A restricted activity is a regulated health service that by law can only be performed by individuals authorized to perform them. Restricted activities for physiotherapists are divided into two groups: basic and advanced.

 

Basic restricted activities for physiotherapist:

  • Inserting and removing catheters
  • Reducing a dislocation of a joint
  • Suctioning or instillation
  • Treating urological, gynaecological and rectal conditions
  • Wound debridement and care

Who may perform them?

All physiotherapists may, in the practice of physiotherapy and within the practice standards, perform a basic activity provided they are competent to do so and it is appropriate to their area of practice. However, physiotherapists on the Provisional Register may only perform the activity under the supervision of another physiotherapist as illustrated in the image below (click to enlarge)

  • When the supervising physiotherapist is present and able to observe and promptly intervene, that is stop or change actions, if required.

Advanced restricted activities for physiotherapists:

  • Order diagnostic imaging (limited to x-rays, magnetic resonance imaging, ultrasound imaging)
  • Perform spinal manipulation
  • Use needles in practice for the purpose of needle acupuncture, intramuscular stimulation or biofeedback

Who may perform them?

Physiotherapist on the General Register may perform an advanced activity. However, whether they may perform them independently or under supervision varies as illustrated in the image below (click to enlarge):

  • Supervision is required when the physiotherapist is learning the restricted activity. That is they are enrolled in an education program that will lead to eligibility for authorization. If this is your situation you do not need to inform Physiotherapy Alberta. It is your responsibility to ensure the supervision requirements are met.
  • Physiotherapists who are authorized may perform the advanced activity independently. To receive authorization you need to apply. Only when authorization is granted and noted on your practice permit may you perform the activity independently.

Applications for authorization will be evaluated to determine that the following requirements are met.

Diagnostic imaging

  • Physiotherapist on the General Register
  • Completed the University of Alberta's REHAB 570 (formerly PTHER 410) Diagnostic Imaging for Physical Therapists Course
  • Five years of clinical physiotherapy experience (completed within Canada)
  • Understanding of the practice standard on Performance of Restricted Activities

Spinal manipulation

  • Physiotherapist on the General Register.
  • Completed a post entry-level spinal manipulation education program that includes as part of the curriculum: theory, practice and final (summative) evaluation conducted by the course instructor which resulted in a passing grade
  • Understanding of the practice standard on Performance of Restricted Activities

Use of needles

  • Physiotherapist on the General Register
  • Completed a post entry-level needling education program that includes as part of the curriculum: theory, practice, safety instruction, and final (summative) evaluation conducted by the course instructor which resulted in a passing grade
  • Understanding of the practice standard on Performance of Restricted Activities
  • A report was created by the Health Quality Council of Alberta (HQCA) of an independent review of adverse outcomes, specifically pneumothorax, resulting from dry needling practices by physiotherapists in Alberta to improve the quality and safety of dry needling. Click here to read The Safe Practice of Dry Needling in Alberta.

To start the application process first review the practice standard on Performance of Restricted Activities as you'll need to declare that you've read it, understand it and will comply with it.

Next download the appropriate application form. (You may have to save the form to your desktop if you are using a newer version of Chrome or Firefox.)

All Physiotherapy Alberta forms are in PDF format which allows you to:

  1. Download the form.

  2. Fill in the form electronically, except your signature. You must print the form before signing. 

  3. Save the completed form in case you need to make changes (works only if you complete the downloaded version).

Email your completed form(s) to registration@physiotherapyalberta.ca.

What happens after you send us your application?

To ensure fair and equitable treatment of all applicants, applications are dealt with in the order received.*  If there is a matter requiring further review registration staff will contact you by email.

Once we've determined you meet the requirements, authorization will be indicated on your registration record and a revised practice permit issued and mailed. Only when authorization is noted on your practice permit may you independently perform the restricted activity. You may use the online public register as proof of authorization prior to receiving your practice permit in the mail. The 'Verify by Name or License' function is updated in real-time.

*To the extent possible a decision on your complete application will be made within approximately 5 business days, however, it may take longer during our peak time (September and October).

The authorization model at this time only includes initial authorization. In the near future, the model will be expanded to include conditions for ongoing authorization. While the criteria has yet to be developed it will include at a minimum:

  • A random selection of authorized physiotherapists to verify that the education reported is accurate.
  • Process and conditions for annual renewal of authorization.

Unless you are authorized to perform a restricted activity independently you may only perform that activity under supervision. The supervision requirements for restricted activities are outlined in section 16 of the Physical Therapists Profession Regulation. The supervision requirements for restricted activities differ from Physiotherapy Alberta's expectations for appropriate supervision in other situations in that there is no flexibility or discretion for inperson supervision:

  • The supervising physiotherapist must be present.
  • The supervising physiotherapist must be able to observe and promptly intervene (i.e., stop or change actions) if required.

Applies to:

  • Physiotherapist on the Provisional Register performing a basic restricted activity.
  • Physiotherapist on the General Register enrolled in an education program who want to use the techniques taught in the program before authorized for independent use.
  • Student enrolled in a physiotherapy program completing a clinical placement.

Who may supervise the performance of a basic restricted activity?

  • A physiotherapist on the General Register who is competent to perform that activity.

Who may supervise the performance of an advanced restricted activity?

  • A physiotherapist on the General Register who is authorized to perform that activity.

Does Physiotherapy Alberta have a list of 'approved' education programs?

No. Physiotherapy Alberta no longer maintains a list of approved spinal manipulation or needling programs. Instead, members may now select the education program that meets their specific needs provided it includes as part of the curriculum: theory, practice, safety instruction (if it is a needling program) and final evaluation. It is your responsibility to determine if the course curriculum include these components.

I just enrolled in a needling program. Can I start to use the techniques I learn in the program immediately or do I need to wait until I complete the program and receive authorization to independently use needles?

If you are registered on the General Register you may use the techniques taught in the program PROVIDED:

  • You only perform the techniques under the supervision of another physiotherapist who is authorized.
  • You adhere to the supervision requirements outlined in the legislation which requires the supervising physiotherapist to be present so they are able to observe and promptly intervene (i.e., stop or change actions) if required.

The same rules apply for spinal manipulation.

Can I take a spinal manipulation course while on the Provisional Register?

No. To use a deliberate, brief, fast thrust to move the joints of the spine beyond the normal range but within the anatomical range of motion, which generally results in an audible click or pop is a restricted activity in Alberta and can only be performed by a physiotherapist on the General Register.

While you are on the Provisional Register you may not perform this restricted activity even in a course setting which would restrict you from participating in any practical components involving another individual. The legislation does not restrict you from taking theory components or practice on inanimate objects.

The same applies for use of needles.

PracID & Diagnostic Imaging

What is a PracID, (and what is it not)?

A Practitioner Identification Number, commonly referred to as a PracID, is a registration number assigned by Alberta Health. 

Although you need a PracID to be able to order diagnostic imaging, a PracID does not grant you authorization to order these tests, nor does it enable you to be reimbursed for physiotherapy services through Alberta Health.

Why would I want a PracID?

The purpose of a PracID is to enable claim payments and patient referrals. Physiotherapists use PracIDs to refer patients to physicians for major and minor consultations, enabling the physician to be paid for the consultation. In the case of diagnostic imaging, the use of the PracID enables reimbursement for Diagnostic Imaging services provided.  

Without the use of a PracID your referral may not be accepted.

Who can apply for a PracID?

Members of several regulated health professions including physicians, physiotherapists, dentists and pharmacists (among others) may apply for a PracID from Alberta Health.  

Does this replace my Physiotherapy Alberta registration number?

NO. Nothing replaces your registration number. Your registration number authorizes you to practice physiotherapy in the Province of Alberta, without this you cannot make use of a PracID for any purpose.

If I have a PracID can I automatically order diagnostic imaging?

No. Only clinicians with authorization to order diagnostic imaging may do so. In order to be authorized the clinician needs to be on the General Register, have 5 years of physiotherapy experience in Canada, completed and passed required course work, and understand the Standard of Practice: Performance of Restricted Activities

Physiotherapists with authorization must only make use of their authorization to order diagnostic imaging within the scope of practice of physiotherapy, and must only order imaging for their own patients.

How can I apply for a PracID?

Complete the application form and send it to Alberta Health at the address on the form.