The revised seventh edition of the Model Practice Act includes information and guidance on animal physical therapy and offers appropriate legislative language to reflect an emerging practice area. This article is by Kirk Peck, Vice Chair of the Nebraska Board of Physical Therapy.
The Federation of State Boards of Physical Therapy (FSBPT) Model Practice Act (MPA) is one of the most influential documents for state jurisdictions to support statutory and regulatory change in physical therapy scope of practice. FSBPT adopted the first MPA in 1997, and now, twenty-five years later, FSBPT published the seventh edition with several updates relevant to current physical therapy practice, including one very historic addition. For the first time since its inception, the MPA now recognizes the evolving niche practice of animal physical therapy as clearly articulated in the section related to patient/client care management.
FSBPT’s revised definition for "Patient/Client Care Management" in the MPA includes a statement and corresponding commentary that addresses the practice of animal physical therapy.
Article 4: Regulation of Physical Therapy: Section 4.03 Patient/Client Care Management of the MPA states: G. Nothing in this [Act] shall prohibit a licensee [certificate holder] from providing Physical therapy to animals for which the licensee [certificate holder] has completed the education and training as further established by rule (p. 12).
In the corresponding "Commentary" related to Section 4.03, the MPA states: The practice of physical therapy continues to evolve including the treatment of animals. While there is currently no consistent standard of specified education and training, it is appropriate to note that additional rule development in a jurisdiction may address minimum standards to demonstrate competency to provide physical therapy to animals (p. 53).
A national organization has not implemented something this historic since the American Physical Therapy Association (APTA) House of Delegates unanimously approved an official Position Statement in 1993 supporting collaborative relationships between physical therapists and veterinarians. Having two national and reputable organizations articulate support of animal physical therapy enhances the validity of this niche practice for jurisdictions seeking to develop and implement applicable statutes and regulations. The seventh edition of the MPA now serves as an essential document that can be leveraged by state PT associations and legislative bodies alike to intentionally codify regulatory language for this uniquely specialized and evolving market of clinical practice.
From an evolution of practice perspective, the revised MPA language is an extraordinary achievement for those engaged in or interested in animal physical therapy. To date, there are only a few states that have successfully codified language intentionally to support animal PT: Colorado, New Hampshire, Nebraska, Nevada, and Utah.
Colorado, New Hampshire, and Utah have language documented in PT statutes, while Nevada and Nebraska have detailed statutes and regulations outlined strictly in veterinary laws that allow referral privileges from veterinarians. Other states, such as Oregon, Indiana, Illinois, and Virginia, have language that allows veterinarians the option to refer animal care to non-veterinarians, but the language is not specific to licensed physical therapists. Ideally, all fifty states will eventually have some statutory and regulatory authority supporting animal physical therapy. Until this goal is achieved, the seventh edition of the MPA serves as an excellent foundational document.
Many current state statutes limit the practice of physical therapy to either humans or individuals versus using the more contemporary and less restrictive language endorsed by the MPA of patients/clients. The revised MPA recognizes a need for many states to change their current definition of physical therapy before they can entertain the option for PTs to treat animals.
In the MPA, under the definition of “Physical Therapy,” it states, Removing the term individuals provides the opportunity for boards to allow the practice of animal physical therapy for those boards who wish to address animal physical therapy. (p. 23). This statement in the MPA is significant as the majority of state PT boards drafted their practice acts decades ago with the primary focus of care being humans. The idea that PTs would also be treating animals in the future was not even conceivable to early regulators. However, times have changed, and the profession is witnessing a growing interest in recognizing animals as clients who may also benefit from the expertise of skilled physical therapists—a benefit that has been long recognized by a few PT pioneers in the field.
While PTs treating animals is still relatively new, forward-thinking practitioners delved into this area decades ago. For example, Ann Downer from The Ohio State published a book in 1978 entitled, “Physical Therapy for Animals: Selected Techniques”. In the United Kingdom, Sir Charles Strong, a physical therapist, was even more prominently known for his skills in treating both dogs and sporting horses, including those from royalty. He published two books on treating horses: “Common Sense Therapy for Horses’ Injuries” (1956) and “Horses' Injuries: Common-Sense Therapy of Muscles and Joints for the Layman” (1967).
In the United States, several insightful physical therapists formed their own organization and sought approval from the American Physical Therapy Association. In 1998, APTA granted recognition of the Animal Rehabilitation Special Interest Group (now Animal Physical Therapy-SIG) under the umbrella of the prior Section (now Academy) of Orthopedic Physical Therapy, APTA.
Over the past fifty years, physical therapists have published several books addressing topics in both canine and equine fitness, wellness, and post-injury rehabilitation. The literature base in peer-reviewed journals also continues to expand with authors from both the physical therapy and veterinary professions. In addition, the number of licensed physical therapists getting certified in animal rehabilitation each year continues to grow. Graduates often have the goal of starting their own clinical practice or providing care to animals on the side. Given the growing trend within the profession, it is imperative that state laws are in place to ensure that PT practice on animals is regulated.
The new edition of the MPA is the first step towards the subsequent development of language to further detail requirements and safeguards for physical therapists to treat animals. As previously noted, Article 4 of the MPA implies that as a pre-requisite to treat animals, a physical therapist should have completed “the education and training as further established by rule” (p. 12). Therefore, the next step will be to create guidelines that address criteria specific to animal PT practice.
The language currently codified in several state laws indicates important criteria to further detail, such as specific requirements for educational standards, continuing competencies in animal practice, animal restraint and handling, veterinary medical clearance with guidelines for direct and indirect supervision, patient/client documentation, professional liability coverage, and provisions that clarify aspects of the veterinarian/physical therapist relationship. Since treating animals is not part of entry-level PT practice, initial regulatory language will need to ensure that physical therapists are competent and appropriately educated to protect the public.
The profession of physical therapy has progressively evolved since its inception in the early 1900s, and regulators must keep pace with the evolution. Although typically focused on assessing and treating human movement disorders, the past several decades have witnessed physical therapists expanding their expertise into a paradigm of treating animal clients as well. With the revised seventh edition of the FSBPT MPA, animal physical therapy is now officially established as part of the profession, and future development of model language will offer invaluable support to enact appropriate legislative and regulatory change.
Kirk Peck, PT, PhD, CSCS, CCRT, CERP, is past President of the Animal Physical Therapy Special Interest Group of the APTA Orthopedic Academy of Physical Therapists (2013-19), and current SIG liaison to the World Physiotherapy Animal PT Network. He is a core instructor in the University of Tennessee Certification Program in Equine Rehabilitation and collaborates with veterinarians to provide PT services for canine clients. Kirk is the Chair of the Department of Physical Therapy at Creighton University, Omaha, Nebraska, where he teaches clinical exercise physiology and political advocacy.
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