100+ Free NBCE Physiotherapy Practice Questions

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What is the primary physiological effect of cryotherapy during the first 0-15 minutes of application?

Vasodilation of superficial blood vessels

Vasoconstriction reducing local blood flow

Increased nerve conduction velocity

Increased muscle spindle activity

to track

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2026 Statistics

Key Facts: NBCE Physiotherapy Exam

100

Multiple-Choice Questions

NBCE 2026

~3 hrs

Two 90-min Sessions

NBCE

6x/year

Prometric Administrations

NBCE

~$295

Exam Fee

NBCE Fee Schedule

~15

States Requiring PT

State Board Survey

25%

Electrotherapy Weight

NBCE Test Plan

The NBCE Physiotherapy Examination is a 100-question national elective offered six times yearly at Prometric, costing approximately $295 and required by roughly 15 state boards (including CA and CO) for chiropractors who use physiotherapy modalities. The exam runs two 90-minute sessions covering electrotherapy (25%), heat/cold (15%), ultrasound (15%), exercise (15%), mechanical modalities (10%), hydrotherapy/light (10%), and safety/documentation (10%). NBCE provides an official sample test for candidates.

Sample NBCE Physiotherapy Practice Questions

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

1What is the primary physiological effect of cryotherapy during the first 0-15 minutes of application?

A.Vasodilation of superficial blood vessels

B.Vasoconstriction reducing local blood flow

C.Increased nerve conduction velocity

D.Increased muscle spindle activity

Explanation: During the initial 0-15 minutes of cold application, the body responds with vasoconstriction, reducing blood flow to the area. This decreases inflammation, edema, and metabolic activity in the tissue. After approximately 15 minutes of continuous cold application, the hunting response (cold-induced vasodilation) may occur as a protective mechanism against tissue damage.

2What is the maximum recommended duration for a single cryotherapy application using an ice pack?

A.5 minutes

B.10 minutes

C.20 minutes

D.45 minutes

Explanation: Cryotherapy applications should generally not exceed 20 minutes. Beyond this duration, the risk of frostbite, nerve injury, and the unwanted hunting response (rebound vasodilation) increases significantly. Standard practice is 15-20 minutes per application, with at least 1-2 hours between treatments.

3Which condition is an absolute contraindication for cryotherapy?

A.Acute ankle sprain

B.Raynaud's phenomenon

C.Postoperative knee swelling

D.Delayed onset muscle soreness

Explanation: Raynaud's phenomenon is an absolute contraindication to cryotherapy. The vasospastic response to cold can trigger severe ischemia in the digits. Other contraindications include cold urticaria, cryoglobulinemia, peripheral vascular disease, and cold hypersensitivity. Acute injuries, postoperative swelling, and DOMS are common indications for cryotherapy.

4The hunting response in cryotherapy refers to:

A.Increased lymphatic drainage from the treated area

B.Cyclic vasodilation that occurs after 15+ minutes of cold application

C.Initial vasoconstriction in the first 5 minutes

D.Decreased muscle spindle activity

Explanation: The hunting response (Lewis hunting reaction) is cold-induced vasodilation that occurs after approximately 15 minutes of continuous cold exposure. It is a protective cycle of vasodilation and vasoconstriction designed to prevent tissue damage from prolonged ischemia. This is one reason cryotherapy applications are limited to about 20 minutes.

5What is the typical temperature range for hydrocollator hot packs?

A.95-105 degrees F

B.115-125 degrees F

C.158-167 degrees F

D.180-200 degrees F

Explanation: Hydrocollator hot packs are stored in water at 158-167 degrees F (70-75 degrees C). Six to eight layers of toweling are placed between the pack and the skin to prevent burns, and the patient should be checked within the first 5 minutes of application. Treatment time is typically 15-20 minutes.

6What is the temperature range for therapeutic paraffin baths?

A.100-110 degrees F

B.125-134 degrees F

C.150-160 degrees F

D.170-180 degrees F

Explanation: Therapeutic paraffin is maintained at 125-134 degrees F (52-57 degrees C). Patients dip the affected area 6-12 times to build a wax glove, then wrap with plastic and toweling for 15-20 minutes. Paraffin is excellent for arthritic hands and feet because of its high heat capacity and ability to conform to irregular surfaces.

7Fluidotherapy operates within which temperature range?

A.80-95 degrees F

B.105-118 degrees F

C.125-135 degrees F

D.140-155 degrees F

Explanation: Fluidotherapy uses dry heat with finely divided cellulose particles suspended in heated air. The operational range is 105-118 degrees F (40-48 degrees C). The agitation of particles provides both desensitization and gentle massage, making it ideal for hand and foot conditions, post-fracture rehabilitation, and patients who cannot tolerate moist heat.

8Which heat transfer method describes the heat moving from a hot pack into the underlying tissue?

A.Conduction

B.Convection

C.Conversion

D.Radiation

Explanation: Hot packs transfer heat by conduction - direct contact between two surfaces of different temperatures. Heat moves from the hotter pack to the cooler skin and superficial tissues. Convection (e.g., whirlpool, fluidotherapy) involves heat transfer by movement of fluid or air. Conversion (e.g., ultrasound, diathermy) converts another energy form into heat. Radiation (e.g., infrared lamp) transfers heat through electromagnetic waves.

9How many layers of toweling are typically placed between a hydrocollator hot pack and the patient's skin?

A.1-2 layers

B.6-8 layers

C.12-15 layers

D.No toweling needed if skin is dry

Explanation: Six to eight layers of toweling provide adequate insulation between a hydrocollator hot pack (158-167 degrees F) and the patient's skin to prevent burns. Fewer layers risk thermal injury, while more layers reduce therapeutic heat transfer. The patient should be checked within the first 5 minutes for excessive redness or discomfort.

10Which patient population should NOT receive thermal modalities over the abdomen?

A.Patients with chronic low back pain

B.Pregnant patients

C.Athletes recovering from training

D.Geriatric patients with osteoarthritis

Explanation: Thermal modalities (heat or ultrasound) should not be applied over the abdomen during pregnancy because of potential adverse effects on the fetus. Other contraindications for thermal modalities include malignancy, acute hemorrhage, peripheral vascular disease, and areas of decreased sensation. Pregnant patients can still safely receive ice or heat to peripheral areas like the lumbar spine when clinically appropriate.

About the NBCE Physiotherapy Exam

The NBCE Physiotherapy Examination is an optional national elective for chiropractors who want to incorporate physiotherapeutic modalities into clinical practice. Approximately 15 state licensing boards (including California and Colorado) require successful completion of this exam before a chiropractor may use modalities such as ultrasound, TENS, interferential current, traction, hot packs, cryotherapy, paraffin, hydrotherapy, low-level laser, and therapeutic exercise. The exam is offered six times per year at Prometric test centers and is delivered in two 90-minute sessions covering eight content domains: heat and cold modalities, electrotherapy, ultrasound and phonophoresis, mechanical modalities, therapeutic exercise, hydrotherapy and light therapy, indications and contraindications, and documentation and modality selection.

Questions

100 scored questions

Time Limit

~3 hours (two 90-min sessions)

Passing Score

Scaled by NBCE

Exam Fee

~$295 (National Board of Chiropractic Examiners (NBCE))

NBCE Physiotherapy Exam Content Outline

25%

Electrotherapy

TENS modes (conventional, acute, burst, modulation), interferential current, Russian stimulation, NMES, iontophoresis (drug polarity, current density limits), HVPC for wound healing, electrode placement, waveform parameters (pulse width, frequency, amplitude), and electrical safety.

15%

Heat and Cold Modalities

Cryotherapy (ice packs, ice massage, cold sprays, hunting response), hot packs (hydrocollator at 158-167 degrees F), paraffin (125-134 degrees F dipping), fluidotherapy (105-118 degrees F), conduction versus convection, and treatment durations.

15%

Ultrasound and Phonophoresis

Frequency selection (1 MHz deep, 3 MHz superficial), continuous versus pulsed mode, thermal versus non-thermal effects (acoustic streaming, cavitation), BNR (less than or equal to 6), ERA, intensity (0.5-2.0 W/cm squared), coupling agents, and phonophoresis with hydrocortisone.

15%

Therapeutic Exercise and Rehabilitation

Range of motion, stretching (static, dynamic, PNF), strengthening (isometric, isotonic, isokinetic), proprioception, neuromuscular re-education, exercise progression, SAID principle, and rehabilitation programming for chiropractic patients.

10%

Mechanical Modalities

Cervical traction (7-10% body weight), lumbar traction (25% BW initial up to 50% BW), intermittent versus continuous traction, intermittent pneumatic compression for edema (40-60 mmHg lower extremity, 30-40 mmHg upper extremity), CPM, and contraindications including spinal instability and malignancy.

10%

Hydrotherapy and Light Therapy

Whirlpool (warm 100-104 degrees F, cold less than 80 degrees F), Hubbard tank, contrast bath (3-4 min hot to 1 min cold), low-level laser therapy (Class 3B cold laser, photochemical effects), infrared lamps for superficial heating, and ultraviolet for psoriasis (Goeckerman regimen).

Indications, Contraindications and Safety

General contraindications for thermal modalities (malignancy, acute hemorrhage, peripheral vascular disease, decreased sensation, abdomen during pregnancy), pacemaker contraindications for electrotherapy, sensory testing, and treatment safety protocols.

Documentation and Modality Selection

Patient assessment, goal setting, modality selection rationale, ICD-10 chiropractic diagnosis codes, CPT modality codes (97014 attended e-stim, 97032 manual e-stim, 97035 ultrasound, 97110 therapeutic exercise), SOAP notes, and outcomes tracking.

How to Pass the NBCE Physiotherapy Exam

What You Need to Know

Passing score: Scaled by NBCE
Exam length: 100 questions
Time limit: ~3 hours (two 90-min sessions)
Exam fee: ~$295

Keys to Passing

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

NBCE Physiotherapy Study Tips from Top Performers

1Memorize parameter ranges - know exact temperatures (paraffin 125-134 F, hot pack 158-167 F, fluidotherapy 105-118 F), ultrasound frequencies (1 MHz deep, 3 MHz superficial), and TENS settings (conventional 50-150 Hz, acute 1-10 Hz)

2Master contraindications for every modality - thermal agents are contraindicated over malignancy, acute hemorrhage, decreased sensation, and the abdomen in pregnancy; electrotherapy is contraindicated over a pacemaker

3Learn iontophoresis polarity - dexamethasone (negative pole), lidocaine (positive pole), 0.5 mA/cm squared current density limit on the active electrode, and 40 mA-min typical total dose

4Drill traction percentages - cervical 7-10% body weight, lumbar 25% BW initial up to 50% BW, and the difference between intermittent and continuous traction

5Know your CPT modality codes - 97014 (attended e-stim), 97032 (manual e-stim), 97035 (ultrasound), 97110 (therapeutic exercise) - these appear in documentation and selection questions

Frequently Asked Questions

What is the NBCE Physiotherapy exam?

The NBCE Physiotherapy Examination is an optional national elective from the National Board of Chiropractic Examiners that tests competency in using physiotherapy modalities such as ultrasound, electrotherapy, traction, and thermal agents. Approximately 15 state boards (including California and Colorado) require it before a chiropractor may use these modalities.

How is the NBCE Physiotherapy exam structured?

The exam contains 100 multiple-choice questions delivered in two 90-minute sessions (about 3 hours of testing time total). It is administered six times per year at Prometric test centers nationwide, and NBCE publishes an official sample test that candidates can take to preview the format.

How much does the NBCE Physiotherapy exam cost?

The NBCE Physiotherapy Examination fee is approximately $295. Always check the current NBCE fee schedule at mynbce.org for the latest pricing before applying, since NBCE updates fees periodically.

Who needs to take the NBCE Physiotherapy exam?

Chiropractors planning to practice in states that require physiotherapy certification (including California, Colorado, and roughly 13 other states) must pass this exam before they may use modalities like ultrasound, TENS, traction, or hot packs in patient care. It is optional for chiropractors in states without this requirement.

What topics are weighted most heavily on the exam?

Electrotherapy is the largest domain at 25% (TENS, interferential, Russian stim, NMES, iontophoresis, HVPC). Heat and cold modalities, ultrasound, and therapeutic exercise each account for 15%. Mechanical modalities and hydrotherapy/light therapy each represent 10%, with safety and documentation rounding out the rest.

How should I prepare for the NBCE Physiotherapy exam?

Focus on parameter values (frequencies, intensities, durations, depths), indications and contraindications for each modality, and CPT coding. Use the official NBCE sample test, review physiotherapy and rehabilitation textbooks, and drill practice questions across all eight content domains. Most candidates study 60-100 hours.