CPTE Exam Study Guide (2026)
Everything the Canadian Physiotherapy Examination (CPTE) tests, topic by topic: what each section covers, the facts that come up most, and how to study it. Pair it with the free 15-question practice test.
The exam at a glance
| Questions | Written Section: 100 multiple-choice questions with 4 options (80 vignette-based in sets of 4, then 20 stand-alone; 20-25% media-enhanced). Oral Section: 10 structured cases answered aloud |
|---|---|
| Time | 5 hours: Oral Section 2.5 hours (10 cases, 15 minutes each), a break of about 60 minutes, then Written Section 2.5 hours (about 90 seconds a question) |
| Passing score | One overall pass/fail from the combined score (Oral 150 points = 60%, Written 100 points = 40%), set by criterion-referenced standard setting. CAPR does not publish the passing score as a percentage; practise to 70% or higher |
| Format | Closed book, computer-based, remotely proctored |
| Certifying body | Canadian Alliance of Physiotherapy Regulators (CAPR) |
| Test provider | Virtual and remotely proctored, from a private room in Canada or abroad |
Mind map: the whole exam on one screen
Read the complete CPTE study notes for “Musculoskeletal Assessment and Diagnosis”
Our first full set of comprehensive notes, about 15 minutes of reading: Screen before you test · Clinical prediction rules for imaging · Special tests worth knowing cold · Neurological examination of the limbs · From findings to a physiotherapy diagnosis, a worked exam example, the traps examiners use and a one-minute recap. Create a free account to read it and see how premium notes work before you decide.
1. Musculoskeletal Assessment and Diagnosis
Musculoskeletal content is 50 ± 5% of the CPTE, and Assessment and Diagnosis is the largest Written Section domain (about 12% of the whole exam). Expect vignettes that ask which test to do next, what a finding means and what the physiotherapy diagnosis is.
Key facts
- Start with screening: red flags (fracture, cauda equina, cancer, infection, vascular compromise) decide whether physiotherapy is indicated before any special test.
- Clinical prediction rules: the Ottawa ankle and knee rules and the Canadian C-Spine Rule decide who needs imaging. C-Spine high-risk factors: age 65 or older, dangerous mechanism, paresthesias in the extremities.
- Knee: Lachman (most sensitive for ACL), pivot shift (most specific for ACL), posterior drawer and sag sign (PCL), valgus stress at 0 and 30 degrees (MCL), McMurray and Thessaly (meniscus).
- Shoulder: painful arc, Hawkins-Kennedy and Neer for subacromial pain; drop arm and external rotation lag sign for full-thickness rotator cuff tears; apprehension and relocation for anterior instability.
- Capsular patterns: shoulder (external rotation > abduction > internal rotation), hip (flexion, abduction and internal rotation most limited), knee (flexion > extension).
- Neural signs: dermatomes, myotomes and reflexes localize a root (C5 biceps, C6 brachioradialis, C7 triceps, L4 patellar, S1 Achilles). Upper motor neuron signs (Babinski, clonus, Hoffmann) need medical referral.
- Use the ICF to frame the diagnosis: body structure and function impairments, activity limitations and participation restrictions, plus personal and environmental factors.
Flashcards
Exam tip: When a vignette asks what to do FIRST, rule out red flags and the need for imaging before you choose a special test.
2. Musculoskeletal Care Planning and Intervention
Care Planning is the other big Written Section domain (about 12%). Questions ask for the best intervention, how to progress or modify it, post-operative precautions, self-management and discharge planning.
Key facts
- Goals are client-centred and SMART: specific, measurable, achievable, relevant and time-bound, set with the client.
- Knee and hip osteoarthritis: education, exercise and weight management first for everyone (GLA:D Canada). Arthroscopic debridement is not recommended for knee osteoarthritis.
- Tendinopathy: load management and progressive loading (isometric, then isotonic, then energy-storage and sport-specific). Complete rest and repeated corticosteroid injections are not first line.
- Posterior approach hip arthroplasty: avoid flexion past 90 degrees, adduction past midline and internal rotation. Anterior approach: be careful with extension combined with external rotation.
- Fracture healing: respect the surgeon's weight-bearing orders (non-weight-bearing, toe-touch, partial, weight-bearing as tolerated); start range of motion of free joints early.
- Acute soft-tissue injury: protect, relative rest, early graded loading, education and return to activity guided by symptoms.
- Persistent low back pain: reassurance, staying active and exercise; imaging is not indicated without red flags.
Flashcards
Exam tip: The best intervention is the one with the strongest evidence for this client's goals. Passive modalities are rarely the BEST answer on their own.
3. Neurological Conditions
Neurological content is 20 ± 2% of the exam: stroke, brain and spinal cord injury, Parkinson disease, multiple sclerosis, peripheral nerve disorders, vestibular disorders and developmental conditions such as cerebral palsy.
Key facts
- Stroke: task-specific, repetitive practice drives recovery. Protect the hemiplegic shoulder (no pulling on the arm, supported positioning).
- Contraversive pushing: pushing toward the paretic side and resisting correction; treat with visual feedback of vertical.
- Spinal cord injury: complete vs incomplete by the ASIA Impairment Scale (A to E). Lesions at T6 and above risk autonomic dysreflexia: sit upright, loosen tight clothing, find and remove the trigger (often bladder or bowel).
- Parkinson disease: external cues (visual, auditory) help freezing; large-amplitude movement training and aerobic exercise are recommended.
- Multiple sclerosis: fatigue and heat sensitivity are common; plan exercise in cooler environments with rest breaks.
- Guillain-Barré syndrome: ascending weakness; monitor vital capacity in the acute phase and avoid overfatigue during recovery.
- BPPV: Dix-Hallpike for posterior canal (upbeating torsional nystagmus) treated with the Epley manoeuvre; the supine roll test for horizontal canal, treated with the barbecue roll.
Flashcards
Exam tip: For neuro vignettes, decide first whether the client is acute and medically unstable or in rehab. Safety and positioning answers win early; task-specific training wins later.
Test yourself on these topics
Take the free 15-question CPTE test, then save your results to unlock your Readiness Score and the mistakes bank.
4. Cardiovascular-Respiratory Conditions
15 ± 2% of the exam: heart failure, myocardial infarction, peripheral vascular disease, obstructive and restrictive lung disease, post-operative pulmonary complications and acute care monitoring.
Key facts
- Stop exercise for chest pain, a fall in systolic blood pressure of more than 10 mmHg as workload rises, new arrhythmia, marked dyspnea, dizziness or SpO2 falling below the prescribed limit.
- Pulmonary rehabilitation for COPD: aerobic and resistance training; dyspnea target about 3-4 on the modified Borg scale.
Flashcards
Exam tip: Read the vital signs in every cardiorespiratory vignette before the question. Often the right answer is to stop, monitor or escalate.
5. Other Systems: Integumentary, Metabolic, Oncology and Pelvic Health
Other Systems are 15 ± 2% of the exam (burns and wounds, diabetes, cancer, immune and multisystem conditions, healthy populations), and pelvic floor dysfunction sits under musculoskeletal in the blueprint. Questions focus on precautions and safe exercise.
Key facts
- Burns: the position of comfort is the position of contracture. Anterior neck in extension, shoulder in about 90 degrees of abduction, elbow in extension, hand in the safe position.
- Diabetes: hypoglycemia is glucose below 4.0 mmol/L. If conscious, give 15 g of fast-acting carbohydrate and recheck in 15 minutes (Diabetes Canada).
Flashcards
Exam tip: Questions in this area usually turn on a precaution: a blood value, a skin finding or a pregnancy warning sign. Spot it before choosing the exercise.
6. Client Safety, Red Flags and Infection Control
Client Safety and Client-Centred Care is 15 ± 3% of the exam and is assessed in every Oral Section case. In the Written Section, expect red flags, urgent conditions, precautions and contraindications, monitoring during treatment and infection control.
Key facts
- Cauda equina syndrome (saddle anesthesia, new bladder or bowel dysfunction, bilateral leg symptoms) needs emergency medical referral the same day.
- Suspected DVT (unilateral calf pain, swelling, warmth) or pulmonary embolism (sudden dyspnea, chest pain, tachycardia): stop treatment and arrange urgent medical assessment.
Flashcards
Exam tip: If a vignette contains a red flag, the safest action that protects the client comes before any treatment option, even an evidence-based one.
7. Professional Responsibilities, Ethics and Consent
Professional Responsibilities are 15 ± 3% of the exam, mostly in the Oral Section, with about 3% in the Written Section. Know CAPR's Code of Ethical Conduct, the Model Standards of Practice, consent, confidentiality, boundaries, conflicts of interest and scope of practice.
Key facts
- Informed consent is ongoing and specific: explain the nature, benefits, material risks, alternatives and the right to refuse or withdraw, and get fresh consent for new interventions.
- A capable client decides for themselves, even if the decision seems unwise. For a client who isn't capable, consent comes from the substitute decision-maker under provincial law.
Flashcards
Exam tip: Ethics answers protect the client and respect their autonomy. Rule out any option that skips consent or puts the clinic's interest first.
8. Collaboration, Communication and Practice Management
Together about 30% of the exam (Collaboration 12%, Communication 10%, Practice Management 8%), mostly in the Oral Section. Written questions cover assigning care to assistants, team communication, interpreters, documentation and managing caseloads.
Key facts
- Assigning to physiotherapist assistants: assess their competence first; assessment, interpretation, changing the plan and discharge stay with the physiotherapist, who remains accountable.
- Interprofessional care: recognize when another provider is needed, share relevant information with consent and agree roles.
Flashcards
Exam tip: In collaboration questions, the best answer usually involves talking directly to the right person, with the client's consent, rather than working around them.
How to pass
- The Written Section is 100 questions in 2.5 hours, about 90 seconds each. Vignette questions come in sets of 4, so read the vignette once carefully and reuse it.
- Look for the capitalized qualifiers BEST, MOST and FIRST. When two options look right, the qualifier decides it, and the safest client-centred step usually comes first.
- Musculoskeletal content is 50 ± 5% of the exam. Special tests, clinical prediction rules and post-operative precautions are reliable points.
- The Oral Section is worth 60%. Practise answering cases aloud in 15 minutes: say what you would do and why, in the order the questions are asked.
Frequently asked questions
How long should I study for the CPTE exam?
Most working candidates need 4 to 8 weeks at 45 to 60 minutes a day. Book your exam once your Readiness Score has stayed at 80 or higher for about a week.
Can I take the CPTE exam online?
Yes. The CPTE is only delivered online: it's a virtual, remotely proctored exam you take from a private room, in Canada or abroad, with a computer, webcam and microphone that meet CAPR's setup requirements. There are no test centres. Format: closed book, computer-based, remotely proctored. Check CAPR's Candidate Guide and testing setup requirements for the rules.
What score do I need to pass the CPTE exam?
One overall pass/fail from the combined score (Oral 150 points = 60%, Written 100 points = 40%), set by criterion-referenced standard setting. CAPR does not publish the passing score as a percentage; practise to 70% or higher. The exam has written section: 100 multiple-choice questions with 4 options (80 vignette-based in sets of 4, then 20 stand-alone; 20-25% media-enhanced). oral section: 10 structured cases answered aloud and a time limit of 5 hours: oral section 2.5 hours (10 cases, 15 minutes each), a break of about 60 minutes, then written section 2.5 hours (about 90 seconds a question).
What are the most tested topics?
The outline covers musculoskeletal assessment and diagnosis, musculoskeletal care planning and intervention, neurological conditions, cardiovascular-respiratory conditions, other systems: integumentary, metabolic, oncology and pelvic health, client safety, red flags and infection control, professional responsibilities, ethics and consent, collaboration, communication and practice management. Use the free practice test to see which ones you need most.
The premium CPTE study path
Premium CPTE prep is studied one topic at a time. Each step starts with that topic's key notes and flashcard deck, then its own question sets of 25, so you master one topic before you move to the next. When every topic is strong, the 6 full mock exams show you're ready.
Your step-by-step study path
- 1Musculoskeletal Assessment and Diagnosis8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Notes free with an account
- 2Musculoskeletal Care Planning and Intervention8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- 3Neurological Conditions8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- 4Cardiovascular-Respiratory Conditions8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- 5Other Systems: Integumentary, Metabolic, Oncology and Pelvic Health7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- 6Client Safety, Red Flags and Infection Control7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- 7Professional Responsibilities, Ethics and Consent7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- 8Collaboration, Communication and Practice Management7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- Final step: 6 full mock exams100 questions each, timed like test day. Pass them, then book your exam.Premium
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- The CPTE: every area of the blueprint, both sections
- 3,000 practice questions + 6 full mock exams per exam
- 800 flashcards + 60 key notes per exam, by topic, plus mind maps
- Spaced repetition + mistakes bank
- Readiness Score & detailed reports
- Video lessons as they release
- Content updates during your access
- 5 bonuses: clinical values and red flags sheet, special tests atlas, study planner and more
- Pass Guarantee: complete the prep, pass or 100% back
Renews once a year until you cancel. We email you before each renewal. Cancel any time from your account; you keep access until the end of the year you've paid for.
Summarized from the Canadian Alliance of Physiotherapy Regulators' official candidate information and the rules cited, checked November 2026. Confirm current requirements with Canadian Alliance of Physiotherapy Regulators (CAPR).