Physical Agents and Mechanical Modalities

Interventions to support occupations including but not limited to physical agent modalities (PAMs), mechanical modalities, dry needling, instrument-assisted modalities, and other techniques are used by Occupational Therapy Practitioners in preparation for, or concurrently with occupations and activities or interventions that ultimately enhance a client’s engagement in occupation.

Interventions to support occupations may not be entry-level skills and may require advanced training and/or certification. New treatment techniques and interventions are routinely developed based on currently available evidence. Practitioners are responsible for maintaining their awareness of these developments as well as their competency in the safe and effective application of new treatment approaches.

Competency is outlined by standards of conduct in the Occupational Therapy Code of Ethics (AOTA, 2020). It is the responsibility of occupational therapy personnel to maintain credentials, licenses, and other certifications to develop, demonstrate, and maintain competent, evidence-based practice and supervision requirements (AOTA, Policy E.18: Interventions to Support Occupations, 2023).


It is the responsibility of each individual Occupational Therapist or Occupational Therapy Assistant to secure the necessary training and supervision, certification, and professional competency pertaining to the use of all selected Physical Agent Modalities, as well as choose such modalities that are within the scope of Occupational Therapy practice, in accordance with the following ARS 32-3401, Definitions, 

6. "Occupational therapy" means the use of therapeutic activities or modalities to promote engagement in activities with individuals who are limited by physical or cognitive injury or illness, psychosocial dysfunction, developmental or learning disabilities, sensory processing or modulation deficits or the aging process in order to achieve optimum functional performance, maximize independence, prevent disability and maintain health. Occupational therapy includes evaluation, treatment and consultation based on the client's temporal, spiritual and cultural values and needs.

8. "Occupational therapy services" includes the following:

(c) Enhancing functional achievement, prevocational skills and work capabilities through the use of therapeutic activities and modalities that are based on anatomy, physiology and kinesiology, growth and development, disabilities, technology and analysis of human behavioral and occupational performance.

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