100+ Free AOBPMR PM&R Practice Questions

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Which technique uses the patient's own muscle force against operator's resistance to reposition or stretch tissues?

Counterstrain

Muscle energy technique (MET)

Cranial OMT

HVLA

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2026 Statistics

Key Facts: AOBPMR PM&R Exam

$750

Application + Exam Fee

AOBPMR 2026

100 MCQs

Written Exam

AOBPMR blueprint

500/800

Scaled Passing Score

AOBPMR scoring

95.38%

5-Year First-Time Pass Rate

AOBPMR published

27-31%

Neurorehab — Largest Category

AOBPMR content outline

4 hours

Written Exam Time

AOBPMR exam structure

The AOBPMR boards are the AOA's certifying exam for osteopathic physiatrists. The written component is 100 single-best-answer MCQs over 4 hours, scaled 200-800 with a 500 cut score and a 95.38% five-year first-time pass rate. The oral exam adds 9 case-based questions across 3 sessions covering 14 topic domains. Blueprint weighting favors neurorehab (27-31%), interventional/spine/OMT/pain (25-29%), and MSK/prosthetics/sports/return-to-work (24-28%), with special populations (peds, geri, cancer, cardiopulmonary) at 16-20%. Application fee is $750 with $200/yr OCC thereafter.

Sample AOBPMR PM&R Practice Questions

Try these sample questions to test your AOBPMR PM&R exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 65-year-old man with right hemiparesis after a left MCA stroke is at week 4 of inpatient rehab. He has impaired arm function with some active wrist extension. Which Brunnstrom stage best describes his recovery?

A.Stage 1 — flaccidity

B.Stage 2 — minimal voluntary movement, spasticity emerging

C.Stage 4 — some movement out of synergy

D.Stage 6 — normal coordinated movement

Explanation: Brunnstrom stage 4 features beginning isolated movement out of synergistic patterns. Active wrist extension reflects out-of-synergy movement emerging. Stages 1-2 are flaccid/early spasticity; 5-6 represent advanced recovery.

2A 28-year-old patient with a C6 ASIA A complete SCI develops sudden severe headache, BP 200/110, sweating above the lesion, and bradycardia. The most likely cause is:

A.Anxiety attack

B.Autonomic dysreflexia, typically triggered by a noxious stimulus below the level of injury (bladder distention, fecal impaction)

C.Migraine

D.Heart attack

Explanation: Autonomic dysreflexia occurs in SCI at or above T6 with noxious stimuli below the lesion. Sit patient up, loosen clothing, check bladder/bowel, treat persistent HTN with topical nitrate or oral nifedipine.

3An EMG study on a patient with suspected carpal tunnel syndrome shows median sensory distal latency of 4.0 ms and motor distal latency of 5.0 ms (cutoffs 3.5 and 4.5 ms). The most appropriate next step is:

A.Diagnose carpal tunnel syndrome

B.Repeat the study in 6 months

C.Order MRI of the wrist

D.Do nothing

Explanation: Prolonged median sensory distal latency >3.5 ms and motor distal latency >4.5 ms with normal ulnar studies confirm carpal tunnel syndrome. Severity grading depends on degree of prolongation, amplitude, and EMG denervation.

4Which Glasgow Coma Scale score defines severe TBI?

A.GCS 13-15

B.GCS 9-12

C.GCS 3-8

D.GCS 16-20

Explanation: GCS classifies TBI severity: mild 13-15, moderate 9-12, severe 3-8. Score is sum of eye (4), verbal (5), and motor (6) responses, with minimum 3 and maximum 15.

5A 7-year-old with cerebral palsy has spasticity primarily affecting both lower extremities, with relative sparing of the upper extremities, and can walk without an assistive device but with crouch gait. This is best classified as:

A.Spastic hemiplegic CP, GMFCS I

B.Spastic diplegic CP, GMFCS II

C.Spastic quadriplegic CP, GMFCS IV

D.Dyskinetic CP, GMFCS III

Explanation: Spastic diplegic CP predominantly affects the legs with relative arm sparing. Crouch gait with independent ambulation suggests GMFCS II (walks with limitations). Premature birth and periventricular leukomalacia are common.

6A transtibial amputee is now community-ambulating with variable cadence and able to traverse most environmental barriers. What K-level best describes his functional status?

A.K1

B.K2

C.K3

D.K4

Explanation: K3 = community ambulator with variable cadence, ability to traverse most environmental barriers. K1 = household only; K2 = limited community; K4 = high impact/athletic activity.

7A football player sustains a head impact and shows brief LOC, headache, and confusion. Which is the most appropriate next step?

A.Return to play immediately if asymptomatic at sideline

B.Remove from play, perform SCAT5 assessment, no return-to-play same day

C.Order immediate CT scan only

D.Return to play next day if symptoms resolve overnight

Explanation: Per consensus statement (Concussion in Sport Group), any suspected concussion mandates removal from play, full SCAT5 evaluation, and no same-day return regardless of how quickly symptoms appear to resolve. Graduated return-to-play protocol follows.

8Which AOA-recognized osteopathic manipulative technique uses operator force to overcome tissue restriction by short, rapid thrust through restriction barrier?

A.Muscle energy

B.High-velocity, low-amplitude (HVLA)

C.Counterstrain (Strain-counterstrain)

D.Myofascial release

Explanation: HVLA uses operator force with a short, rapid, low-amplitude thrust through the restriction barrier. The patient is positioned to engage barriers; thrust direction follows the appropriate vector. Muscle energy uses patient isometric contraction; counterstrain holds tender points in shortened position.

9Which is the standard imaging modality of choice for a suspected meniscal tear in a young athlete?

A.Plain radiograph

B.Magnetic resonance imaging (MRI) of the knee

C.CT scan

D.Ultrasound

Explanation: MRI is the gold standard for soft-tissue knee evaluation including meniscus, ligaments, and articular cartilage. Plain films assess bony alignment, joint space, and avulsion injuries but do not visualize soft tissue.

10A 60-year-old with multiple sclerosis presents with sudden bilateral leg weakness and bladder retention. Which is the most appropriate first-line treatment for acute MS exacerbation?

A.Plasmapheresis

B.IV methylprednisolone 1 g daily x 3-5 days

C.Interferon beta

D.Stem cell transplant

Explanation: IV methylprednisolone (1 g/day for 3-5 days) is first-line treatment for acute MS exacerbations. Plasmapheresis is for steroid-refractory cases. DMTs (interferons, glatiramer, fingolimod, ocrelizumab, natalizumab) are for long-term disease modification.

About the AOBPMR PM&R Exam

The AOBPMR Physical Medicine & Rehabilitation Certifying Examination validates expertise across neurologic rehabilitation (stroke, SCI, TBI, MS, neuromuscular), musculoskeletal medicine, interventional pain and spine, electrodiagnostic medicine (EMG/NCS), prosthetics and orthotics, sports medicine, pediatric/geriatric/cancer/cardiac rehab, and osteopathic manipulative treatment. DO candidates complete an AOA- or ACGME-accredited PM&R residency. The certification has two components: a 100-question, 4-hour written exam scored on a 200-800 scale (passing 500) and a separate oral exam consisting of three 45-minute case sessions covering 14 PM&R topics.

Questions

100 scored questions

Time Limit

4 hours written exam; ~135 minutes oral exam (three 45-minute sessions)

Passing Score

Scaled score >=500 on 200-800 scale

Exam Fee

$750 application + exam fee (AOBPMR 2026); $225 late fee (American Osteopathic Board of Physical Medicine and Rehabilitation (AOBPMR) under the AOA)

AOBPMR PM&R Exam Content Outline

27-31%

Brain, Spinal Cord, Muscle & Connective Tissue Rehabilitation

Stroke (ischemic vs hemorrhagic, modified Rankin, FIM, Brunnstrom stages, constraint-induced movement therapy), SCI (ASIA A-E, central cord, Brown-Sequard, anterior cord, conus vs cauda, autonomic dysreflexia >20 mmHg SBP rise with bladder/bowel trigger), TBI (GCS 3-15, Rancho I-X, post-traumatic amnesia), MS Expanded Disability Status Scale, Parkinson disease (Hoehn-Yahr, LSVT BIG), ALS (riluzole, NIV), GBS, myopathies, post-polio.

25-29%

Interventional Therapeutics, Spine, OMM & Pain

Cervical/lumbar radiculopathy red flags, interlaminar vs transforaminal ESI, medial branch block + RFA for facet pain, SI joint injection, kyphoplasty/vertebroplasty, intradiscal procedures. OMT techniques: HVLA, muscle energy, myofascial release, counterstrain, BLT, articulatory. Chapman points. WHO analgesic ladder, opioid CDC guidelines, ketamine infusions, dorsal column SCS, intrathecal pumps.

24-28%

Prosthetics, Orthotics, Sports Medicine, MSK & Return to Work

Transtibial (PTB, TSB, ICRO socket) vs transfemoral (ischial containment, suction) prosthetics, Syme/Symes, K-levels 0-4, microprocessor knees. AFO (solid, posterior leaf spring, hinged), KAFO, WHFO. Shoulder (rotator cuff, SLAP, AC), knee (ACL/PCL/meniscus, McMurray), hip, foot/ankle (high ankle, Lisfranc, Achilles). Concussion (SCAT5, return-to-play), AMA Guides 6th Ed impairment ratings, FCE, FMLA/ADA.

10-12%

Electrodiagnostic Medicine (EMG/NCS)

Nerve conduction studies (amplitude, latency, velocity), F-waves (proximal slowing, plexopathy/radiculopathy), H-reflex (S1, neuromuscular junction), needle EMG (insertional activity, spontaneous fibs/PSWs, fasciculations, MUAP morphology, recruitment). Carpal tunnel (median sensory >3.5 ms, motor >4.5 ms), ulnar at elbow, peroneal at fibular head, radiculopathy paraspinal denervation. Myopathy vs neuropathy patterns, NMJ disorders (MG decrement, LEMS increment).

6-8%

Pediatric Rehabilitation

Cerebral palsy (spastic diplegia/hemiplegia/quadriplegia, GMFCS I-V, baclofen/botulinum toxin, SDR), spina bifida (Sharrard levels, neurogenic bladder, Chiari II), brachial plexopathy (Erb-Duchenne C5-C6, Klumpke C8-T1), Duchenne muscular dystrophy (corticosteroids, exon-skipping therapy), spinal muscular atrophy (nusinersen, onasemnogene), developmental delay, autism spectrum considerations.

6-8%

Cardiac, Pulmonary, Cancer, Burn & Geriatric Rehab

Cardiac rehab phases I-IV, MET levels, post-MI/CABG protocols. Pulmonary rehab (COPD, ILD, post-LTx). Cancer rehab (lymphedema CDT, fatigue, chemo-induced peripheral neuropathy, RT-induced fibrosis). Burn rehab (TBSA Rule of Nines, scar/contracture management). Geriatric falls (Tinetti, Berg Balance, Timed Up & Go >12 sec), polypharmacy (Beers criteria), pressure injury staging (1-4, DTI, unstageable).

How to Pass the AOBPMR PM&R Exam

What You Need to Know

Passing score: Scaled score >=500 on 200-800 scale
Exam length: 100 questions
Time limit: 4 hours written exam; ~135 minutes oral exam (three 45-minute sessions)
Exam fee: $750 application + exam fee (AOBPMR 2026); $225 late fee

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

AOBPMR PM&R Study Tips from Top Performers

1Master the SCI exam: ASIA Impairment Scale (A complete, B sensory incomplete, C motor incomplete <3/5, D motor incomplete >=3/5, E normal), key motor levels (C5 elbow flexion, C6 wrist extension, C7 elbow extension, C8 finger flexion, T1 finger abduction, L2 hip flexion, L3 knee extension, L4 ankle dorsiflexion, L5 great toe extension, S1 plantar flexion), autonomic dysreflexia management (sit up, loosen clothing, find trigger — usually bladder or bowel — treat HTN with topical nitrate or nifedipine), neurogenic bladder types (UMN spastic vs LMN flaccid), heterotopic ossification (alkaline phosphatase + triple-phase bone scan early).

2Drill stroke recovery: Brunnstrom stages 1-6 (flaccidity to normal), modified Rankin Scale 0-6, FIM 1-7, NIHSS scoring, tPA eligibility (<=3 hr standard, <=4.5 hr extended; mechanical thrombectomy up to 24 hr with DAWN/DEFUSE-3). Predictors of recovery: initial severity, arm vs leg, age. Constraint-induced movement therapy (>=10% finger movement). Dysphagia screening, swallow study, modified barium swallow. Hemineglect right > left hemisphere. Post-stroke depression in 30-50% — SSRI first line.

3Internalize EMG/NCS thresholds: median antidromic sensory latency >3.5 ms or motor distal latency >4.5 ms = CTS; ulnar across-elbow velocity drop >10 m/s with >0.6 ms latency difference; peroneal at fibular head; F-waves and H-reflex (S1) for proximal pathology. Needle EMG: spontaneous activity (fibrillations, PSWs) = denervation 2-4 weeks; MUAP polyphasia >25%; reduced recruitment = neurogenic; small short-duration polyphasic with early full recruitment = myopathic. Decrement at 3 Hz repetitive stim = NMJ junction (MG); increment >100% at high-rate = LEMS.

4For prosthetics/orthotics know: K-levels (K0 nonambulator, K1 household, K2 limited community, K3 community with variable cadence, K4 high activity). Transtibial sockets (PTB patellar tendon bearing, TSB total surface bearing, ICRO ischial containment), suspension (suction, pin-lock, sleeve). Transfemoral knees: manual locking, single-axis, polycentric, fluid (hydraulic/pneumatic), microprocessor (C-Leg, Rheo, Genium). AFOs: solid plastic, posterior leaf spring (foot drop), hinged (allows DF), GRAFO. Pediatric orthoses HKAFO, RGO.

5Master pediatric rehab: cerebral palsy GMFCS I (walks without limits) - V (transported in wheelchair); spasticity ladder (oral baclofen, tizanidine, diazepam — botulinum toxin for focal, intrathecal baclofen for severe spasticity, SDR for L2-S2). Spina bifida Sharrard levels (T12 above no leg movement; L1-2 hip flexion; L3 knee extension; L4 ankle DF; L5 toe extension; S1 plantar flexion). Erb-Duchenne C5-C6 (waiter's tip); Klumpke C8-T1 (claw hand, Horner). DMD: corticosteroid initiation by age 4-6, cardiac surveillance, exon-skipping (eteplirsen 51, golodirsen 53).

Frequently Asked Questions

Who is eligible for the AOBPMR PM&R certifying exam?

Candidates must be DOs from a COCA-accredited osteopathic college (MD eligibility per AOA policy) who have completed an AOA-approved or ACGME-accredited PM&R residency. They must be within three months of residency completion by the exam date, hold an unrestricted state/territorial/Canadian medical license, and adhere to the AOA Code of Ethics. Program director attestation of satisfactory training is required.

How is the AOBPMR exam structured?

The AOBPMR certification has two components: a 4-hour written exam with 100 single-best-answer multiple-choice questions and a separate oral exam structured as three 45-minute sessions in which examiners ask three questions each (9 cases total, randomly drawn from 14 PM&R topics including pediatrics, SCI, MSK, sports, stroke, electrodiagnosis, and OMT). Both components are required for certification.

What is the fee for the AOBPMR exam?

The application fee is $750, submitted with the completed application. A $225 late fee applies after the initial deadline. There is a 50% refund up to 31 days before the exam and no refund within 30 days. After certification, the annual OCC fee is $200 with a $50 late registration penalty. Confirm current amounts on the AOBPMR exam page.

What topics carry the most weight on the AOBPMR blueprint?

The AOBPMR written exam allocates 27-31% to rehabilitation of brain, SCI, muscle and connective tissue disorders, 25-29% to interventional therapeutics/spine/OMT/pain, 24-28% to prosthetics/orthotics/sports/MSK/return-to-work, and 16-20% to special populations (pediatric, geriatric, cancer, cardiac, pulmonary rehab, plus electrodiagnostic medicine threads). The oral exam pulls cases randomly from 14 PM&R topics.

What is the pass rate for the AOBPMR written exam?

AOBPMR publishes a 95.38% five-year aggregate first-time pass rate on the written exam, among the highest in AOA certifying exams. The high pass rate reflects strong residency preparation and the focused single-specialty blueprint, but candidates should still complete at least 300-500 hours of dedicated review including question banks, AANEM EMG self-assessments, and oral-case rehearsal.

How long should I study for the AOBPMR boards?

Most PM&R residents report 300-500 hours over 4-8 months. A common split: ~30% neurorehab (stroke, SCI, TBI, MS, neuromuscular), ~25% MSK/sports/prosthetics, ~15% EMG/electrodiagnosis, ~10% pediatric rehab, ~10% pain/OMT/interventional, and ~10% cardiac/pulmonary/cancer/burn/geriatric. Daily question-bank practice and weekly oral case run-throughs are high-yield.

Does the AOBPMR exam test osteopathic manipulative treatment (OMT)?

Yes. Unlike ABPMR, the AOBPMR explicitly includes OMT and osteopathic principles. Expect items on HVLA, muscle energy, myofascial release, counterstrain, BLT, articulatory, cranial, and visceral techniques. Chapman points, viscerosomatic reflexes, and the five osteopathic models (biomechanical, respiratory-circulatory, neurologic, metabolic, behavioral) appear in both MCQ and oral case formats.

What is OCC and how does it affect my AOBPMR certification?

Osteopathic Continuous Certification (OCC) consists of four components: 1) unrestricted licensure, 2) lifelong learning/CME, 3) cognitive assessment (Component 3 — being replaced by Longitudinal Assessment with quarterly questions), and 4) practice performance assessment. AOBPMR diplomates pay $200 annually to maintain OCC status. Failure to comply transitions you to 'not certified' status.

100+ Free AOBPMR PM&R Practice Questions

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