EMG AND MSKUS LAWS FOR HAWAII

The Physical Therapy Practice Act of the State of Hawaii defines Physical Therapy as:

“Physical therapy” or “physical therapy services” means the examination, treatment, and instruction of human beings to detect, assess, prevent, correct, alleviate, and limit physical disability, bodily malfunction, pain from injury, disease, and any other physical or mental condition as performed by a physical therapist appropriately licensed under this chapter. It includes but is not limited to: (1) Administration, evaluation, modification of treatment, and instruction involving the use of physical measures, activities, and devices, for preventive and therapeutic purposes; provided that should the care or treatment given by a physical therapist or physical therapist assistant contravene treatment diagnosed or prescribed by a medical doctor, osteopath, or as determined by the board, the physical therapist shall confer with the professional regarding the manner or course of treatment in conflict and take appropriate action in the best interest of the patient. “Practice of physical therapy” includes, but is not limited to, the use of the following: (1) Physical agents, such as heat, cold, water, air, sound, compression, light, electricity, and electromagnetic radiation; However, under Prohibited Practices the statute prohibits invasive procedures that break the integrity of the skin.

So, 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.

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.

Find here information about Direct Access to Physical Therapy in your state.