Clinical electrophysiology is the physical therapy specialization that focuses on electrotherapy and wound management. Clinical electrophysiology encompasses the evaluation, examination, and intervention of abnormal neural or muscular function – otherwise known as compromised skin integrity.
The utilization of physical therapy for wound care and management continues to grow, particularly in hospital-based outpatient wound clinics. Physical therapy strategies, such as electrotherapy, have increased the quality of life for patients with chronic, non-healing wounds by implementing healing strategies that maximize overall function and range of motion.
Clinical electrophysiology also encompasses physical therapies and assistive devices that improve strength and ambulation/mobility for those with neuromuscular disorders.
Clinical electrophysiology is now an important component of a collaborative approach to care for patients with chronic wounds and/or abnormal muscular function.
What is Electrotherapy?
Electrotherapy is a form of rehabilitative therapy that uses small, electrical impulses to:
- Repair tissues
- Stimulate muscles
- Increase muscle strength
- Increase sensations
- Decrease muscle spasms
- Promote range of motion
- Alleviate pain
Some of the impairments treated through electrotherapy include:
- Burns
- Frost bite
- Gangrene
- Chronic and post-surgical wounds
- Neuromuscular disorders, such as traumatic brain injuries, spinal cord injuries, strokes, etc.
Job Duties of Physical Therapist Assistants in Clinical Electrophysiology
Under the guidance and supervision of physical therapists, physical therapist assistants address restoration and function for patients suffering from chronically and acutely wounded tissues and neuromuscular disorders.
Their work in wound management includes the following:
Electromyography
Electromyography is a diagnostic procedure used as an evaluation and treatment tool. The purpose of this wound care management diagnostic tool is to detect the electrical potential generated by the muscles when activated—either electrically or neurologically.
It allows physical therapists and physical therapist assistants to achieve a more accurate picture of a patient’s nerve and muscular function so as to provide the patient with the best treatment.
Electrotherapy
Clinical electrophysiology involves using electrotherapy to treat wounds. The care and management of wounds through clinical electrophysiology also involves prevention and early intervention. Some of the wounds treated through clinical electrophysiology and electrotherapy treatments include:
- Diabetic ulcers
- Abrasions
- Blisters
- Lacerations
- Post-surgical incisions
Electrotherapy consists of a current that controls the direction of ion flow. Physical therapist assistants can control the direct currents to run positive to negative, and vice versa, as to match the stage of injury or healing and induce cell reproduction and tissue repair.
The two most often electrotherapy applications for wound treatment applications are microcurrent and high-volt pulsed current (HVPC):
Microcurrent: Used for both acute and chronic wounds
High-Volt Pulsed Current: HVPC is often employed to enhance pain management; the sensations produced by HVPC often allows patients to associate the sensation to increased benefits
Other types of electrotherapy also utilized in physical therapy treatments for wound care/management include:
Low-Level Laser Therapy: Used to treat both acute and chronic wounds, facilitate the inflammatory process, and provide enhance cell replication; may also provide an antimicrobial effect
Shortwave Diathermy: Uses electromagnetic energy to facilitate psychological responses; often used to treat large areas
Wound Care
In addition to electrotherapy, physical therapist assistants may perform a number of interventions to facilitate wound closure and healing:
- Using pneumatic compression, compression bandaging, and manual lymphatic drainage to reduce edema
- Applying absorbent dressings to maintain a moist wound bed
- Implementing ambulation, range of motion, and strengthening exercises
Education, Training, and Certification in Clinical Electrophysiology and Wound Management
Physical therapists working in clinical electrophysiology often possess the American Board of Physical Therapy Specialties (ABPTS) specialist certification in clinical electrophysiology. This designation allows physical therapists to display their expertise and advanced proficiency in this subspecialty of physical therapy.
Although the ABPTS specialty certification in clinical electrophysiology is not available to physical therapist assistants, PTAs seeking to advance their knowledge of clinical electrophysiology and achieve recognition of advanced proficiency in this area of physical therapy may choose to:
- Take additional courses on clinical electrophysiology within their physical therapist assisting associate’s degree program
- Take continuing education courses in clinical electrophysiology
- Work alongside ABPTS clinical electrophysiology certified physical therapists to gain valuable work experience
- Become a member of the Academy on Clinical Electrophysiology and Wound Management, a component of the American Physical Therapy Association
- Earn the American Physical Therapy Association’s Recognition of Advanced Proficiency in integumentary and/or neuromuscular
- To achieve this recognition, candidates must meet specific advanced proficiency goals in four areas:
- Education: Must possess at least 5 years of work experience and at least 500 hours of work experience in the past year in the selected area of advanced proficiency
- Continuing Education: Must possess at least 60 contact hours of continuing education in physical therapy in the past 5 years, including at least 45 hours in the selected area of advanced proficiency
- Job Performance: Must show proof of consistent, above-average job performance in a physical therapy team
- Community Service/Leadership: Must show proof of involvement in at least three activities that demonstrate leadership abilities and contributions to the community or the profession
- To achieve this recognition, candidates must meet specific advanced proficiency goals in four areas: