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North Carolina Physical Therapy Assistant Practices 

Removal of Sutures or Staples by a Physical Therapist Assistant

Since this procedure is not within the scope of practice of physical therapy, the Board does not take a position on whether a PTA can remove sutures or staples; however, it is important to reiterate the basic premise that the supervising physical therapist is ultimately responsible for the activities of the PTA.

Position Statement – North Carolina Board of Physical Therapy Examiners

Adopted – August 11, 2006 (PT); July 13, 2007 (PTA)

Reviewed – September 23, 2010, June 17, 2015

Performance of Sharp Debridement by a Physical Therapist Assistant

The NCBPTE has determined that in those limited situations in which engaging in interventions involving sharp debridement does not require continuing evaluation during the intervention, it is not a violation of the North Carolina Physical Therapy Practice Act or Board’s rules for a physical therapist assistant who is properly trained and appropriately supervised to perform sharp debridement provided that the debridement is strictly treatment. If a continuing evaluation is required during the treatment, then performance by the physical therapist is required, and the determination of whether sharp debridement should be performed is made by the physical therapist.

Position Statement – North Carolina Board of Physical Therapy Examiners

Posted – March 29, 2007

Reviewed – September 23, 2010, June 17, 2015

Performance of soft tissue mobilization vaginally or rectally by a PTA

The NCBPTE determined that to perform soft tissue mobilization vaginally or rectally would require a continuous ongoing re-evaluation and reassessment that can only be performed by a physical therapist; therefore, it would not be appropriate for a physical therapist assistant to perform internal vaginal and rectal interventions.

Position Statement – North Carolina Board of Physical Therapy Examiners

Adopted – June 6, 2007

Reviewed – September 23, 2010, June 17, 2015

Performance of Sharp Debridement by a Physical Therapist Assistant

The NCBPTE has determined that in those limited situations in which engaging in interventions involving sharp debridement does not require continuing evaluation during the intervention, it is not a violation of the North Carolina Physical Therapy Practice Act or Board’s rules for a physical therapist assistant who is properly trained and appropriately supervised to perform sharp debridement provided that the debridement is strictly treatment. If a continuing evaluation is required during the treatment, then performance by the physical therapist is required, and the determination of whether sharp debridement should be performed is made by the physical therapist.

Position Statement – North Carolina Board of Physical Therapy Examiners

Posted – March 29, 2007 Reviewed – September 23, 2010, June 17, 2015

Performance of Mobilization by a Physical Therapist Assistant

The NCBPTE was clear in its determination that it would be inappropriate for a PTA to engage in spinal mobilization under any circumstances. The question of whether a PTA can engage in peripheral mobilization is less clear. Some members felt that it is difficult to perform peripheral mobilization without continuing evaluations. However, it was also recognized that PTAs have been engaged in peripheral mobilization in this State. Under any circumstances, a PTA must have the requisite knowledge and skill to engage in peripheral mobilization.

The NCBPTE was advised that since the typical PTA education program does not provide the sufficient education and training for a graduate to be able to perform peripheral mobilization, those skills must be developed by additional training before a PTA can perform peripheral mobilization in a practice setting.

BULLETS ADDED FOR CLARIFICATION – September 23, 2010

    • Gentle manual cervical traction is not considered mobilization and would not be prohibited.
    • As the sacroiliac joint is considered part of the spine, mobilization of the sacroiliac joint would be prohibited.
    • The competence of the physical therapist assistant will be determined by the supervising physical therapist as the supervising physical therapist is ultimately responsible for the care of the patient / client.

Position Statement – NC Board of Physical Therapy Examiners

Posted - December 28, 2001

Updated – September 23, 2010 (Bullets added below for clarification), June 17, 2015

Scope of Authority of the Physical Therapist Assistant to Assist the Physical Therapist with Functional Capacity Evaluations

Board Conclusions

    • An FCE must be performed by the PT.
    • Before proceeding with an FCE, the PT must assess the patient’s medical condition and whether the tests can be performed without further injury to the patient.
    • A PTA can utilize a form to ask a patient questions regarding medical history, incidents of pain or dysfunction and work history.
    • If a standard form is used to obtain responses from each patient to basic questions, a PT must ask any questions generated by the patient’s responses to the basic questions.
    • When assisting with the performance of an FCE, a PTA cannot perform tests of cardiovascular or pulmonary capacity, observations of integumentary changes, or assessments of musculoskeletal or neuromuscular function.
    • An appropriately trained PTA may perform objective tests and measures related to strength and lifting and range of motion.
    • A PTA can determine whether a patient is performing a test in a safe and correct manner.
    • A PT must make all observations that require an evaluation or determination, including whether a task can be performed in the workplace, at what level a task can be performed, or how long the task can be performed.
    • Any observations made by a PTA should be reported to the supervising PT.
    • A PTA must document in the patient record all procedures performed by the PTA.

Position Statement – North Carolina Board of Physical Therapy Examiners

Adopted – December 2, 2004

Reviewed – September 23, 2010, June 17, 2015

Utilization of the Physical Therapist Assistant to Assist the Physical Therapist With Patient Screens

It is the position of the North Carolina Board of Physical Therapy Examiners that the physical therapist assistant (PTA) is qualified and permitted by the North Carolina Physical Therapy Practice Act to assist the physical therapist (PT) with the performance of patient screens. A physical therapist assistant may not perform screens independently. The following assumptions support this position:

  • The physical therapist retains the ultimate responsibility for the provision of physical therapy services.
  • The purpose of a screen is to determine if an examination of a patient by a physical therapist is indicated.
  • Screens may be either “hands-on” or “hands-off” procedures.
  • The physical therapist should only delegate aspects of a patient screen that are appropriate to the assistant’s education, experience, knowledge, and skill according to the guidelines identified herein under: Delegation and Supervision.
  • The physical therapist assistant may participate in the collection of data. It is the responsibility of the physical therapist to interpret the data.
  • The physical therapist assistant may review the patient medical record to gather information to assist the physical therapist with the screen.
  • The physical therapist assistant should never make a determination whether the patient needs to be seen by a physical therapist or another healthcare professional.

Position Statement – NC Board of Physical Therapy Examiners

Adopted July 17, 1997



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