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Kentucky Occupational Therapy Deep Agent Modalities


"Deep physical agent modalities" means any device that uses sound waves or agents which supply or induce an electric current through the body, which make the body a part of the circuit, including iontophoresis units with a physician's prescription, ultrasound, transcutaneous electrical nerve stimulation units and functional electrical stimulation, or microcurrent devices.

"Superficial physical agent modalities" means hot packs, cold packs, ice, fluidotherapy, paraffin, water, and other commercially available superficial heating and cooling devices.


A licensee, before utilizing deep physical agent modalities, shall submit to the board a DPAM Specialty Certification Application.

The application shall be accompanied by:

    • Payment of the certification fee of twenty-five (25) dollars; and
    • Proper documentation that the applicant has met all educational and clinical requirements for certification which shall include:
      • Successful completion of the requisite hours of training and instruction required for the level of licensure held by the applicant; and
      • Successful completion of the five (5) treatment sessions that are signed off by the DPAM supervisor and meet the requirements specified below.

The documentation shall include:

    • The name and address of the person or organization presenting the course, workshop, seminar, or training attended by the applicant;
    • A copy of the course syllabus or a description of the course, workshop, or seminar which includes a summary of the learning objectives and teaching methods employed in the course, workshop, or seminar, a timed agenda of the course, workshop, or seminar with the content areas identified below clearly detailed within the timeframes, the qualifications of the instructors, and KBLOT course approval documentation provided by the board to the person or organization presenting the course, workshop, or seminar;
    • The name, address, and credentials of the person identified as the DPAM supervisor who supervised the five (5) treatment sessions;
    • Proof of successful completion of the training or course of instruction; and
    • A statement signed by the DPAM supervisor confirming that the applicant has completed five (5) supervised treatment sessions and that the criteria set forth in Section 4 of this administrative regulation have been met.

A DPAM Specialty Certification shall be issued by the board before the individual can begin using deep physical agent modalities except when a qualified licensee is performing those modalities as part of a supervised program to complete the five (5) supervised treatment sessions required for a DPAM Specialty Certification under this administrative regulation.

Training and Instruction

The training and instruction shall be earned by direct personal participation in courses, workshops, or seminars.

The content of the courses, workshops, or seminars shall include hands on training and instruction. Training shall not consist of all on-line courses that do not provide hands on lab instruction. Training shall include the following subject areas:

    • Principles of physics related to specific properties of light, water, temperature, sound, and electricity;
    • Physiological, neurophysiological, and electrophysiological changes which occur as a result of the application of each of the agents identified in KRS 319A.010(8);
    • Theory and principles of the utilization of deep physical agents which includes guidelines for treatment or administration of agents within the philosophical framework of occupational therapy;
    • The rationale and application of the use of deep physical agents;
    • The physical concepts of ion movement;
    • Critical thinking and decision making regarding the indications and contraindications in the use of deep physical agents;
    • Types selection and placement of various agents utilized;
    • Methods of documenting the effectiveness of immediate and long-term effects of interventions;
    • Characteristics of equipment including safe operation, adjustment, and care of the equipment; and
    • Application and storage of specific pharmacological agents.

The training and instruction shall include at a minimum eight (8) hours for an OTA/L and four (4) hours for an OT/L of hands on laboratory experience using DPAMs.

All courses, workshops, or seminars utilized for DPAM Specialty Certification shall meet the requirements above, be at least four (4) hours in length, and be approved by the board.

Supervised Treatment Sessions

The supervised treatment sessions required for DPAM Specialty Certification shall be sufficiently detailed to allow the DPAM supervisor to determine that the supervisee has demonstrated the following skills:

    • The ability to evaluate or contribute to the evaluation of the client, depending upon the applicant's licensure status as an OT/L or an OTA/L and make an appropriate selection of the deep physical agent to be utilized;
    • A thorough knowledge of the effects of the deep physical agent which is to be utilized;
    • The ability to explain the precaution, contraindication, and rationale of the specific deep physical agent utilized;
    • The ability to formulate and justify the occupational therapy intervention plan specifically delineating the adjunctive strategy associated with the use of each deep physical agent;
    • The capability to safely and appropriately administer the deep physical agent;
    • The ability to properly document the parameters of intervention which include the client’s response to treatment and the recommendations for the progression of the intervention process; and
    • The skills identified are not applicable to an OTA/L’s practice and an OTA/L is not required to demonstrate the skill in a supervised treatment session.

The supervised treatment sessions shall include one (1) session for each of the following areas:

    • Iontophoresis;
    • Ultrasound; and
    • Electrical stimulation.

The remaining two (2) sessions may cover any deep physical agent including those identified above.

Supervised treatment sessions may be completed in a laboratory portion of an instructional course, provided that the instructor meets the board’s requirements for a DPAM supervisor and that all of the requirements of this administrative regulation have been met.

Treatment sessions shall be completed under the direct supervision of an OT/L who meets the requirements of this section and is approved by the board.

Before an OT/L may be a DPAM supervisor for the treatment sessions specified in this administrative regulation, he or she shall:

    • Have a DPAM Specialty Certification issued by the board;
    • Be in good standing with the board;
    • Submit a DPAM Specialty Certification Supervisor Application; and
    • Have one (1) year of clinical experience in the use of deep physical agent modalities.

Individuals other than OT/Ls who have previously been approved as a DPAM supervisor under this administrative regulation shall maintain the status as a DPAM supervisor until June 1, 2015. After this time, only OT/Ls who meet the requirements shall remain active DPAM supervisors and be approved by the board.

The issuance of the DPAM specialty certification by the board only shows that the applicant has met the minimum requirements. It shall be the duty of the individual licensee to determine his or her competency to provide a specific DPAM for a client.


An OTA/L certified to use DPAMs under this administrative regulation may only use DPAMs when supervised by an OT/L certified to use DPAMs under this administrative regulation.


Ky, Rev. Stat. Ann. ยง319A.010

201 KAR 28:170

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