NBCE Physiotherapy cheat sheet

Goniometric normal ROM: shoulder flexion/abduction 180°, elbow flexion 150°, hip flexion 120°, knee flexion 135°, ankle dorsiflexion 20°.

Manual muscle test scale: 0 no contraction, 1 trace, 2 active without gravity, 3 against gravity, 4 against gravity plus resistance, 5 normal.

Deep tendon reflex grading: 0 absent, 1+ diminished, 2+ normal, 3+ exaggerated, 4+ clonus.

Reflex roots: biceps C5-C6, brachioradialis C5-C6, triceps C7, patellar L3-L4, Achilles S1.

Dermatomes: C5 lateral arm, C6 thumb, C7 middle finger, C8 little finger, T4 nipple, T10 umbilicus, L4 medial malleolus, L5 dorsum of foot, S1 lateral foot.

Special tests: Lachman for ACL, McMurray for meniscus, Phalen for carpal tunnel, Spurling for cervical radiculopathy, FABER for hip or sacroiliac dysfunction.

Adult vital signs: heart rate 60-100 bpm, respiratory rate 12-20 breaths/min, blood pressure below 120/80 mm Hg, SpO2 at least 95% on room air.

Sensation testing: light touch and pinprick assess pain and temperature pathways; vibration and proprioception assess dorsal column function.

Ultrasound frequency determines depth: 3 MHz heats about 1-2 cm superficially; 1 MHz penetrates about 3-5 cm for deeper tissue.

Continuous ultrasound uses 100% duty cycle for thermal effects; pulsed ultrasound uses 20-50% duty cycle for primarily nonthermal effects.

Ultrasound intensity is commonly 0.5-2.0 W/cm2; effective radiating area is 2-3 times the transducer head area.

Ultrasound contraindications: malignancy, pregnancy, pacemaker, growth plates, eyes, carotid sinus, and thrombophlebitis.

TENS parameters: high-frequency 80-150 Hz at low intensity for pain gating; low-frequency 2-10 Hz at higher intensity for endogenous opioid effects.

Iontophoresis polarity: negatively charged dexamethasone is delivered under the cathode; positively charged lidocaine is delivered under the anode.

Cryotherapy is applied 10-20 minutes; contraindicated in Raynaud phenomenon, cold urticaria, impaired circulation, and over superficial nerves.

Thermotherapy is applied 15-20 minutes; contraindicated over acute inflammation, bleeding, malignancy, impaired sensation, and ischemic tissue.

SAID principle: Specific Adaptation to Imposed Demands means training adaptations are specific to the load, velocity, and movement pattern imposed.

Overload principle: load must exceed habitual demands to improve strength or endurance; reversibility occurs when training stimulus is removed.

Static stretching dose: hold each stretch 15-30 seconds for 2-4 repetitions; ballistic stretching is avoided in older or untrained individuals.

Isometric exercise generates muscle tension without joint motion and is used early after surgery or during immobilization.

Concentric contraction shortens muscle under tension; eccentric contraction lengthens muscle under tension and can generate greater force.

Closed-chain exercise fixes the distal segment and promotes joint compression and co-contraction; open-chain exercise moves the distal segment freely.

Target heart rate maximum equals 220 minus age; Karvonen target equals ((HRmax - HRrest) × intensity) + HRrest.

Normal gait cadence is 100-120 steps/min; step length is the distance between opposite heel strikes, and stride length is between same-foot heel strikes.

SOAP note format: Subjective, Objective, Assessment, Plan.

SMART goals are Specific, Measurable, Achievable, Relevant, and Time-bound.

FIM has 18 items scored 1-7, total 18-126; Barthel Index scores 0-100 for activities of daily living.

Informed consent elements: diagnosis, proposed procedure, risks, benefits, alternatives, and right to refuse.

Discharge criteria include goals met, safe independent function, no remaining skilled therapy need, or plateau in progress.

HIPAA requires minimum necessary disclosure of protected health information and allows patients access to their records.

Functional outcome measures are documented at baseline and re-evaluation to quantify change and justify continuation of care.

Red flags requiring urgent referral: unexplained weight loss, night pain, fever, bowel or bladder changes, saddle anesthesia, and progressive neurologic deficit.

DVT signs: unilateral swelling, warmth, tenderness, and erythema; massage and vigorous mobilization are withheld until medical clearance.

Orthostatic hypotension is a systolic drop of at least 20 mm Hg or diastolic drop of at least 10 mm Hg on standing.

Fall precautions: keep bed low, call light and assistive device within reach, use non-skid footwear, and assist high-risk patients during transfers.

Electrical safety: inspect cords and plugs, keep electricity away from water, use grounded equipment, and avoid stimulation across the anterior neck or chest.

Infection control: perform hand hygiene before and after patient contact and follow standard precautions for body fluid exposure.

Exercise contraindications: unstable angina, acute myocardial infarction, severe aortic stenosis, uncontrolled hypertension, and dangerous arrhythmias.

Burn precautions: inspect skin before and after modality use and avoid thermal agents over insensate or poorly perfused areas.