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North Carolina PT General Scope of Practice

How does the state define physical therapy?

"Physical therapy" means the evaluation or treatment of any person by the use of physical, chemical, or other properties of heat, light, water, electricity, sound, massage, or therapeutic exercise, or other rehabilitative procedures, with or without assistive devices, for the purposes of preventing, correcting, or alleviating a physical or mental disability. Physical therapy includes the performance of specialized tests of neuromuscular function, administration of specialized therapeutic procedures, interpretation and implementation of referrals from licensed medical doctors or dentists, and establishment and modification of physical therapy programs for patients. Evaluation and treatment of patients may involve physical measures, methods, or procedures as are found commensurate with physical therapy education and training and generally or specifically authorized by regulations of the Board. Physical therapy education and training shall include study of the skeletal manifestations of systemic disease.

What is the scope practice for PTs?

The practice of physical therapy includes tests of joint motion, muscle length and strength, posture and gait, limb length and circumference, activities of daily living, pulmonary function, cardio-vascular function, nerve and muscle electrical properties, orthotic and prosthetic fit and function, sensation and sensory perception, reflexes and muscle tone, and sensorimotor and other skilled performances; treatment procedures such as hydrotherapy, shortwave or microwave diathermy, ultrasound, infra-red and ultraviolet radiation, cryotherapy, electrical stimulation including transcutaneous electrical neuromuscular stimulation, massage, debridement, intermittent vascular compression, iontophoresis, machine and manual traction of the cervical and lumbar spine, joint mobilization, machine and manual therapeutic exercise including isokinetics and biofeedback; and training in the use of orthotic, prosthetic and other assistive devices including crutches, canes and wheelchairs. Physical therapy further includes:

Examining (history, system review and tests and measures) individuals in order to determine a diagnosis, prognosis, and intervention within the physical therapist's scope of practice. Tests and measures include the following:

    • Aerobic capacity and endurance;
    • Anthropometric characteristics;
    • Arousal, attention, and cognition;
    • Assistive and adaptive devices;
    • Community and work (job/school/play) integration or reintegration;
    • Cranial nerve integrity;
    • Environmental, home, and work (job/school/play) barriers;
    • Ergonomics and body mechanics;
    • Gait, locomotion, and balance;
    • Integumentary integrity;
    • Joint integrity and mobility;
    • Motor function;
    • Muscle performance;
    • Neuromotor development and sensory integration;
    • Orthotic, protective and supportive devices;
    • Pain;
    • Posture;
    • Prosthetic requirements;
    • Range of motion;
    • Reflex integrity;
    • Self-care and home management;
    • Sensory integrity; and
    • Ventilation, respiration, and circulation.

Alleviating impairment and functional limitation by designing, implementing, and modifying therapeutic interventions that include the following:

    • Coordination, communication and documentation;
    • Patient/client-related instruction;
    • Therapeutic exercise (including aerobic conditioning);
    • Functional training in self-care and home management (including activities of daily living and instrumental activities of daily living);
    • Functional training in community and work (jobs/school/play) integration or reintegration activities (including instrumental activities of daily living, work hardening, and work conditioning);
    • Manual therapy techniques (including mobilization and manipulation);
    • Prescription, application, and fabrication of assistive, adaptive, orthotic, protective, supportive, and prosthetic devices and equipment that is within the scope of practice of physical therapy;
    • Airway clearance techniques;
    • Wound management;
    • Electrotherapeutic modalities; and
    • Physical agents and mechanical modalities.

Preventing injury, impairment, functional limitation, and disability, including the promotion and maintenance of fitness, health, and quality of life in all age populations.

What services are expressly prohibited?

Physical therapy does not include the application of roentgen rays or radioactive materials, surgery, manipulation of the spine unless prescribed by a physician licensed to practice medicine in North Carolina, or medical diagnosis of disease.

A physical therapist must not employ acts, tests, procedures, modalities, treatments, or interventions in the treatment of patients that are beyond the scope of the practice of physical therapy. Any patient whose condition requires medical diagnosis of disease or treatment beyond the scope of physical therapy must be referred.

Physical therapy does not include the application of roentgen rays or radioactive materials, a physical therapist may review x-rays and may also request radiologic consultations; however, a physical therapist shall not order radiological examinations.

Citations

21 NCAC 48C .0103

N.C. Gen. Stat. ยง 90-270.24



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