We are commonly asked whether Blood Flow Restriction is part of a physical therapist's practice act or whether a BFR Certification is required?
According to the American Physical Therapy Association (APTA), Blood Flow Restriction Training is part of a licensed physical therapist's scope of practice. According to the APTA, additional BFR certification is NOT required, however therapists need to be competent and follow evidence-based practice.
For these reasons, we would always recommend that physical therapists utilize FDA Listed Blood Flow Restriction Cuffs when performing BFR with patients. Utilizing non-FDA approved BFR Cuffs may increase the chance of lawsuit as the physical therapist would not be utilizing a medical device despite being in a medical setting.
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"Blood-flow restriction training is achieved through the application of external pressure over the extremities. The applied pressure is sufficient to maintain arterial inflow while occluding venous outflow distal to the occlusion site. The goal is to enable patients to make greater strength gains while lifting lighter loads, thereby reducing the overall stress placed on the limb.
Physical therapists have an existing firm foundation in anatomy, physiology, therapeutic exercise, and the cardiorespiratory system, as well as clinical reasoning, which are the components of the safe application of blood flow restriction training.
Physical therapist education provides PTs with the requisite knowledge (muscular and vascular anatomy, and physiology and exercise physiology), as well as skills (therapeutic exercise prescription, monitoring of physiological vital signs and blood flow) to perform and monitor this type of therapeutic exercise. BFRT is part of the professional scope of practice for physical therapists.
Documents that reference such knowledge and skills include:
- Commission on Accreditation of Physical Therapy Education (CAPTE) Standards (2016), Minimum Required Skills of Physical Therapist Graduates at Entry-Level (2005), and
- A Normative Model for Physical Therapist Education (2004).
Putting BFRT Into Practice
Each PT should consider his or her personal scope of practice before engaging in BFRT, and consideration should be given to at-risk populations such as older adults and those with compromised cardiovascular systems.
Additionally, because each state has its own jurisdictional scope of physical therapy practice, PTs should check their state practice act, which may be silent on BFRT. If that is the case, PTs should check their state's laws for confirmation."