DWD 81.09(3)(e)2.b.b. Patient may use the electrical stimulation device unsupervised for one month, at which time effectiveness of the treatment shall be reevaluated by a health care provider before continuing home use of the device.

DWD 81.09(3)(f)(f) Acupuncture treatments. For purposes of this paragraph, “acupuncture treatments” include endorphin-mediated analgesic therapy that includes classic acupuncture and acupressure. All of the following guidelines apply to acupuncture treatments:

DWD 81.09(3)(f)2.2. Maximum treatment frequency is up to 3 times per week for the first one to 3 weeks, decreasing in frequency until the end of the maximum treatment duration period in subd. 3.

DWD 81.09(3)(g)(g) Phoresis. For purposes of this paragraph, “phoresis” includes phonopheresis and iontophoresis. All of the following guidelines apply to phoresis:

DWD 81.09(3)(g)2.2. Maximum treatment frequency is up to 3 times per week for the first one to 3 weeks, decreasing in frequency until the end of the maximum treatment duration period in subd. 3.

DWD 81.09(3)(g)3.3. Maximum treatment duration is 9 sessions of either iontophoresis or phonophoresis, or combination, to any one site, with a maximum duration of 12 weeks for all treatment.

DWD 81.09(3)(h)(h) Manual therapy. For purposes of this paragraph, “manual therapy” includes soft tissue and joint mobilization and therapeutic massage. All of the following guidelines apply to manual therapy:

DWD 81.09(3)(h)2.2. Maximum treatment frequency is up to 5 times per week for the first one to 2 weeks decreasing in frequency until the end of the maximum treatment duration period in subd. 3.

DWD 81.09(3)(i)(i) Splints, braces, and other movement-restricting appliances. Bracing required for longer than 2 weeks shall be accompanied by active motion exercises to avoid stiffness and prolonged disability. All of the following guidelines apply to splints, braces, and other movement-restricting appliances:

DWD 81.09(3)(i)2.2. Maximum treatment frequency is limited to intermittent use during times of increased physical stress or prophylactic use at work.

DWD 81.09(3)(i)3.3. Maximum continuous duration is 8 weeks. Prophylactic use is allowed indefinitely.

DWD 81.09(3)(j)(j) Rest. Prolonged restriction of activity and immobilization are detrimental to a patient’s recovery. Total restriction of use of an affected body part may not be prescribed for more than 2 weeks, unless rigid immobilization is required. In cases of rigid immobilization, active motion exercises at adjacent joints shall begin no later than 2 weeks after application of the immobilization.

DWD 81.09(4)(a)(a) A health care provider shall use active treatment modalities as set forth in pars. (b) to (f). A health care provider’s use of active treatment modalities may extend past the 12-week limitation on passive treatment modalities so long as the maximum treatment for the active treatment modality is not exceeded.

DWD 81.09(4)(b)(b) Education shall teach the patient about pertinent anatomy and physiology as it relates to upper extremity function for the purpose of injury prevention. Education includes training on posture, biomechanics, and relaxation. The maximum number of treatments is 3 visits which include an initial education and training session, and 2 follow-up visits.

DWD 81.09(4)(c)(c) Posture and work method training shall instruct the patient in the proper performance of job activities. Topics include proper positioning of the trunk, neck, and arms, use of optimum biomechanics in performing job tasks, and appropriate pacing of activities. Methods include didactic sessions, demonstrations, exercises, and simulated work tasks. The maximum number of treatments is 3 visits.

DWD 81.09(4)(d)(d) Worksite analysis and modification shall examine the patient’s work station, tools, and job duties. A health care provider may make recommendations for the alteration of the work station, selection of alternate tools, modification of job duties, and provision of adaptive equipment. The maximum number of treatments is 3 visits.

DWD 81.09(4)(e)(e) Exercise, which is important to the success of a nonsurgical treatment program and a return to normal activity, shall include active patient participation in activities designed to increase flexibility, strength, endurance, or muscle relaxation. Exercise shall, at least in part, be specifically aimed at the musculature of the upper extremity. While aerobic exercise may be performed as adjunctive treatment, this shall not be the primary focus of the exercise program.

DWD 81.09(4)(f)(f) Exercises shall be evaluated to determine if the desired goals are being attained. Strength, flexibility, or endurance shall be objectively measured. A health care provider may objectively measure the treatment response as often as necessary for optimal care after the initial evaluation. Subdivisions 1. and 2. govern supervised and unsupervised exercise, except for computerized exercise programs and health clubs, which are governed by s. DWD 81.13.

DWD 81.09(4)(f)1.1. ‘Guidelines for supervised exercise.’ One goal of an exercise program shall be to teach the patient how to maintain and maximize any gains experienced from exercise. Self-management of the condition shall be promoted. All of the following guidelines apply to supervised exercise:

DWD 81.09(4)(f)1.a.a. Maximum treatment frequency is up to 3 times per week for 3 weeks and shall decrease with time until the end of the maximum treatment duration period in subd. 1. b.