[Chrissy Durrough Lugge]

Hi Rachael,

This is one of the trickier concepts of the ASIA exam. Because there is no myotome testing for the trunk, we have to make assumptions about this region – and the ASIA is standardized to make conservative assumptions. In regions with no formal muscle test (T2-L1), motor function is presumed to be the same as sensory function if testable motor function above that level is also normal. So, even if motor scores are normal in all testable regions, if sensation is impaired between T2 and L1, the motor level is the lowest level with intact sensation. This is also outlined in the Steps to Classification section on page 2 of the PDFs.

If sensation were normal between T2 and L1 for this patient, you are correct that the motor levels would be L4 on the right and L3 on the left.

Let me know if I can provide any further clarification.

Thanks!

Chrissy

[Chrissy Durrough Lugge]

Hi Allison,

Pediatrics definitely isn’t emphasized on the NCS exam, likely due to the fact that there is a PCS exam. When I completed my residency program, I remember being told that pediatrics was being phased out of the NCS exam. Neurologic pediatrics remain fair game on the NCS exam, but I doubt it will be a large component of the exam and likely not worth investing a significant amount of time.

Hope this helps!

Chrissy

[Chrissy Durrough Lugge]

Hi Sarah,

If I understand the 2020 candidate guide (link below) and accurately remember when I took the exam in 2014, the exam consists of four 50-question/1.5-hour blocks. There is one 50-minute break period permitted, which most people take after the second block (or after 100 questions).

Hope this helps!

Chrissy

http://www.abpts.org/uploadedFiles/ABPTSorg/Specialist_Certification/Neurology/SpecCert_Neurologic_Application.pdf

[Chrissy Durrough Lugge]

Hi Roxanne,

Just emailed you!

Chrissy

[Chrissy Durrough Lugge]

Thanks so much, Anthony! I’m thinking about everyone taking their specialist exams right now and excited to hear how you all do!

[Chrissy Durrough Lugge]

Thanks, Barb! 🙂

[Chrissy Durrough Lugge]

Hi Erika,
I believe the 50-minute break has to be taken in one block between test sections. When I took the NCS exam, I took my break for lunch after the second section. This document from the ABPTS describes the exam day guidelines: http://www.abpts.org/uploadedFiles/ABPTSorg/Specialist_Certification/ABPTS_SpecialistCertificationExamDayGuidelines.pdf

Thank you for this question! It won’t be in time for your exam, but I will add some information about exam day logistics to the site before the next exam cycle to help next year’s participants.

Chrissy

[Chrissy Durrough Lugge]

Hi Scott,
I used my last week to review a lot of items that required memorization – outcome measures and diagnoses I don’t see every day, lab values, etc. I also skimmed through my lectures from my DPT program to do a high-level overview of most topics (now, I would also/alternatively recommend skimming the NCS Advantage module handouts).
Good luck! You’re so close!
Chrissy

[Chrissy Durrough Lugge]

Hi Grace,
I would recommend at least being familiar with the highly recommended measures for each diagnosis and knowing the Core Outcome Measures very well. Knowing the NCS is a multiple choice exam, I think it is helpful to generally know what a measure assesses (identify most appropriate outcome measures for a certain case), the minimum and maximum scores (to interpret a given score), and any critical cut-off scores (like falls risk). The Outcome Measures Master List on the course homepage will hopefully provide most of this information.

I don’t have any novel strategies for learning the measures. When I was studying for the NCS exam, I took a block of time and reviewed the highly recommended outcome measures for each diagnosis. I remember doing this pretty close to my exam date because some of it was memorizing numbers and I didn’t want to give myself too much time to forget them.

Elise mentioned knowing all the outcome measures with ratings of 4. The EDGE Task Forces use a rating scale of 1-4 for each outcome measure:
4= highly recommended; the outcome measure has excellent psychometric properties and clinical utility
3= recommended; the outcome measure has good psychometric properties and good clinical utility
2= reasonable to use, but limited study in target group; the outcome measure has good or excellent psychometric properties and clinical utility in a related population, but insufficient study in target population to support higher recommendation.
1= do not recommend; the outcome measure has poor psychometric properties and/or poor clinical utility

Hope this helps! Let me know if you have any other questions.

Chrissy

[Chrissy Durrough Lugge]

Hi Shari,

On my version of the NCS exam, there were videos like those in the course and we were asked to name the nystagmus/involved canal/BPPV type/etc.

Chrissy

[Chrissy Durrough Lugge]

Hi Cristina,
I agree – I don’t think it’s worthwhile to memorize specific studies. Understanding the big concepts and general recommendations is more important. Individual studies are included in the lectures to review specific interventions from the body of literature. If you read the associated articles, I would spend most of your time on the introductions and conclusions while just skimming through the methodology sections. Additionally, taking a look at systematic reviews is likely a more effective use of your time than digging too deep into specific studies, as review articles can be applied to a larger population and are more likely to be captured by the NCS exam. Hope this is helpful!
Chrissy

[Chrissy Durrough Lugge]

Hi Katy – Just letting you know that the orthoses reference guide is up on the course homepage in the Gait and Movement Analysis module. This is a new resource this year; any feedback or suggestions are welcome!

[Chrissy Durrough Lugge]

Hi Katy,
I am editing the reference guide a bit this weekend. It will be up again by next weekend. I will shoot you an email when it is on the site so you don’t have to keep checking.
Chrissy

[Chrissy Durrough Lugge]

Hi Crystal,

Good question! My best understanding of this part of the algorithm is this: If someone has excessive plantarflexion/knee extension, they likely have knee instability/quad weakness that places them at risk for knee buckling. The dorsiflexion stop provides a guard against potential buckling. Hope this helps!

[Chrissy Durrough Lugge]

Thanks for sharing, James! This supports what I see clinically – that most of my patients who are told to rest for weeks-months after sustaining a concussion before being referred to PT tend to have much more protracted recoveries than those to return to some level of activity sooner.

The ABPTS has a rigorous process for developing and vetting exam questions. As a result, there is a bit of a lag in content and much of the latest evidence is not directly tested. My advice is always to answer questions based on what you know…but don’t be surprised if there isn’t a ton of material from the last 2-3 years.

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