
Passive ROM
- • No muscle contraction
- • Therapist moves limb
- • Maintains joint mobility
- • For paralyzed patients
Active-Assisted ROM
- • Patient initiates
- • Assistance provided
- • Weak muscles
- • Transition exercise
Active ROM
- • Patient performs alone
- • Full muscle contraction
- • Maintains strength
- • Independent movement
Strengthening Exercises
Progressive Resistance Exercise (PRE)
- DeLorme Technique: 3 sets × 10 reps; 50%, 75%, 100% of 10RM
- Oxford Technique: 3 sets × 10 reps; 100%, 75%, 50% of 10RM (regressive)
- DAPRE: Daily Adjusted PRE; 4 sets, adjust based on performance
Manual Muscle Testing (MMT) Grades
| Grade | Description | Criteria |
|---|---|---|
| 5 (Normal) | Full ROM against gravity + max resistance | 100% |
| 4 (Good) | Full ROM against gravity + mod resistance | 75% |
| 3 (Fair) | Full ROM against gravity only | 50% |
| 2 (Poor) | Full ROM gravity-eliminated | 25% |
| 1 (Trace) | Palpable contraction, no movement | 10% |
| 0 (Zero) | No contraction | 0% |
Stretching Techniques
Static Stretching
- • Hold position 30-60 seconds
- • Low force, long duration
- • Safe, effective
- • Best after warm-up
PNF Stretching
- • Contract-Relax (CR)
- • Hold-Relax (HR)
- • Contract-Relax-Agonist-Contract (CRAC)
- • Most effective for flexibility
Part 4: Physical Agents & Electrotherapy
Thermal Modalities
Heat (Thermotherapy)
- • Vasodilation, increased blood flow
- • Decreased muscle spasm
- • Increased tissue extensibility
- Superficial: Hot packs, paraffin, IR
- Deep: Ultrasound, diathermy
- Contraindications: Acute inflammation, impaired sensation, malignancy
Cold (Cryotherapy)
- • Vasoconstriction initially
- • Decreased inflammation
- • Decreased pain & spasm
- Methods: Ice packs, ice massage, cold bath
- Hunting Response: Alternating vasoconstriction/dilation
- Contraindications: Raynaud's, cryoglobulinemia
Ultrasound
Parameters
- Frequency: 1 MHz (deep, 3-5 cm) vs 3 MHz (superficial, 1-2 cm)
- Intensity: 0.5-2.0 W/cm²
- Mode: Continuous (thermal) vs Pulsed (non-thermal)
- Effects: Increased collagen extensibility, accelerated healing
- Contraindications: Over eyes, heart, pregnant uterus, growth plates, malignancy
Electrotherapy
TENS
- • Pain management
- • High frequency: Gate control theory
- • Low frequency: Endorphin release
- • Parameters: 1-150 Hz, 50-100 μs
NMES
- • Muscle strengthening
- • Prevent atrophy
- • Re-education
- • Parameters: 20-50 Hz, 200-400 μs
Iontophoresis
- • Drug delivery via DC current
- • Dexamethasone (negative pole)
- • Lidocaine (positive pole)
IFC
- • Deep tissue penetration
- • 4000 Hz carrier frequency
- • Beat frequency 1-100 Hz
Part 5: Clinical Conditions
Orthopedic Conditions
Shoulder
- Frozen shoulder: Capsular pattern; ER > ABD > IR limited
- Rotator cuff tear: Drop arm test positive
- Impingement: Neer, Hawkins tests positive
Knee
- ACL tear: Anterior drawer, Lachman positive
- PCL tear: Posterior drawer positive
- Meniscus tear: McMurray positive
Spine
- Disc herniation: SLR positive, dermatomal symptoms
- McKenzie: Extension-biased exercises for disc
- Spinal stenosis: Flexion relieves symptoms
Hip
- THR precautions (posterior): No flexion >90°, adduction, IR
- Hip OA: Capsular pattern; IR > Flex > ABD limited
Neurological Conditions
Stroke
- • UMN lesion: Spasticity, hyperreflexia
- • Brunnstrom stages of recovery (1-7)
- • Synergy patterns: Flexor (UE), Extensor (LE)
- • Bobath/NDT approach
Spinal Cord Injury
- • ASIA classification (A-E)
- • Tetraplegia: Cervical level
- • Paraplegia: Thoracic/below
- • Functional goals by level
Parkinson's Disease
- • Bradykinesia, rigidity, tremor
- • Festinating gait
- • LSVT BIG exercises
- • Visual/auditory cues
Peripheral Neuropathy
- • Wallerian degeneration
- • Nerve regeneration: 1mm/day
- • Sensory re-education
- • Strengthening as recovery occurs
Cardiopulmonary
- Cardiac Rehab Phases: I (inpatient), II (outpatient), III (maintenance)
- RPE: Should exercise at 11-13 ("fairly light" to "somewhat hard")
- Postural drainage: Position-based secretion clearance
- Breathing exercises: Diaphragmatic, pursed-lip, segmental
- Signs to stop exercise: Chest pain, dyspnea, SBP drop >20 mmHg, new arrhythmia
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