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Mobilization and Manipulation by Physical Therapist Assistants

Disclaimer: Law, rules and regulations, not Guidelines, specify the requirements for practice and violating them constitutes professional misconduct. Not adhering to this Guideline may be interpreted as professional misconduct only if the conduct also violates pertinent law, rules and regulations.

Alert 11: Mobilization and Manipulation by Physical Therapist Assistants

The State Board for Physical Therapy has received questions from clinicians, educators and others about the role of the physical therapist assistant (PTA) in the performance of mobilization and manipulation. While professional practice is affected by the recommendations of professional membership associations, accrediting bodies, and others, the overarching authority to define professional practice by New York State licensees is contained in Education Law and the Regulations of the Commissioner of Education.

New York State Education Law does not specifically address the performance of mobilization by PTAs. Article 136 of New York State Education Law defines the practice of physical therapy and defines the qualifications for licensure and practice as a physical therapist (PT) or PTA. A PTA must be under the supervision of a licensed PT and is restricted to performing patient/client-related activities as assigned by the supervising PT. Education Law states that the duties of the PTA must "not include evaluation, testing, interpretation, planning or modification of patient programs." 1

In no instance would it be appropriate for a PTA to perform a manipulation (or high velocity thrust) due to the need for on-going evaluation during the manipulation and the level of skill required to perform the intervention.

A PTA may perform mobilization activities as assigned by the licensed PT . Therefore, the supervising PT must determine what grades of mobilization are appropriate to be assigned to the PTA and provide supervision consistent with Education Law and regulation. Furthermore, the PTA must notify the supervising PT whenever there is a change in the status, condition or performance of the patient/client.

The inclusion of an intervention within the allowed activities of professional practice does not permit every licensed person to perform that intervention. Before applying any intervention, a licensed professional must be appropriately trained and competent to perform the intervention. Education Law and the Commissioner's Regulations define professional misconduct as the performance of activities by a licensee, or the assignment of activities by a supervisor, that are beyond the capabilities of the licensee. A licensed PTA could be charged with professional misconduct for performing an activity that, although within the scope of practice, is beyond his or her competence. Similarly, a licensed PT who delegated activities to a PTA that are beyond the PTA's competency or prohibited by the practice act, could be charged with misconduct.

For more information about the practice of physical therapy by licensed PTs and PTAs, please visit the Office of the Professions website (New York State Licensed Professions). You can contact the State Board for Physical Therapy by phone at 518-474-3817 ext. 180, by fax at 518-474-6375, or by email at ptbd@nysed.gov.

1New York State Education Law section 6738(a).