Neurology Certification (NCS) Prep

Our NCS Prep Program provides all of the tools you'll need to pass the board specialization test, develop your clinical skill set, and elevate your career - all while earning CEUs. With advanced certification, you'll set yourself apart as a distinguished professional equipped to provide an advanced level of care.

We can help you get there faster.

In this program you will study advanced topics taught by the best instructors in neurologic therapy. With over 300 practice questions, this 20-week program will have you well-prepared for success on test day.

Acute Brain Injury and Disorders of Consciousness: Assessment and Intervention

Presented by Mary Beth Osborne, PT, DPT, NCS

Cognitive Impairments: Executive Function

Presented by Karen L. McCulloch, PhD, PT, MS, NCS(E), FAPTA

Neuroimaging and Stimulation for Rehabilitation Part 1: Brain Imaging

Presented by Michael Borich, DPT, PhD

Central Vestibular System: Normal Anatomy and Physiology

Presented by Laura Morris, PT, NCS

Advanced Physical Therapy Examination of Clients with Huntington's Disease

Presented by Anne Kloos, PT, PhD, NCS

Considerations of Cognition: Mobility and Relation of Exercise to Cognitive Function

Presented by Deb Kegelmeyer, PT, DPT, MS, GCS

Treatment Maneuvers for BPPV

Presented by Jeff Walter, DPT, NCS

Identification and Management of Unilateral Vestibular Disorders

Presented by Jeff Walter, DPT, NCS

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Case Excerpt:

A 76-year-old male is admitted to an inpatient rehabilitation hospital 20 days after a left middle cerebral artery ischemic cerebrovascular accident (CVA). He underwent tissue plasminogen activator (TPA) treatment, but his hospital course was complicated by the emergence of shingles on his left flank, and MRSA in his urine. His past medical history includes atrial fibrillation, degenerative joint disease, osteoporosis, coronary artery disease, hypertension, myocardial infarction, peripheral vascular disease (PVD), coronary artery bypass graft x2, abdominal aortic aneurysm repair, and a history of smoking 1 pack per day for many years. He currently has a 2-cm unstageable ulcer on his right heel. He lives with his wife in a 2-story home and has 2 sons who live in a neighboring town. He is a retired police officer. Prior to his stroke, he walked with a cane and was able to walk 10-15 minutes before tiring. He enjoys puzzles of any kind—crossword, word search, jigsaw, etc. His wife is 10 years younger than he is, works part-time at a discount store, and is in good health.

Question:

An initial examination of this patient’s ambulation reveals the following:

assistance required: minimal
HR changes: 72–96 bpm after 100'
distance at which motor components of gait begin to deteriorate: 100'
walking speed: 0.3 m/s
qualitative analysis: lack of R push-off and reduced R foot clearance during R swing phase; R hip flexion and mild knee hyperextension during R stance phase; asymmetrical step length R > L

Impairment in which muscle group is the most likely contributor to this patient’s slow walking speed?

Correct! Incorrect! Subscribe to access over 300 more questions like this one.

The correct answer is "weak right plantarflexors"

The neurologic clinical specialist is expected to be familiar with common gait deviations and their causes post- stroke, as well as musculoskeletal contributions to slow vs. faster walking speed. Ankle plantarflexors are important for forward propulsion and paretic leg weakness in these muscles is a common occurrence after stroke. This patient exhibits decreased push-off, consistent with such weakness. Further, plantarflexor weakness is associated with slow walking in both healthy individuals and those poststroke. The quadriceps do contribute to forward progression during gait in healthy individuals but these do not appear to be significantly weak in this patient since the knee is stable in stance phase. Muscle tightness represents a passive restriction rather than an active muscle contraction and, therefore, would not be a likely contributor to reduced walking speed.

tight right plantarflexors

Incorrect.
tight right quadriceps

Incorrect.
weak right plantarflexors

Correct. The neurologic clinical specialist is expected to be familiar with common gait deviations and their causes post- stroke, as well as musculoskeletal contributions to slow vs. faster walking speed. Ankle plantarflexors are important for forward propulsion and paretic leg weakness in these muscles is a common occurrence after stroke. This patient exhibits decreased push-off, consistent with such weakness. Further, plantarflexor weakness is associated with slow walking in both healthy individuals and those poststroke. The quadriceps do contribute to forward progression during gait in healthy individuals but these do not appear to be significantly weak in this patient since the knee is stable in stance phase. Muscle tightness represents a passive restriction rather than an active muscle contraction and, therefore, would not be a likely contributor to reduced walking speed.
weak right quadriceps

Incorrect.

Karen McCain, PT, DPT, NCS

Dr. McCain received a BS in physical therapy from UT Southwestern in 1992 and a doctorate in physical therapy from Regis University in 2006. She is board certified by the American Physical Therapy Association (APTA) as a Neurologic Clinical Specialist. She has been teaching at the university level since 1998 and recently retired from a position as Associate Professor in a DPT program where she taught for 13 years. She has always practiced in the area of neurology and has published research in the areas of stroke rehabilitation and the use of orthoses in the neurologic population. She has presented continuing education courses across the United States and is a frequent reviewer for scientific publications including Topics in Stroke Rehabilitation, Physical Therapy, Physiotherapy Theory and Practice, and American Journal of Physical Medicine and Rehabilitation. She continues to teach courses around the country and provide consultative services.

Jeff Walter, DPT, NCS

Jeff Walter, DPT, NCS, is the director of the Otolaryngology Vestibular and Balance Center at Geisinger Medical Center in Danville, Pennsylvania. His clinical practice focuses on vestibular diagnostic testing and vestibular rehabilitation. He is an adjunct faculty member at Misericordia University's Department of Physical Therapy and a graduate of the University of Wisconsin with a Bachelor of Science in Physical Therapy (1996). Jeff Walter attained competency certification in vestibular rehabilitation and vestibular function test interpretation and has a doctorate in physical therapy (2009) from the University of Scranton. Since 1999, Jeff has lectured at professional conferences, universities, and continuing education courses for audiologists, physicians, and therapists involved in managing patients with dizziness and imbalance. Connect with Jeff on LinkedIn

Mary Beth Osborne, PT, DPT, NCS

Mary Beth Osborne PT, DPT, NCS earned her BS and doctorate in physical therapy from the University of North Carolina at Chapel Hill. Her area of clinical expertise is in adult neurologic rehabilitation including working with people following brain injury, stroke, spinal cord injury, and neurologic diseases. She has over 30 years of clinical experience in both inpatient and outpatient settings. Dr. Osborne has served as adjunct faculty at UNC Chapel Hill assisting with online and traditional classroom courses focusing on neurologic physical therapy and evidence based practice. She is currently working on the outpatient adult neurology team at Duke University Health in Durham, North Carolina and serves as the outpatient co-director for the neurologic physical therapy residency program. Dr. Osborne is involved as a volunteer for the Academy of Neurologic Physical Therapy of the American Physical Therapy Association as a nominating committee member for the Residency and Fellowship Special Interest Group and the past chair of the Brain Injury Special Interest Group and served as a member of the practice committee. She serves as a Foundation Group committee member for the International Neurological Physiotherapy Association.

Anne Kloos, PT, PhD, NCS

Anne Kloos, PT, PhD, NCS received her physical therapy degree from the University of Wisconsin-Madison and her master's and doctoral degrees in biology/neuroscience from Cleveland State University. Dr. Kloos is currently a Professor-Clinical in the Physical Therapy Division at the Ohio State University, where she teaches adult neurorehabilitation and neuroscience courses and conducts research on balance and gait interventions and fall prevention in individuals with neurodegenerative diseases. She is a board-certified neurologic physical therapy specialist and has over 25 years of clinical experience, including working as a consultant physical therapist in the Amyotrophic Lateral Sclerosis (ALS) Clinic at the Cleveland Clinic Foundation and at the Ohio State University Movement Disorders Clinic. Dr. Kloos has presented her research both nationally and internationally and has numerous publications. Currently, she serves as Co-Director of the Ohio State University Neurologic Physical Therapy Residency Program and as Associate Editor for the Journal of Neurologic Physical Therapy. Her past service has included being the Chair of the Degenerative Diseases Special Interest Group and of the Neurologic Residency Curriculum Task Force for the American Physical Therapy Association.

Herb Karpatkin, PT, DSc, NCS, MSCS

Herb Karpatkin, PT, DSc, graduated from the physical therapy program at Boston University's Sargent College in 1989 and received his doctoral degree in neurologic physical therapy from Rocky Mountain University of Health Professions. He is a Multiple Sclerosis Certified Specialist from the Consortium of Multiple Sclerosis Centers and a board-certified Neurologic Clinical Specialist through the American Physical Therapy Association. Before starting his own practice, he worked at Rusk Rehabilitation, the Beth Abraham Center, the Hospital for Joint Diseases, Burke Rehabilitation Hospital, and the International Multiple Sclerosis Management Practice. He specializes in the treatment of persons with neurologic impairments, including multiple sclerosis, stroke, Parkinson's disease, spinal cord injury, brain injury, and cerebral palsy. His particular area of expertise is in multiple sclerosis. He has published and presented extensively in the field of MS and is a nationally recognized authority on multiple sclerosis and exercise.

Susan Stralka, PT, DPT, MS

Susan W. Stralka, PT, DPT, MS, is a licensed physical therapist with many years of experience treating both musculoskeletal and neurovascular consequences of injury. She earned her bachelor's degree, master's degree, and Doctorate in Physical Therapy from The University of Tennessee Health Sciences Center in Memphis, Tennessee (UTHSC). She has a strong clinical background in treating neurological and musculoskeletal consequences of injury. Susan has presented nationally and internationally in upper and lower extremity dysfunctions as well as pain management. Susan has written articles on a wide variety of topics related to physical therapy for many national publications and health journals. Her most recent publications are "Graded Motor Imagery" in the Journal of Hand Therapy 2011 and a chapter on "Thoracic Outlet Syndrome" in the book entitled Neck and Arm Pain Syndromes by Elsevier in 2011. In 2009, Susan was recognized by the Arthritis Association as Volunteer of the Year. With the goal of providing the best rehabilitative care to patients, Stralka continually recruits and supports innovative clinical programs to benefit future patients.

Karen L. McCulloch, PhD, PT, MS, NCS(E), FAPTA

Karen L. McCulloch, PhD, PT, MS, NCS(E), FAPTA is a Professor in Physical Therapy in the Division of Physical Therapy, Department of Allied Health Sciences, School of Medicine at University of North Carolina - Chapel Hill, where she has taught entry-level and advanced-level students in neurorehabilitation since 1993. She has served in multiple roles within the Academy of Neurologic Physical Therapy, including the inaugural Director of Education, and has been honored with the Service to the Section Award and the APTA Lucy Blair Service Award. Karen has cared about individuals with traumatic brain injury since beginning as a PT in clinical practice, extending from moderate to severe brain injury to a recent focus on military and sports concussion. Her research has focused on developing outcome measures and interventions to improve active movement, balance, and functional mobility, with the aim to improve quality of life. She developed the Arm Motor Ability Test (for upper limb recovery following stroke) and the Walking and Remembering Test (for dual-task performance in older adults and individuals with acquired brain injury). Her current research efforts are focused on military mild traumatic brain injury developing performance based testing that incorporates dual- and multi-task activities, stemming from the Assessment of Military Mutlitasking Performance project, but now being validated in more clinically applicable forms. She is also a collaborator on studies that examine acute exercise testing post-concussion and exercise intervention, and a practice-based evidence analysis of multidisciplinary rehabilitation in military mild TBI. She was the co-lead of the APTA sponsored group that developed the clinical practice guideline for physical therapy management of concussion, and is involved in intervention studies that address treatment for sports and military concussion. She is active in the American Congress of Rehabilitation Medicine mTBI Task Force. Funding support for her research has come from the Foundation for Physical Therapy, Centers for Disease Control and Prevention, National Institutes of Health, National Football League, and Department of Defense. As an active member of the Academy of Neurologic Physical Therapy she received awards for Service (to the Academy, Lucy Blair Service award) and is a Fellow of the American Physical Therapy Association.

Deb Kegelmeyer, PT, DPT, MS, GCS

Dr. Kegelmeyer has over 30 years of clinical experience and is currently a Professor of Health and Rehabilitation Sciences at The Ohio State University. She has extensive clinical expertise, having worked in acute care and outpatient therapy, and spent 10 years as director of physical therapy at a skilled nursing facility. Currently she works as a consultant at the Movement Disorders Clinic at Wexner Medical Center, Ohio State University. She studies mobility and fall prevention in individuals with neurodegenerative diseases and the elderly. Her publication titles include "Use of the Tinetti Mobility Test in Parkinson and Huntington's Disease" and "Use of Dance, Dance Revolution to Improve Balance in Huntington's Disease." She is also one of the co-authors of the textbook Neurologic Rehabilitation: Neuroscience and Neuroplasticity in Physical Therapy Practice.