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Hawaii Physical Therapy Scope of Practice

How is physical therapy defined in Hawaii?

"Physical therapy" or "physical therapy services" means the examination, treatment, and instruction of human beings to detect, assess, prevent, correct, alleviate, and limit physical disability, bodily malfunction, pain from injury, disease, and any other physical or mental condition as performed by a physical therapist appropriately licensed under this chapter. It includes but is not limited to:

    • Administration, evaluation, modification of treatment, and instruction involving the use of physical measures, activities, and devices, for preventive and therapeutic purposes; provided that should the care or treatment given by a physical therapist or physical therapist assistant contravene treatment diagnosed or prescribed by a medical doctor, osteopath, or as determined by the board, the physical therapist shall confer with the professional regarding the manner or course of treatment in conflict and take appropriate action in the best interest of the patient; and
    • The provision of consultative, educational, and other advisory services for the purpose of reducing the incidence and severity of physical disability, bodily malfunction, or pain.

What is included in the practice of physical therapy?

The practice of physical therapy includes, but is not limited to, the use of the following:

    • Physical agents, such as heat, cold, water, air, sound, compression, light, electricity, and electromagnetic radiation;
    • Exercise with or without devices, joint mobilization, mechanical stimulation; biofeedback; postural drainage; traction; positioning, massage, splinting, training in locomotion, and other functional activities with or without assisting devices; and correction of posture, body mechanics, and gait;
    • Tests and measurements of: muscle strength, force, endurance, and tone; joint motion, mobility, and stability; reflexes and automatic reaction; movement skill and accuracy; sensation and perception; peripheral nerve integrity; locomotor skill, stability, and endurance; activities of daily living; cardiac, pulmonary, and vascular functions; and fit, function, and comfort of prosthetic, orthotic, and other assisting devices; posture and body mechanics; limb strength, circumference, and volume; thoracic excursion and breathing patterns; vital signs; nature and locus of pain and conditions under which pain varies; photosensitivity; and the home and work physical environments.

Physical Therapy Examination

"Physical therapy examination" means the process of obtaining a history, a systems review, and selecting and administering tests and measures to gather data about the patient. The initial physical therapy examination is a comprehensive screening and specific testing process. Tests and measurements may include, but are not limited to:

    • Muscle strength, force, endurance, and tone;
    • Joint motion, mobility, and stability;
    • Reflexes and automatic reaction;
    • Movement skill and accuracy;
    • Sensation and perception;
    • Peripheral nerve integrity;
    • Locomotor skill, stability, and endurance;
    • Activities of daily living;
    • Cardiac, pulmonary, and vascular functions;
    • The fit, function, and comfort of prosthetic, orthotic, and other assistive devices;
    • Posture and body mechanics;
    • Limb length, circumference, and volume;
    • Thoracic excursion and breathing patterns;
    • Vital signs;
    • The nature and locus of pain and conditions under which pain varies;
    • Photosensitivity; and
    • Home, community, and work physical environments.

Physical Therapy Treatment or Intervention

"Treatment" or “intervention” means purposeful and skilled interaction between the physical therapist, PTA, temporary physical therapist licensee or student and the patient in the care of the patient using various physical therapy methods and techniques to produce changes in the patient's condition that are consistent with the diagnosis and treatment. A physical therapy treatment or intervention may consist of the following components:

    • Air;
    • Sound;
    • Compression;
    • Light;
    • Mechanical stimulation;
    • Biofeedback;
    • Positioning;
    • Therapeutic heat and cold;
    • Therapeutic exercise;
    • Gait training;
    • Activities of daily living and functional training;
    • Therapeutic electric current;
    • Therapeutic massage;
    • Ultrasound;
    • Behavior modification;
    • Traction;
    • Hydrotherapy;
    • Pulmonary therapy;
    • Wound care and external dressings;
    • Orthoses and external supports;
    • Assistive/adaptive devices;
    • Therapeutic equipment;
    • Neurodevelopmental activities;
    • Mobilization and manipulation;
    • Posture training;
    • Prosthetic management;
    • Cardiopulmonary rehabilitation;
    • Coordination, communication and documentation;
    • Patient-related instruction; and
    • Procedural interactions including but not limited to:
      • Therapeutic exercise;
      • Functional training in self-care and home management, including activities of daily living and instrumental activities of daily living;
      • Functional training in work, including school and play, community and leisure integration or reintegration, including instrumental activities of daily living, work hardening, and work conditioning;
      • Manual therapy techniques, including mobilization or manipulation;
      • Prescription, application, and, as appropriate, fabrication of devices, and assistive, adaptive, orthotic, protective, supportive, and prosthetic equipment;
      • Airway clearance techniques;
      • Integumentary repair and protection techniques;
      • Electrotherapeutic modalities;
      • Physical agents; and
      • Mechanical modalities.

What is specifically excluded from the practice?

A physical therapist shall not use invasive procedures. For purposes of this section, an invasive procedure is the breaking or puncturing of a person's good skin integrity, for example, through surgery or injections.

Are there any special trainings required?

N/A

Reference

H.R.S. §461J-1

H.A.R. §12-110-2

H.R.S. §461J-2.5

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