Michael Harris-Love, PT, MPT, DSc
This model has been accepted as part of the initial review for Innovation Summit 2.0. This proposal team will participate in the May workshop where they will receive valuable feedback from researchers and other clinicians. It will then be submitted for further review and for the chance to receiving funding and in-kind services to advance their model and promote the impact of physical therapy in the health care environment. Below is a brief description of the model.
The Veterans Health Administration (VHA) manages the nation's largest integrated health care system, and serves a Veteran population that is significantly older than the civilian population. Given the consequences of sarcopenia related to physical disability and insulin resistance, assessment of the age-related changes in muscle is a critical component of geriatric care. However, sarcopenia is not typically assessed within the VHA or civilian healthcare system and objective measures of muscle mass or strength are not featured in the VHA Electronic Medical Record (EMR). "The Sarcopenia Project" features the innovative use of mobile diagnostic ultrasound by physical therapists to screen for age-related muscle dysfunction. Additionally, we will examine how intramuscular adipose tissue levels (i.e., myosteatosis) influence the consequences of sarcopenia and explore how this characteristic of muscle may enhance the sarcopenia diagnostic criteria. "The Sarcopenia Project" has both research and clinical components. The research arm of the project is a VA-funded study involving the sonographic assessment of myosteatosis to determine the association between muscle tissue composition and potential biologic contributors to insulin resistance. The clinical arm of the project embodies a preventative model of care involving our proposed screening approach within a VA medical center setting. Participants with positive screening results will receive instruction in progressive resistance exercise and type 2 diabetes prevention and management strategies prior to engaging in a supervised 12-week exercise intervention program. This multidisciplinary effort involves rehabilitation, geriatrics, radiology, research, and nursing professionals, and will serve to demonstrate the feasibility and clinical importance of our screening paradigm. This project has broad implications for the use of rehabilitative ultrasound by physical therapists, and the appropriate level of screening for age-related muscle dysfunction within the VHA and civilian health care settings.