1. (a) The required professional education relating to ultrasound modalities, including phonophoresis, shall:

   1. (1) Be at least 6 hours in duration for occupational therapists and occupational therapy assistants; and

   2. (2) Cover the following topics:

      1. a. Proper use of ultrasound equipment, including:

         1. 1. The use of treatment controls;
         2. 2. Soundhead selection;
         3. 3. Frequency;
         4. 4. Application method; and
         5. 5. Equipment maintenance as it relates to overall client safety;
      2. b. Knowledge of the clinical use, optimal parameters, precautions and contraindications to determine, prior to administration, the appropriateness of ultrasound for a client;
      3. c. Knowledge of the physiological effect of ultrasound, including the therapeutic benefits as well as the tissue response for both thermal and non-thermal delivery;

      4. d. Understanding of the optimal parameters for maximum therapeutic benefit in regards to:

         1. 1. Tissue depth;
         2. 2. Tissue type;
         3. 3. Intensity;
         4. 4. Size of the area to be sonated; and
         5. 5. The mode of ultrasound delivery, including but not limited to, pulse, continuous and medication;

      5. e. The appropriate selection and storage of topical drugs:

         1. 1. Prescribed by a licensed healthcare practitioner authorized to prescribe medicine; and
         2. 2. Used in the ultrasound treatment; and
      6. f. The proper positioning of the client for maximum safety and therapeutic effectiveness.

2. (b) The required professional education relating to electrical stimulation modalities, including, at a minimum, NMES, TENS, iontophoresis and HVGS, shall:

   1. (1) Be at least 15 hours in duration for occupational therapists and occupational therapy assistants; and

   2. (2) Cover, for each of the specific electrical stimulation modalities listed in (b) above, the following topics:

      1. a. Electrotherapeutic terminology and biophysical principles, including current, voltage and amplitude;
      2. b. The normal electrophysiology of nerve and muscle;
      3. c. The types of current, direct, pulsed and alternating, used for electrical stimulation;
      4. d. The duration and type of current appropriate for the client’s neurological status;

      5. e. The following common denominators of electrical currents:

         1. 1. Normal and abnormal human responses to direct and alternating current;
         2. 2. Current flow effect on tissue, including thermal, chemical and kinetic changes;

         3. 3. Waveforms, including:

            1. (i) The true direct current of iontophoresis; and
            2. (ii) Pulsed currents, including monophasic, biphasic and polyphasic;

         4. 4. The characteristics of phase, including:

            1. (i) Duration;
            2. (ii) Intensity;
            3. (iii) Charge; and
            4. (iv) Frequency or rate;
         5. 5. The modulation of the characteristics listed in e.4. above; and
         6. 6. The physiological correlates of the phase characteristics listed in e.4. above;
      6. f. The indications, contraindications, warnings and precautions of electrotherapy, including considerations regarding pathology of nerve and muscle tissue;
      7. g. The rationale and clinical indications of electrotherapy necessary for the safe and appropriate integration in the delivery of occupational therapy;

      8. h. The appropriate selection and storage of topical drugs:

         1. 1. Prescribed by a licensed healthcare practitioner authorized to prescribe medicine; and
         2. 2. Used in electrical stimulation treatments;
      9. i. The proper positioning of, and adequate instructions to, the client during application of the modality;
      10. j. Appropriate education of the client as to the benefits and risks of the electrotherapeutic treatment;

      11. k. Knowledge of the safe and appropriate operation of the electrical stimulation device and the optimal parameters, including:

          1. 1. The intensity;
          2. 2. The frequency or rate;
          3. 3. The type of current; and
          4. 4. The duration of treatment; and
      12. l. The optimal electrode placement, including motor points and physiological effects desired.

Source. #13312, eff 12-21-21; renumbered by #14477, eff 3-13-26, EXPIRES 3-13-36 (formerly Occ 305.03)