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Washington Physical Therapy Spinal Manipulation

A physical therapist may perform spinal manipulation only after being issued a spinal manipulation endorsement by the secretary. The secretary, upon approval by the board, shall issue an endorsement to a physical therapist who has at least one year of full-time, orthopedic, postgraduate practice experience that consists of direct patient care and averages at least thirty-six (36) hours a week and who provides evidence in a manner acceptable to the board of all of the following additional requirements:

  • Training in differential diagnosis of no less than one hundred (100) hours outlined within a course curriculum;
  • Didactic and practical training related to the delivery of spinal manipulative procedures of no less than two hundred fifty (250) hours clearly delineated and outlined in a course curriculum;
  • Specific training in spinal diagnostic imaging of no less than one hundred fifty (150) hours outlined in a course curriculum; and
  • At least three hundred (300) hours of supervised clinical practical experience in spinal manipulative procedures. 

Supervising Clinical Instructor

  • Holds a spinal manipulation endorsement under this section;
  • Is a licensed chiropractor or osteopathic physician and surgeon; or
  • Holds an endorsement or advanced certification the training requirements for which are commensurate with the training requirements.

The training must be under the close supervision of the clinical supervisor for a minimum of the first one hundred fifty (1500 hours of the supervised clinical practical experience, after which the supervised clinical practical experience must be under the direct supervision of the clinical supervisor.

The training must completed within eighteen (18) months of completing the educational requirements, unless the physical therapist has completed the educational requirements prior to July 1, 2015, in which case the supervised clinical practical experience must be completed by January 1, 2017.

Continuing Education

A physical therapist holding a spinal manipulation endorsement under this section shall complete at least ten (10) hours of continuing education per continuing competency reporting period directly related to spinal manipulation. At least five (5) hours of the training required under this subsection must be related to procedural technique and application of spinal manipulation.

If procedures are required beyond six treatments

A physical therapist holding a spinal manipulation endorsement shall consult with a health care practitioner, other than a physical therapist, authorized to perform spinal manipulation if spinal manipulative procedures are required beyond six (6) treatments.

Coordination with a Chiropractor

 If a physical therapist is intending to perform spinal manipulation on a patient who the physical therapist knows is being treated by a chiropractor for the same diagnosis, the physical therapist shall make reasonable efforts to coordinate patient care with the chiropractor to prevent conflict or duplication of services.

Prohibited Actions

A physical therapist holding a spinal manipulation endorsement may not:

  • Have a practice in which spinal manipulation constitutes the majority of the services provided;
  • Practice or utilize chiropractic manipulative therapy in any form;
  • Delegate spinal manipulation; or
  • Bill a health carrier for spinal manipulation separately from, or in addition to, other physical therapy procedures.

Clinical Supervisor

To qualify as a clinical supervisor, a person must be a licensed physical therapist who holds an endorsement or advanced certification for which the training requirements are commensurate with the training requirements and have at least one of the following credentials:

  • Orthopedic Manual Therapy Fellowship/Fellow American Academy of Orthopedic Manual Physical Therapy designation trained under an American Board of Physical Therapy residencies and Fellowship Education.
  • Orthopedic Physical Therapy Residency trained under an American Board of Physical Therapy residencies and Fellowship Education credentialed program.
  • Orthopedic Certified Specialist/Orthopedic Clinical Specialist designation (American Board of Physical Therapy Specialties).
  • Orthopedic manual physical therapy certification as a:
    • Certified Functional Manual Therapist at the Institute of Physical Art; or
    • Certified Manual Physical Therapist at the North American Institute of Orthopaedic Manual Therapy; or
    • Certified Orthopedic Manual Therapist at the:
      • Maitland Australian Physiotherapy Seminars; or
      • North American Institute of Orthopaedic Manual Therapy; or
      • Ola Grimsby Institute; or
  • Therapist with a Manual Therapy Certification from:
    • Evidence in Motion; or
    • The University of St. Augustine for Health Sciences; or
    • Other certifications approved by the board.

Citations

RCW 18.74.190

WAC 246-915-382

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