Oklahoma

The Physical Therapy Practice Act of the State of Oklahoma defines Physical Therapy as

“Practice of physical therapy” means the use of selected knowledge and skills in planning, organizing and directing programs for the care of individuals whose ability to function is impaired or threatened by disease or injury, encompassing preventive measures, screening, tests in aid of diagnosis by a licensed doctor of medicine, osteopathy, chiropractic, dentistry or podiatry, or a physician assistant, and evaluation and invasive or noninvasive procedures with emphasis on the skeletal system, neuromuscularand cardiopulmonary function, as it relates to physical therapy. Physical therapy includes screening or evaluations performed to determine the degree of impairment of relevant aspects such as, but not limited to, nerve and muscle function including transcutaneous bioelectrical potentials, motor development, functional capacity and respiratory or circulatory efficiency. Physical therapy also includes physical therapy treatment performed including, but not limited to, exercises for increasing or restoring strength, endurance, coordination and range of motion, stimuli to facilitate motor activity and learning, instruction in activities of daily living and the use of assistive devices and the application of physical agents to relieve pain or alter physiological status. The use of roentgen rays and radium for diagnostic or therapeutic purposes, the use of electricity for surgical purposes, including cauterization and colonic irrigations are not authorized under the term “physical therapy” as used in this chapter;

Although there is very clear statement in the PT Practice Act permitting PTs to collect data, screen and evaluate transcutaneous bioelectrical potentials, the Oklahoma Medical board issued a conflicting and ambiguous statement indicating that “interpretation of nerve conduction studies and the performance and interpretation of needle electromyography as they are used for diagnostic purposes, falls without (outside) the practice of physical therapy.”

A case could be made that a PT would not be able to perform needle EMG independently. However, Nerve Conduction Studies are not invasive studies as they only involve surface electrodes. Other Electrodiagnostic studies such as Evoked Potential Studies (SSEP, VEP, BAERs) as well as Musculoskeletal Ultrasound Imaging are not invasive studies as there is no penetration of the integrity of the skin.

It is still our opinion that the Position Statement of the Oklahoma Medical Board is in conflict with the Oklahoma Physical Therapy Practice Act and the Medical Board’s position could and should be challenged

EMG/NCS Testing uses electricity and Musculoskeletal Ultrasound uses sound waves for the evaluation (testing and measurement) of the neuro-musculoskeletal system.

APTA fully supports PTs practicing EMG/NCS Testing as it is within the scope of Physical Therapy Practice. The Orthopedic Section of the APTA in a white paper not only advocates the use of Musculoskeletal Ultrasound Imaging within the scope of practice for Physical Therapy but also endorses its application both for diagnostic as well as procedural purposes to aid neuromuscular re-education, dry needling and electroneuromyography.

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