Neurological conditions can affect a person’s movement, physical function, and ability to carry out everyday activities independently. For people living with conditions that affect the nervous system, physical therapy plays an important role in improving mobility and supporting greater independence.
Neurological physical therapists are licensed physical therapists who focus their practice on helping patients manage these types of movement and functional limitations. For those interested in combining physical rehabilitation with specialized knowledge of the nervous system, this field can lead to quite a fulfilling and rewarding career.
In the article below, we will explain how to become a neurological physical therapist and walk through the qualification and specialization process involved. We will also take a closer look at the profession itself, the patients these therapists work with, the settings in which they practice, and the advanced training available in neurologic physical therapy.
Understanding the Neurological Physical Therapist Profession
Neurological physical therapists are licensed PTs who specialize in treating patients whose movement and physical function have been affected by conditions involving the nervous system. Their work is centered on helping these patients improve their ability to move, function more independently, and manage the physical limitations associated with their condition.
When working with a new patient, neurological PTs first assess how the neurological condition affects their movement and ability to perform everyday activities. After reviewing the patient’s neurologic diagnoses, they develop an individualized treatment plan aimed at addressing the specific functional problems the patient is experiencing.
Depending on the patient’s needs, this treatment plan may include therapeutic exercises, mobility and gait training, balance activities, and other interventions intended to improve physical function. As the patient progresses through rehabilitation, the therapist will monitor their response to treatment and adjust the plan when their abilities or rehabilitation needs change.
In addition to providing treatment during rehabilitation sessions, neurological PTs may also help support patients outside the clinical setting by educating them and their caregivers about safe movement, exercises, assistive devices, and strategies that can make everyday activities easier to manage.
Considering that neurologic physical therapy is a specialized area of practice, becoming a neurological PT is a multi-stage process that includes qualifying for general physical therapy practice and then specializing in neurologic physical therapy.
Patients and Conditions Treated by Neurological Physical Therapists
Given that the nervous system plays a major role in controlling movement and physical function, neurological PTs can work with patients affected by a wide range of conditions that interfere with their mobility and independence, including:
- Strokes, which can lead to weakness, impaired coordination, balance problems, and difficulty walking or performing everyday movements
- Parkinson disease, where physical therapy may help patients maintain mobility, improve balance and walking, and manage changes in movement as the condition progresses
- Multiple sclerosis, which can affect strength, balance, coordination, endurance, and mobility in different ways depending on the individual
- Traumatic brain injuries, which may cause problems with balance, coordination, strength, movement control, and other areas of physical function
- Spinal cord injuries, where rehabilitation may focus on improving mobility, strength, transfers, wheelchair use, and the greatest possible level of independence
- Cerebral palsy, which can affect posture, coordination, muscle control, and movement and may require ongoing physical therapy throughout different stages of life
- Vestibular and other neurological disorders, which may cause dizziness, balance difficulties, or other movement-related problems that interfere with everyday activities
In other words, the expertise of a skilled neurologic PT can find application in a wide range of rehabilitation scenarios, from helping patients recover from a brain injury to supporting those living with long-term or progressive conditions.
Professional Work Settings for Neurological Physical Therapists
As we just established above, neurological PTs can work with patients who have very different rehabilitation needs, which means they can practice in a variety of healthcare, rehabilitation, and residential settings, including:
- Hospitals, where they may work with patients who need physical rehabilitation after a neurological injury, medical event, or newly diagnosed condition
- Inpatient rehabilitation facilities, where patients can receive more intensive therapy while recovering from serious neurologic conditions that significantly affect mobility and independence
- Outpatient rehabilitation clinics, where neurological PTs may provide ongoing treatment to patients who no longer require inpatient care but still need help improving or maintaining their physical function
- Skilled nursing and residential care facilities, where they may work with older adults and other patients who need longer-term rehabilitation or support with mobility
- Home healthcare services, where therapists can provide rehabilitation to patients whose condition makes regular travel to a clinical facility difficult
- Specialized neurological rehabilitation centers, where they may work alongside other healthcare professionals to treat patients with more complex neurological conditions
Naturally, the work setting can have a considerable influence on the patients neurological PTs treat and the stage of rehabilitation in which they become involved. While some may help patients begin recovering after an acute neurological event, others may provide longer-term support to individuals managing chronic or progressive conditions.
Becoming a Neurological Physical Therapist: Required Qualifications
Now that we have a better understanding of the neurological physical therapy profession, we can turn our attention to the requirements aspiring individuals need to meet to enter this specialized field.
Because neurological physical therapy is a specialization within the broader physical therapy profession, the individuals who aspire to join this field must first complete the standard education and licensing process required of PTs before moving on to advanced neurologic training.
This includes earning the following qualifications:
- Completing the undergraduate education and prerequisite coursework required for admission to a DPT program
- Earning a Doctor of Physical Therapy degree from a CAPTE-accredited program
- Accumulating the required supervised clinical practice
- Passing the National Physical Therapy Examination
- Obtaining a professional physical therapist license from the state in which they intend to practice
- Completing a neurologic physical therapy residency
- Passing the Neurologic Specialty Examination and earning board certification as a Neurologic Clinical Specialist
Granted, obtaining a board certification is not a mandatory requirement for licensed PTs to work in neurologic physical therapy, and they can practice in this area without earning the NCS credential.
However, earning it can certainly improve the therapist’s professional profile and allow them to demonstrate their advanced competency more clearly and credibly to their patients and employers.
How to Become a Neurological Physical Therapist: Step-by-Step
Having outlined the qualifications required for becoming a neurological PT, we can now move on to the practical part of the guide and walk you through each stage of the qualification process.
Complete the Required Undergraduate Education
The first step toward becoming a neurological PT is completing the undergraduate education needed for admission to a Doctor of Physical Therapy program. Most physical therapy programs require applicants to hold a bachelor’s degree, although they generally do not require a specific undergraduate major.
This means that at the undergraduate level, aspiring neurological PTs can choose to enroll in any health sciences field that interests them as long as they also complete the prerequisite coursework required by the programs they intend to apply to. These prerequisites commonly include subjects such as anatomy, physiology, biology, chemistry, physics, psychology, and statistics.
We should point out that different DPT programs, offered by different institutions, may also establish additional admission criteria, such as minimum GPA requirements, observation or volunteer experience in a physical therapy setting, recommendations, or other application requirements.
For this reason, prospective students should identify suitable programs early and make sure they satisfy both the required coursework and any other criteria before applying.
Earn a Doctor of Physical Therapy Degree
After earning a bachelor’s degree, aspiring neurological PTs need to continue their academic journey into the graduate level and enroll in a Doctor of Physical Therapy degree program accredited by the Commission on Accreditation in Physical Therapy Education.
Most CAPTE-accredited DPT programs take about three years to complete and combine classroom instruction, laboratory training, and supervised clinical education. During this period, students study advanced coursework in anatomy, physiology, neuroscience, biomechanics, kinesiology, pathology, pharmacology, and therapeutic interventions.
Additionally, the curriculum of most DPT programs also introduces students to the evaluation and treatment of patients with neurological conditions, allowing them to begin developing the knowledge and clinical reasoning skills they will later build on through more focused specialty training.
Beyond learning about physical therapy in theory, this stage of physical therapy education can also give students an opportunity to begin applying what they have learned in real clinical settings.
As such, students who want to pursue neurologic physical therapy may want to choose a DPT program that can provide clinical exposure to neurologic rehabilitation, as this can help them begin building relevant experience before they move into postgraduate specialty training.
Accumulate the Required Supervised Clinical Practice
In addition to completing their academic coursework, DPT students must also complete full-time clinical experiences in approved patient-care settings under the supervision of qualified clinical instructors as part of their professional education.
Under the current CAPTE standards, these experiences need to total at least 30 weeks and are designed to give students the opportunity to apply their academic and laboratory training while taking on progressively greater responsibility for patient care.
Depending on the program and the placements available, students may complete their clinical practice in outpatient clinics, hospitals, rehabilitation facilities, or other healthcare environments. Those who are specifically interested in neurologic physical therapy may be able to complete one or more placements in settings where they can work with patients affected by neurological conditions.
By the time they complete this stage, students should have developed the practical experience needed to complement their academic preparation and move on to the licensing process.
Pass the National Physical Therapy Examination
With their academic and supervised clinical preparation complete, DPT graduates can move on to the examination stage of the physical therapy licensing process.
The main exam they need to take here is the National Physical Therapy Examination, commonly known as the NPTE, which is developed and administered by the Federation of State Boards of Physical Therapy. The examination is designed to assess whether candidates have the knowledge and abilities required for entry-level physical therapy practice.
Before registering for the exam, it is a good idea for candidates to review the requirements of the state or jurisdiction where they intend to become licensed, as individual licensing authorities establish their own eligibility criteria and generally need to approve candidates to sit for the NPTE.
It is also important to distinguish this examination from the neurologic specialty exam candidates may take later in their careers. At this stage, the NPTE is used to qualify them for general physical therapy licensure, while specialty certification comes only after they have completed the additional preparation required for neurologic practice.
Secure Your State Physical Therapist License
Once the examination stage is complete, candidates who achieved passing scores on the NPTE and satisfied all the other requirements for licensure can move forward and apply for a professional PT license in their state.
Now, the exact application process can vary from one state to the next, though generally, candidates need to submit proof of their DPT education, examination results, and any other documentation requested by the relevant licensing authority.
Depending on the state, they may also be required to undergo a criminal background check and, naturally, pay the necessary fees for processing their application.
Once the licensing authority reviews the application and confirms that all applicable requirements have been met, candidates can receive their license and become legally authorized to practice physical therapy as professionals in that state.
Begin Practicing as a Licensed Physical Therapist
With their state license secured, newly qualified PTs can finally enter professional practice and begin treating patients independently within the scope of practice established by their jurisdiction. This milestone marks the end of the formal qualification process of becoming a PT and allows them to start building professional experience in the field.
At this stage, under this professional status, therapists may start looking for employment in outpatient clinics, hospitals, rehabilitation facilities, home healthcare, skilled nursing facilities, or other settings where physical therapy services are provided.
However, for those who want to practice as neurological PTs, securing a position in a setting where neurological rehabilitation services are provided can be a great way to gain some early exposure to this area of practice and begin working with the patient populations they hope to focus on in the long term.
Complete a Neurologic Physical Therapy Residency Program
While licensed PTs have all the qualifications they need to practice and build their careers as professionals, those who want to become neurological PTs have a few more specialized training steps they need to take to reach that goal.
The first of these involves completing a post-professional residency program that focuses on neurological physical therapy.
Under the current ABPTRFE standards, accredited clinical residency programs for physical therapists must include at least 1,800 total program hours. Of these, a minimum of 1,500 must consist of patient-care clinic hours, while at least 300 must be devoted to educational activities.
Most full-time neurologic physical therapy residencies take around 12 to 12.5 months to complete, although their exact length can vary depending on the program and the institution that offers it. During their time as residents, physical therapists combine structured education and mentoring with extensive clinical practice focused specifically on neurologic patient care.
Depending on the program, residents may gain experience with different neurological conditions and patient populations across rehabilitation, inpatient, and outpatient settings.
Once residents complete the required clinical and educational hours and satisfy all of the other requirements established by their program, they graduate from the residency and receive a certificate of completion, which formally documents their successful completion of the program.
Obtain Board Certification as a Neurologic Clinical Specialist
In addition to completing a neurologic physical therapy residency, the other major step that can further establish a PT’s specialization in neurology is obtaining board certification.
Granted, holding this credential is not mandatory for practicing as a neurological PT, however, earning it can help professionals demonstrate their expertise in neurologic physical therapy more clearly to patients, employers, and other healthcare professionals.
Board certification in this specialty practice is awarded by the American Board of Physical Therapy Specialties and leads to the Board-Certified Clinical Specialist in Neurologic Physical Therapy credential, commonly abbreviated as NCS.
To qualify for the certification examination, candidates must hold a current unrestricted physical therapist license and satisfy the applicable specialty experience requirements.
Graduates of an accredited neurologic physical therapy residency can qualify through their residency training, while PTs who follow the clinical experience route need to document at least 2,000 hours of direct patient care in neurologic physical therapy within the previous 10 years, including at least 500 hours completed during the previous three years.
Once they meet the eligibility requirements, candidates can apply for and take the Neurologic Specialty Examination, which will assess their advanced knowledge and clinical competency expected of physical therapists practicing at the specialist level.
Those who achieve a passing score earn board certification and can use the NCS designation alongside their professional credentials, and formally identify themselves as Board-Certified Clinical Specialists in Neurologic Physical Therapy.
Final Words
Neurologic dysfunction can significantly affect a person’s mobility, independence, and ability to carry out everyday activities. Neurological PTs can help patients manage these challenges through targeted rehabilitation and specialized physical therapy care.
Becoming a neurological physical therapist is a demanding, multi-stage process that requires completing the education, clinical training, examination, and licensing process required of all physical therapists and then continuing into specialized neurologic training.
However, for those who are willing to commit to the additional preparation and want to build a career helping patients manage complex neurological conditions, the profession can offer a meaningful path within the broader field of physical therapy.
Frequently Asked Questions
What does a neurological physical therapist do?
A neurological physical therapist evaluates and treats patients whose movement and physical function have been affected by conditions involving the nervous system.
Their work can include assessing how a neurological condition affects mobility, balance, coordination, strength, and the ability to perform everyday activities. Based on these findings, they develop individualized rehabilitation plans that may involve therapeutic exercise, gait and mobility training, balance activities, and other interventions.
How long does it take to become a neurologic physical therapist?
Becoming a neurologic physical therapist can take anywhere between eight and nine years from the moment a student begins their undergraduate education, depending on how long it takes to complete the licensing and specialty-training stages.
This timeframe includes around four years to earn a bachelor’s degree, followed by approximately three years in a Doctor of Physical Therapy program. Candidates then need additional time to pass the NPTE, complete the state licensing process, and begin practicing as licensed physical therapists.
From there, a neurologic physical therapy residency typically takes around 12 to 12.5 months to complete. Those who also pursue board certification will need additional time to apply for and pass the Neurologic Specialty Examination.
What is the difference between a physical therapist and a neurophysical therapist?
The main difference between a physical therapist and a neurophysical therapist is the area of practice they focus on.
Physical therapists can work with patients experiencing a wide range of movement and rehabilitation problems caused by injuries, surgeries, chronic conditions, or other health issues. A neurophysical therapist, on the other hand, focuses specifically on patients whose movement and physical function have been affected by neurological conditions.
Becoming a neurological physical therapy usually involves additional postgraduate training and may also include board certification as a Neurologic Clinical Specialist.