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Illinois Occupational Therapy Modalities

Physical Agent Modalities

Modalities that produce a response in soft tissue through the use of light, water, temperature, sound, or electricity.

They are characterized as adjunctive methods used in conjunction with or in immediate preparation for: patient involvement in purposeful activity; the use of ergonomic principles; the adaptation of environments and processes to enhance functional performance; or the promotion of health and wellness.

Modalities include but are not limited to the following:

  • Electrical stimulation;
  • Iontophoresis;
  • Superficial heating agents;
  • Cryotherapy; and
  • Deep heating agents.

Required Training and Education


Modalities using electricity would cover: pain control, edema reduction, and muscle reeducation.  Examples include, but are not limited to: biofeedback, neuromuscular electrical stimulation/functional electrical stimulation (NMES/FES), transcutaneous electrical nerve stimulation (TENS), high volt galvanic stimulation (HVGS), interferential, iontophoresis.  The training shall include:

  • A minimum of twelve (12) hours of didactic training in a program that includes demonstration and return demonstration and an examination; and
  • Five (5) treatments in each modality supervised by a licensed health care professional trained in the use of the modality.

Thermal Modalities

Thermal modalities would include superficial and deep heat and cyrotherapy.  Examples include, but are not limited to, hot and cold packs, ice massage, fluidotherapy, warm whirlpool, cool whirlpool, ultrasound, phonophoresis, paraffin and contrast baths.

  • A minimum of three (3) hours of didactic training in a program that includes demonstration and return demonstration and an examination. The training session should include the mechanics and precautions of using the modality safely as well as case studies and problem solving on when to use. The ethics, economics, liability, and insurance issues related to using modalities should also be addressed in the educational process.
  • Five (5) treatments in each modality supervised by a licensed health care professional trained in the use of the modality.

Educational Programs

The didactic training shall be obtained through educational programs, workshops, or seminars offered or approved by a college or university, Illinois Occupational Therapy Association, the American Occupational Therapy Association and its affiliates, Illinois Physical Therapy Association, the American Physical Therapy Association, National Board for Certification in Occupational Therapy (NBCOT), or the Hand Therapy Certification Commission.


The training shall be documented and made available to the Division or Board upon request.  Training shall be completed prior to the use of these modalities.  Documentation shall include:

  • A transcript or proof of successful completion of the coursework, including the number of educational hours;
  • The name and address of the individual or organization sponsoring the activity;
  • The name and address of the facility at which the activity was presented;
  • A copy of the course, workshop, or seminar description that includes topics covered, learning objectives, credentials of presenters and standards for meeting the objectives;
  • Documentation of the five (5) clinical treatments that includes date of the treatments, the modality and the name and credentials of the supervisor.

Clinical Treatment Demonstration

The clinical treatment demonstration shall include the following:

  • The ability to evaluate or contribute to the evaluation of the client and make an appropriate selection of the modality to be utilized.
  • A thorough knowledge of the effects of the modality that is to be utilized;
  • The ability to explain the precaution, contraindication and rationale of the specific modality utilized;
  • The ability to formulate and justify the occupational therapy intervention plan, specifically delineating the adjunctive strategy associated with the use of each modality;
  • The capability to safely and appropriately administer the modality;
  • The ability to properly document the parameters of intervention, which include the client's response to treatment and the recommendation for the progression of the intervention process.

Clinical Supervision

The clinical supervisor for the treatment session shall:

  • Be licensed or certified and in good standing in this profession or another profession within Illinois that permits the use of the physical agent modalities;
  • Be a practitioner at the same or greater professional level;
  • Have a minimum of one (1) year of clinical experience, within the previous three (3) years, in the use of the physical agent modalities.

Training Prior to 2002

Occupational therapists and occupational therapy assistants who, prior to January 1, 2002, have attended training programs and have developed competencies in the use of physical agent modalities may demonstrate competency through proof of one or more of the following:

  • Documentation of previous attendance and completion of the required training;
  • Documentation of professional experience at the work place through policy and procedures indicating the use of modalities, inservice training, proof of prior use.  The experience shall include at least twenty (20) applications for each modality within the last three (3) years;
  • Documentation of attendance at educational programs, including post‑professional programs, in-service training and specific certifications in the use of modalities; or
  • Documentation of certification as a hand therapist from the Hand Therapy Certification Commission.


Ill. Admin. Code § 1315.162

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