HAPTA Proposing to Include Dry Needling within PT Scope of Practice

After years of preparation, the HAPTA Legislative Committee is moving forward with a bill to add dry needling to the Hawaii PT Practice Act. This bill will focus on three changes: removing a prohibitive practice clause that prevents the puncturing of intact skin, stating that dry needling is within PT scope of practice, and including health and wellness in the definition of PT.

Research continues to show the safety of dry needling when provided by a physical therapist. In a study published in the Journal of Manual and Manipulative Therapy in 2013, researchers reported that the risk of adverse effects of dry needling performed by physical therapists is less than 0.04 percent – lower than for common over-the-counter pain medication such as ibuprofen (.137 percent). All reported adverse events were considered “mild” (bleeding, bruising, pain while being needled) and no significant adverse events (such as pneumothorax or collapsed lung) were reported.

In a report by the Human Resource Research Organization (HumRRO) for the Federation of State Boards of Physical Therapy (FSBPT), HumRRO concluded that “86 percent of the knowledge requirements needed to be competent in dry needling are acquired during the course of PT entry-level education,” and that only 14 percent must be acquired through post-graduate education or specialized training in the psychomotor skills needed to handle needles and palpate tissues. Read the HumRRO report here.

In August 2018, APTA reported that Hawaii is one of only seven states prohibiting PTs from performing dry needling.

The current law in Hawaii states that we are not allowed “to use invasive procedures,” such as “breaking or puncturing of a person’s good skin integrity,” which has been problematic for therapists performing wound care, as well.

Finally, improving community health through advocacy of health and wellness is not new territory for PTs and PTAs. Therapists are educating the community about sports injury prevention, reducing fall risk through balance programs, and encouraging healthy lifestyle choices. Updating our practice act language would reflect that our profession looks beyond injury rehabilitation and toward effective population health management.

Joanne Zazzera
HAPTA Legislative Committee Chair

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