A new literature and financial analysis, published online June 4 in Archives of Internal Medicine, supports the National Physicians Alliance's recommendation against routine imaging in patients with acute low back pain, says an article by Medscape Medical News.
The recommendation to avoid early imaging for low back pain within the first 6 weeks of onset unless red flags are present was published August 8, 2011, as part of the alliance's list of Top 5 Health Care Activities for Which Less Is More. The Less Is More series is focused on areas that responsible physician stewardship can help improve the quality and reduce the potential harms of care.
In the current literature review, the authors report that imaging for low back pain is extremely common and does not improve clinical outcomes in patients without indications of serious underlying conditions. Furthermore, they estimate that "nearly $300 million could be saved annually by restricting imaging during the first 6 weeks of lumbar back pain to specific severe indications, including severe or progressive neurological deficits or when serious underlying conditions, such as osteomyelitis, are suspected," Medscape says.
Reasons why physicians may continue to order imaging for acute low back pain include legal concerns, patient preferences, time pressures that might make it easier to order an imaging procedure than to discuss the condition, and financial incentives, say the authors.
Outgoing APTA president R. Scott Ward, PT, PhD, was honored for his service at the closing ceremonies of APTA's House of Delegates on Wednesday. The association invites physical therapists, physical therapist assistants, and students to watch this video tribute from APTA's Board of Directors and to leave thanks to or memories of Ward at the following blog post.
A summary of Ward's address at Wednesday's Opening Ceremonies is available in today's PT 2012 Daily News. The June 8 issue also includes coverage of the keynote address, delivered by Terry Bradshaw, Football Hall of Fame quarterback and NFL analyst for Fox; the 43rd McMillan Lecture, presented by Alan M. Jette, PT, PhD, FAPTA; and educational sessions on imaging, patient adherence, and the Human Genome Project. Access the issue at the PT 2012 webpage under "The Basics."
The Health System Measurement Project tracks government data on critical US health system indicators. The project focuses on 10 critical dimensions of the ever-changing health care system and the availability, quality, and cost of care, in addition to the overall health of Americans. The project examines the evolution of these aspects of the system over time and assesses the status of the dimensions of the system with respect to subgroups of the population, with a particular emphasis on vulnerable populations. An All Measures page lists every measure available in the system. Users can browse measures by population characteristics, by an alphabetic index, or by the audience the data might interest.
Developed by the Department of Health and Human Services (HHS), the project aims to ensure a robust monitoring system through which people inside and outside the government can assess how the health care system is doing and identify areas that need improvement. One important purpose of the project is to track the consequences of implementation of the Affordable Care Act across this broad set of dimensions of the health system.
APTA recently launched a Facebook page for the American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE). Physical therapists and students are encouraged to visit www.facebook.com/ABPTRFE, 'like' the page to get the latest news and updates, and connect with other programs and participants. E-mail feedback related to the page and content to firstname.lastname@example.org.
Today's issue of PT 2012 Daily News is available online. Read about the 8 chapters and sections that were recognized at Sunday's Component Leadership Meeting for their inspirational and outstanding work. A summary on the career of Alan M. Jette, PT, PhD, FAPTA, who delivered the 43rd annual McMillan Lecture this morning, also is available. Access the issue at the PT 2012 webpage under "The Basics."
The 5-year outcome in most patients with chronic patellofemoral pain syndrome (PFPS) who undergo knee arthroscopy and participate in a home exercise program is equally good to patients who participate in a home exercise program only, say authors of an article published in the British Journal of Sports Medicine. However, some of the patients in both groups do have long-term symptoms, they add.
Fifty-six patients with PFPS were randomized into 2 groups—an arthroscopy group (N=28) and an 8-week home exercise program, and a control group (N=28) treated with a similar 8-week home exercise program only. The primary outcome was the Kujala score on pain and function at 5 years. Secondary outcomes were visual analogue scales (VASs) to assess activity-related symptoms.
According to the Kujala score, both groups showed a marked improvement during the 5-year follow-up—a mean improvement of 14.7 in the arthroscopy group and 13.5 in the controls. No differences between the groups in mean improvement in the Kujala score (group difference 1.2) or in the VAS scores were found. None of the investigated factors predicted the long-term outcome, but in most of the cases the treatment result immediately after the exercise program remained similar also after the 5-year follow-up.