Kyle Rice
NPTE Clinical Files | Physical Therapy
NPTE Clinical Files is a podcast from the creator of Dominating the NPTE, hosted by Kyle Rice. NPTE Clinical Files explains a true clinical scenario in the form of a mock NPTE-based question. Each question is followed by a set of answer choices, where Dr. Kyle Rice explains the right answer with a detailed rationale. Each season covers all of the major systems and topics found in physical therapy and likely to be found on an NPTE. NPTE Clinical Files gives the Physical Therapist a weekly opportunity to solve clinical puzzles while learning the latest research related to the topic.
Be sure to visit the podcast's website and support the creator: www.thepthustle.com
Where to listen?
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Episodes
Cerebral Palsy: Gait Analysis 12.11.2025 8:02
Orion is a 12-year-old with spastic diplegic cerebral palsy and is evaluated for gait abnormalities. The therapist observes excessive hip flexion, knee flexion, and ankle dorsiflexion throughout the gait cycle. Which of the following gait patterns BEST describes these findings? A) Crouch gait B) Scissoring gait C) Ataxic gait D) Steppage gait TEXT OUR TEAM: (727) 732-4573
Osteoarthritic Impacts On Gait 05.11.2025 10:07
Kai is a 65-year-old male who presents with deep groin pain, morning stiffness lasting 30 minutes, and a positive scour test. Which gait deviation is MOST likely to be observed? A) Uneven cadence B) Decreased step length on the unaffected limb C) Lateral trunk lean toward the unaffected limb D) Marked hip internal rotation on the affected side DOWNLOAD THIS EPISODE'S CHEATSHEET: www.nptecheats...
Cervical Spine Radiculopathy 29.10.2025 8:37
Harper presents with neck pain and tingling radiating into the right hand. Symptoms worsen with overhead activities and improve with the arm at rest. Examination reveals weakness in elbow flexion, diminished biceps reflex, and reduced sensation over the lateral forearm. Which of the following tests is the MOST effective to assess this condition? A) Spurling’s test B) Cervical distraction test C) U...
Pediatric Growth Milestones 22.10.2025 8:30
DeShawn is assessing a 12-month-old child during a developmental screening. The child can pull to stand, cruise along furniture, and grasp small objects using a pincer grip, but has not yet started walking independently. Which of the following findings is MOST concerning? A) Inability to walk independently B) Absence of babbling or single words C) Persistence of the Moro reflex D) Lack of interest...
Scar Tissue Mobilization Techniques 15.10.2025 7:42
Diego is six weeks post-rotator cuff repair and reports stiffness and a pulling sensation near the surgical incision during overhead movement. Examination reveals restricted shoulder range of motion and palpable adhesions. Which technique is MOST appropriate to address the patient’s symptoms? A) Effleurage B) Transverse friction massage C) Myofascial release D) Joint mobilization DOWNLOAD THIS EPI...
COPD: Exercise Testing & Prescription 08.10.2025 11:10
Luca is a 68 year old male with moderate COPD who is referred for physical therapy to improve exercise tolerance. He reports dyspnea with minimal exertion and has a 6-minute walk test distance of 250 meters. His resting oxygen saturation is 92% on room air. Which of the following is the MOST appropriate initial exercise approach? A) Interval training with short work and rest periods at moderate in...
Alzheimer’s Disease: PT Treatment 01.10.2025 10:30
Amara presents with mild to moderate Alzheimer’s disease and has impaired gait and balance. She becomes disoriented in new environments and struggles with multi-step instructions. Which intervention is MOST appropriate for this patient? A) High-intensity balance exercises on uneven surfaces B) Dual-task training to improve cognitive function C) Structured gait training in a familiar environment D)...
Post-Op Total Knee Arthroplasty 24.09.2025 9:50
Helga is two days post-total knee arthroplasty (TKA) and reports moderate knee pain and stiffness. Her knee range of motion is 0–45 degrees, and her incision is well-approximated with mild edema. Which intervention is MOST appropriate to prioritize during this session? A) Full weight bearing on the surgical leg B) Low-intensity range of motion exercises to increase knee flexion C) Ambulation with...
Electrotherapy- Indications & Contraindications New 17.09.2025 10:48
Freda presents with persistent shoulder pain following rotator cuff repair surgery. The therapist considers using electrical stimulation for pain management. The patient has a history of mild hypertension controlled with medication and reports occasional muscle spasms in the surgical area. Which of the following would MOST likely require avoidance of electrical stimulation? A) Metal anchors used d...
Integumentary Outcome Measures 10.09.2025 8:52
Mohammad is documenting outcomes for a patient who has been treated for a venous ulcer. Which of the following improvements is the MOST significant to report? A) The patient reports a decrease in pain from 6/10 to 2/10 B) The patient's walking distance has increased from 100 meters to 300 meters C) The wound size has decreased from 6 cm² to 3 cm² D) The patient's lower leg swelling has red...
Surgical Pain Examination 03.09.2025 8:38
Sweeney recently underwent a hysterectomy and requests to sit after ambulating a few feet. The patient reports dizziness and right lower extremity pain. On examination, her resting heart rate is 102 bpm, and she has significant swelling in her right lower leg. Which of the following should be assessed FIRST: A) Walking distance before stopping B) Pulse pressure C) Deep calf tenderness D) Dorsal pe...
Shoulder Instability- Recognizing & Testing 27.08.2025 8:13
Azaria is a 22-year-old swimmer with intermittent right shoulder pain who complains of a slipping sensation during overhead activities. Which of the following tests should be performed FIRST? A) Apprehension test B) Speed's test C) Drop arm test D) Load and shift test Join the FREE Facebook Group: www.nptegroup.com
Vestibular Assessment 20.08.2025 12:14
John reports dizziness and unsteadiness when walking, especially in busy environments or when turning his head quickly. He denies positional dizziness but struggles to read signs while walking. Examination reveals normal balance in static postures and no spontaneous nystagmus. Which test is MOST appropriate to assess the suspected deficit? A) Dix-Hallpike maneuver B) Head thrust test C) Snellen Ch...
Medical Imaging Interpretation 13.08.2025 10:48
Before an evaluation, Arial is reviewing the patient's MRI report that describes sequestration at the L4 – L5 level. The intake form reveals sensory changes along the lateral calf, and dorsum of the foot. Which clinical finding is the most consistent with the medical record? A) Impaired heel walking B) Gastrocnemius and soleus atrophy C) Extensor hallicus longus weakness D) Saddle paraesthesia...
Hand & Wrist Pathologies 06.08.2025 10:00
Samantha is an office worker who presents with pain and numbness in the right hand, particularly at night. On examination, there is decreased sensation along the palmar aspect of the thumb, index, and middle fingers. Which the of the following is the LEAST likely impaired: A) Abductor pollicus brevis B) Flexor pollicus longus C) Opponens pollicus D) 2nd Lumbrical DOWNLOAD THIS EPISODE'S CHEATS...
Post-Surgical Incision Care 30.07.2025 10:04
Denise is six days post-abdominal surgery with a midline incision. The incision is well-approximated with slight redness but no drainage or dehiscence. She is concerned about safely participating in physical therapy. Which recommendation is MOST appropriate for this patient? A) Avoid core exercises until 6 weeks post-op B) Continue light activities and monitor for redness, swelling, or drainage C)...
CABG / Post-Op PT Guidelines 23.07.2025 12:18
Kelly is referred to physical therapy six days after coronary artery bypass graft (CABG) surgery. She reports mild fatigue but denies chest pain or shortness of breath. Her resting heart rate is 85 bpm, and her blood pressure is 125/80 mmHg. The therapist plans to begin light aerobic exercise as part of her cardiac rehabilitation. Which of the following is the MOST appropriate guideline to follow...
Mystery Pathology Examination Findings 16.07.2025 9:20
Ollie reports progressive weakness in his legs and tingling sensations in his hands and feet after a recent upper respiratory infection. On examination, he has moderate dorsiflexor weakness, and mild gait instability. Which of the following is the MOST anticipated finding? A) Hyperreflexia with distal weakness B) Loss of tactile sensation C) Severe gross hip muscle weakness D) Limb contractures DO...
Frozen Shoulder Rehab Protocols 09.07.2025 12:48
Rella presents with a diagnosis of adhesive capsulitis in the freezing phase. She reports persistent, deep shoulder pain at rest and significant discomfort with attempted movement. Passive range of motion reveals capsular end-feel in all directions, particularly with external rotation. Which intervention is MOST appropriate to address the patient’s symptoms at this stage? A) Low-load prolonged pas...
Pharmacology for PTs 02.07.2025 8:39
Bailey presents with a history of osteoarthritis and hypertension and is referred to physical therapy for knee pain management. She reports taking over-the-counter medication daily for pain relief. During the session, she mentions experiencing mild stomach discomfort and occasional dizziness. Her blood pressure is 138/86 mmHg. Which medication is MOST likely contributing to the patient’s symptoms?...
Lymphedema Management - Compression & Therapy 25.06.2025 11:39
Pouria presents with secondary lymphedema following breast cancer treatment. The patient reports heaviness in the arm and mild discomfort but denies significant pain. The affected arm shows a circumference 3 cm greater than the contralateral arm. She has no open wounds or signs of infection. Which compression and therapy strategy is MOST appropriate to manage this patient’s lymphedema? A) High-str...
Atrial Fibrillation / PT Considerations 18.06.2025 8:15
Jafar has a history of atrial fibrillation and reports occasional fatigue and palpitations. His resting heart rate is 96 bpm and irregular, and he takes a beta-blocker. During a six-minute walk test, he experiences mild shortness of breath but completes the test without difficulty. Which consideration is MOST important when developing this patient’s exercise program? A) Monitor for a target heart...
Traumatic Brain Injury / Assessment & Treatment 11.06.2025 11:04
Taylor presents with a TBI and is recently learning to transfer from a wheelchair to a bed independently. The therapist aims to facilitate the learning process while minimizing cognitive load. Which training strategy is MOST effective for this stage of motor learning? A) Massed practice; intrinsic feedback B) Distributed practice; concurrent feedback C) Blocked practice; knowledge of results feedb...
Ankle Pain - Clinical Patholophysiology 04.06.2025 10:31
Kyle reports sudden posterior ankle pain after jumping, describing it as feeling “kicked.” Examination reveals mild swelling, a palpable gap above the calcaneus, limited active plantarflexion, and inability to perform a single-leg heel raise. Passive range of motion is full and pain-free. Which finding BEST explains the patient’s inability to perform a single-leg heel raise? A) Tear of the medial...
Lumbar Spine Pathologies / Red Flags 28.05.2025 10:36
Martha presents with six weeks of dull, intermittent low back pain. The pain worsens with standing but improves slightly with rest. Examination reveals mild lumbar tenderness and restricted motion. Which line of questioning is MOST important to uncover a potential red flag? A) “Have you noticed changes in bowel or bladder habits?” B) “What activities seem to aggravate or relieve your pain?” C) “Ha...
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