January 20, 2020 at 9:52 am #33378nathanbrosharMember
I am starting this thread as discussed at the recent Foundation Course in Glenview Jan 16-19, 2020. I got some information from IPTA’s dry needling group which I will post below. Some of the stuff relates to what we need to do prior to needling (some is vague, some is clear, some is contradictory), while others relate to skills we learned that we cannot use (e-stim, use of distal/non-local points). I will post my summarized thoughts, then a PDF of the document in the attachments. I will also paste most relevant questions in the body of this text.
Req’s: 54 hours over 2 courses, as well as 200 hours of GENERALLY supervised treatments (doc attached). This is 200 treatments, not 200 different patients. The questions section notes the 2 courses needed to be completed within 12 months of each other. It also implies that the 200 treatments can begin after the first course, as it specifically notes that completing them is NOT a pre-req to 27 hour part II course. I would use your discretion here at is unclear to say the least. It is prudent to keep a spreadsheet of these 200 treatments for verification purposes, in compliance with HIPAA.
Exclusions: We cannot perform e-stim, needle retention, or use distal or non-local points here in IL. this is ostensibly a grey area to protect acupuncture side, but I think can be creatively managed. E-stim, seems fairly cut-and-dry as a “no”. No needle retention is greyer. I would feel comfortable placing a set of needles then removing once all are set and calling that non-retention of needles, as the needles were only in as long as it would take to place them all, then they came right out. Others may feel more comfortable doing only 1 at a time to remain in the broadest compliance. As for distal or non-local points, I will tread carefully, but make sure I note local irritation/tenderness wherever I place a needle. This is easier with radiculopathies I think, but may feel tougher to explain with non-radicular localized pain. At the minimum, I would ensure I am assessing and noting tenderness/pain anywhere I put a needle, but other may feel comfortable tracing a nerve’s pathway as local. Up to your comfort level I suppose.
BEGIN COPY OF IL REQ’s:
A physical therapist licensed to practice in the State of Illinois may only perform intramuscular manual therapy under the following conditions:
Prior to completion of the education under subsection (a)(2), successful completion of a total of 50 hours of instruction in the following areas:
A) the musculoskeletal and neuromuscular system;
B) the anatomical basis of pain mechanisms, chronic pain and referred pain;
C) myofascial trigger point theory; and
D) universal precautions.
Completion of at least 30 hours of didactic course work specific to intramuscular manual therapy. This requirement can be fulfilled by the didactic pre-study required for the intramuscular manual therapy practicum course.
Successful completion of at least 54 practicum hours in intramuscular manual therapy course work approved by the Federation of State Boards of Physical Therapy or its successor (or substantial equivalent), as determined by the Department. Each instructional course shall specify what anatomical regions are included in the instruction and describe whether the course offers introductory or advanced instruction in intramuscular manual therapy. Each instruction course shall include the following areas:
A) intramuscular manual therapy technique;
B) intramuscular manual therapy indications and contraindications;
C) documentation of intramuscular manual therapy;
D) management of adverse effects;
E) practical psychomotor competency; and
F) the Occupational Safety and Health Administrations Bloodborne Pathogens standard.
Postgraduate classes qualifying for completion of the mandated 54 hours of intramuscular manual therapy shall be in one or more modules, with the initial module being no fewer than 27 hours. Therapists shall complete at least 54 hours in no more than 12 months. Physical therapists who completed the initial module prior to the adoption of this Section shall complete the remainder of the 54 hours by July 11, 2019.
Completion of at least 200 patient treatment sessions under general supervision recognized by the American Physical Therapy Association.
Successful completion of a competency examination approved by the Division. The Division will accept competency examinations administered as part of the intramuscular manual therapy practicum course work.
In addition, The rules also specify the following:
Each licensee is responsible for maintaining records of the completion of the requirements of this subsection (a) and shall be prepared to produce those records upon request by the Division.
A newly-licensed physical therapist shall not practice intramuscular manual therapy for at least one year from the date of initial licensure unless the practitioner can demonstrate compliance with subsection (a) through his or her prelicensure educational coursework.
Intramuscular manual therapy may only be performed by a licensed physical therapist and may not be delegated to a physical therapist assistant or support personnel.
A physical therapist shall not advertise, describe to patients or the public, or otherwise represent that dry needling is acupuncture, nor shall he or she represent that he or she practices acupuncture unless separately licensed under the Acupuncture Practice Act [225 ILCS 2].
END COPY OF REQ’S
BEGIN COPY OF SELECTED FAQ’S:
Can I apply electric stimulation to the needles?
Section 1.5 of the PT Act provides this description of dry needling:
Sec. 1.5. Dry needling.
(a) For the purpose of this Act, “dry needling”, also known as intramuscular therapy, means an advanced needling skill or technique limited to the treatment of myofascial pain, using a single use, single insertion, sterile filiform needle (without the use of heat, cold, or any other added modality or medication), that is inserted into the skin or underlying tissues to stimulate trigger points. Dry needling may apply theory based only upon Western medical concepts, requires an examination and diagnosis, and treats specific anatomic entities selected according to physical signs. Dry needling does not include the stimulation of auricular points, utilization of distal points or non-local points, needle retention, application of retained electric stimulation leads, or the teaching or application of other acupuncture theory.
How long do I have to complete the coursework and treatments? Must I finish the 200 treatments before taking the second course?
Section 1340.75 Intramuscular Manual Therapy of the Rules for the Administration of the PT Act addresses the timeline for completion of dry needling education:
Sec. 1340.75(a)4. Postgraduate classes qualifying for completion of the mandated 54 hours of intramuscular manual therapy shall be in one or more modules, with the initial module being no fewer than 27 hours. Therapists shall complete at least 54 hours in no more than 12 months. Physical therapists who completed the initial module prior to the adoption of this Section shall complete the remainder of the 54 hours by July 11, 2019.
Neither the PT Act or Rules for the Administration of the PT Act require any certain amount of the 200 supervised treatments be performed in any given time frame, and completing the 200 supervised treatments is not a prerequisite for completing the second 27 hours of continuing education.
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