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California Physical Therapy Electromyography

Board Opinion:

A physical therapist certified to perform electroneuromyographical evaluations may conduct electroneuromyographical examinations using needles and electrodes, collect data by measuring the electrical waveforms generated during the examination, use his or her professional physical therapy expertise to analyze and interpret such data and develop findings or conclusions regarding the functioning of the patient's nerves or muscles. In other words, the physical therapist is authorized to provide a "professional" component of an ENMG study, exercising substantive judgment to interpret or read the significance of data collected and convey an opinion about the performance and functioning of the muscles and nerves to the referring physician.

Definitions

As used in these regulations:

 “Electroneuromyography” means the performance of tissue penetration for the purpose of evaluating neuromuscular performance, and includes the evaluation of specific abnormal potentials and evoked responses.

 “Kinesiological electromyography” means the study, including tissue penetration, of the phasic activity of individual or multiple muscles in relation to another physical or physiological event or exercise and does not include the evaluation of specific abnormal potentials or evoked responses.

Certification Required

No physical therapist shall perform tissue penetration for the purpose of making an electromyographical evaluation unless he or she is certified by the board to perform such tests or such practice is appropriately supervised in order to meet the experience requirements for examination by the board for certification.

No physical therapist who is certified to perform kinesiological electromyography shall perform electroneuromyographical evaluations without additional authorization from the board as indicated on his or her certification.

No physical therapist who is certified to perform electroneuromyographical evaluations shall perform kinesiological electromyography without additional authorization from the board as indicated on his or her certification.

Application Required

All applications for certification by the board in electromyography shall be on a form provided by the board which is accompanied by whatever documentation is required therein and the certification fee.

Application to Apply for KEMG or ENMG Certification

Requirements for Kinesiological Electromyography Certification

In order to be examined by the board for certification in kinesiological electromyography an applicant shall meet the following requirements:

Licensure

Be licensed as a physical therapist by the board.

Training in Tissue Penetration. Provide evidence of training under a licensed physician or a physical therapist certified to perform electromyography, in tissue penetration for the purpose of evaluation of muscular or neuromuscular performance which shall include instruction and demonstrations in:

  • Pertinent anatomy and physiology,
  • Choice of equipment,
  • Proper technique,
  • Hazards and complications,
  • Post test care, and
  • Satisfactory performance by the trainee in the technical skills of tissue penetration.
  • Such training may be completed as part of the coursework obtained below.

Education

Provide evidence of one of the following educational requirements:

Completion of regular or extension coursework pertinent to electromyography obtained in a public university or state college or in a private postsecondary educational institution which is accredited or approved for which academic credit is awarded or continuing education coursework, which is acceptable to the board. The curriculum vitae of the instructor, course outline, course objectives and evaluation mechanism of any extension or continuing education coursework which is presented by the applicant as meeting the requirements of this section shall be forwarded to the board upon request. Such coursework in order to qualify the applicant for certification shall include instruction in the following subject areas:

  • Gross anatomy -the muscular system of the body with emphasis on the structural and cross sectional relationships.
  • Neuroanatomy -organization and functional features of the central and peripheral nervous system.
  • Nerve and muscle physiology -bioelectric currents and their characteristic wave forms and conduction over peripheral nerves.

Self-Study

Completion of a period of self-study which prepares the applicant to pass an examination for certification in kinesiological electromyography. Evidence and documentation shall include a summarization of what matters were contained in the self-study including the applicant's clinical exposure to electromyography and any materials studied on that subject and the names and statements, of any proctors who may have supervised the applicant in electromyography;

Authorization to perform electromyography issued by another state with similar requirements.

Experience

Provide evidence of the following experience requirements:

  • Completion of not less than 200 clock hours in kinesiological electromyography satisfactory to the board which provides a progressive level of training under a physical therapist certified in kinesiological electromyography in this state or another state which has similar requirements for certification, or under a licensed physician who is similarly qualified to perform and who performs kinesiological electromyography as part of his or her practice of medicine who is approved by the board.
  • Documentation of completion of fifty (50) kinesiological electromyographic examinations.

Requirements for Electroneuromyography Authorization

In order to be examined by the board for additional authorization to perform electroneuromyographical examinations an applicant shall meet the following requirements:

Education

Provide evidence of one of the following education requirements:

In addition to that coursework, completion of the following additional coursework which meets the requirements of that section in the following subject areas:

  • Neuroanatomy which also emphasizes the course of peripheral nerves and patterns of innervation.
  • Clinical neurology, myology and pathology -identification of clinical characteristics of neurogenic and myogenic disorders.
  • Physical science of electroneuromyography -basic electrophysiology and the identification and recording of bioelectric signals.
  • Clinical science of electroneuromyography -knowledge and procedures of patient evaluation and examination, including electromyographic and nerve conduction velocity studies, and training in tissue penetration.

Completion of a period of self-study which prepares the applicant to pass a supplemental examination for additional certification to perform electroneuromyographical examination. Evidence and documentation shall include a summarization of what matters were contained in the self-study including the applicant's clinical exposure to electroneuromyography and any materials studied on that subject and the name and statements, of any proctors who may have supervised the applicant in electroneuromyography.

Authorization to perform electroneuromyographical examinations issued by another state with similar requirements.

Experience

Provide evidence of the following experience requirements:

  • Completion of not less than 400 clock hours in electroneuromyography, satisfactory to the board which provides a progressive level of training under 
    • A physical therapist authorized to perform electroneuromyography, in this state or, 
    • Under a licensed physical therapist in another state which has similar requirements for certification, who is authorized to perform electroneuromyography or who is certified by the American Board of Physical Therapy Specialists as an electrophysiological clinical specialist, or 
    • Under a licensed physician who is similarly qualified to perform and who performs electroneuromyography, as part of his or her practice of medicine.
  • Documentation of completion of 200 electroneuromyographic examinations.

Examination Required

All physical therapists applying for certification to perform kinesiological electromyography shall take and pass the examination  which will be administered by the board.

All physical therapists applying for certification to perform electroneuromyography shall take and pass the examination which will be administered by the board.

Certification Renewal

All certificates to perform electromyography shall be renewed concurrently with each holder's physical therapist license.

Suspension or Revocation of Certificates

Any certificate to perform electromyography may be suspended or revoked or have probationary conditions imposed thereon by the board as directed by the board after proceedings held in accordance to the Administrative Procedure Act for any violation of this article, the Physical Therapy Regulations or Section 2660 of the code.

It shall constitute unprofessional conduct and a violation of these rules for a physical therapist certified to perform kinesiological electromyography only to perform electroneuromyography without additional authorization obtained from the board, unless such practice is appropriately supervised in order to meet the experience requirements for examination by the board for such additional authorization.

Electromyography Reports

The findings reported to the patient's physician shall include the following statement:

“This study has been performed in accordance with the Physical Therapy Practice Act (Chapter 5.7 of Division 2 of the Business and Professions Code) and with the Physical Therapy Regulations (Title 16, California Code of Regulations, Division 13.2). The findings in this report do not represent diagnostic interpretations or medical diagnoses. The results of the electromyographic examination by the certified electromyographer are intended for integration by the physician and surgeon with the patient's history, clinical examination, and the results of any other tests performed in establishing a medical diagnosis.”

Citations

16 CCR § 1399.60

16 CCR § 1399.61

16 CCR § 1399.62

16 CCR § 1399.63

16 CCR § 1399.64

16 CCR § 1399.65

16 CCR § 1399.68

16 CCR § 1399.69

16 CCR § 1399.70


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