Manual physical therapy provided
benefits over usual care that were sustained to 1 year for patients with
osteoarthritis of the hip or knee, say authors of an article published online
in Osteoarthritis and Cartilage. Exercise
physical therapy also provided physical performance benefits over usual care.
There was no added benefit from a combination of the 2 therapies.
In this 2x2 factorial randomized
controlled trial conducted in New Zealand, 206 adults (mean age 66 years) who
met the American College of Rheumatology criteria for hip or knee
osteoarthritis were allocated to receive manual physical therapy (n=54),
multimodal exercise physical therapy (n=51), combined exercise and manual
physical therapy (n=50), or no trial physical therapy (n=51). The primary
outcome was change in the Western Ontario and McMaster osteoarthritis index
(WOMAC) after 1 year. Secondary outcomes included physical performance tests.
Outcome assessors were blinded to group allocation.
Of 206 participants recruited, 193
(93.2%) were retained at follow-up. Mean (SD) baseline WOMAC score was 100.8
(53.8) on a scale of 0 to 240. Intention-to-treat analysis showed adjusted
reductions in WOMAC scores at 1 year compared with the usual care group of 28.5
for usual care plus manual therapy, 16.4 for usual care plus exercise therapy,
and 14.5 for usual care plus combined exercise therapy and manual therapy. There
was an antagonistic interaction between exercise therapy and manual therapy.
Physical performance test outcomes favored the exercise therapy group.
private and governmental payers continue to ramp up efforts to curb fraud and
abuse, physical therapists are facing more audits of their services. APTA
recently published FAQs on audits that identifies
strategies to prepare for and respond to private insurance audits. The FAQ document
also identifies additional resources available through APTA, including APTA's Medicare Claims Audits webpage, and
has released a statement
commending the final report of the Blue Ribbon Panel on Medical Rehabilitation
Research at the National Institutes of Health (NIH). The association supports the
panel's call for the development and implementation of a NIH rehabilitation research
plan that is periodically updated, elevation of the role of the National Center
for Rehabilitation Research within NIH's structure, and the elimination of "Medical"
from the name of the center to better reflect the inclusive and
multidisciplinary nature of rehabilitation, among other recommendations.
members Rebecca Craik, PT, PhD, FAPTA, Anthony Delitto, PT, PhD, FAPTA, and Alan M. Jette, PT, PhD, FAPTA, served on the 13-member panel.
The panel, formed in August 2011, was charged with assessing rehabilitation
research across NIH while focusing on the National Center for Medical
congratulates the following association members for their winning entries to
the 2012 photo contest: Jan Black, PT,
MSPT, first place; Megan Herrman, PT,
and Gayati Mathur, PT, second place;
and Bob Wellmon, PT, PhD, NSC, third
place. Black will receive $500. Herman and Mathur will receive a total of $250.
Wellmon also will receive $250.
therapists, physical therapist assistants, and students submitted 73 entries to
the contest. The 3 winning photos and 5 honorable mentions are available at www.apta.org/PhotoContest/. They also will be displayed at association headquarters and may appear
in APTA's online or print publications.
Submissions to the contest were
judged on how well they:
Information on the 2013 photo contest will be
available February 1 on APTA's website.
a part of this important time in the history of your profession and join us April
14-16 for the 2013 Federal Advocacy Forum. At the event, you will hear from
decision makers on Capitol Hill, learn to effectively communicate with your
elected officials, receive an update on the legislative and regulatory issues
affecting the physical therapy profession, and lobby your members of Congress
on behalf of your profession.
programming for the 2013 Federal Advocacy Forum will begin on Sunday, April 14,
with an evening reception. Monday, April 15, will be dedicated to advocacy
programming and preparation for your hill visits. The event will conclude with
the opportunity for you to take your message directly to your members of
Congress on April 16.
number of CEUs earned for this event is pending. To claim CEU credit, you must
attend the live event and complete the online posttest with at least 70%
accuracy. The online posttest will be available on APTA's Learning Center by April 16.
a full agenda and more information, visit www.apta.org/FederalForum. APTA encourages
you to get the word out to your friends and colleagues and bring someone with
you to the event. Register now and bring your
voice to Capitol Hill on behalf of your profession.
Magistro Family Foundation recently bestowed a gift of $500,000 to support the
Magistro Family Foundation Endowment Fund.
was created in 1998 to support relevant clinical research that evaluates the
effectiveness of interventions most commonly delivered by physical therapists.
forward, the fund will support health policy research. This most recent gift to
the Foundation for Physical Therapy includes support for the campaign to
establish a Center of Excellence for Health Policy Research.
this donation, the Magistro Family Foundation Endowment Fund now exceeds $2
million and will continue to provide vital grant funding well into the future.
view the news release, click here.
is with a heavy heart that I share the news of the sudden passing of our friend
and colleague, APTA Board Member Dave Pariser, PT, PhD," says APTA
President Paul A. Rockar Jr, PT, DPT, MS, in a statement released this morning.
"Dave was an outstanding gentleman and professional whose friendship,
devoted service, and leadership we will sorely miss."
member of APTA since 1981, Pariser served in various capacities within APTA
and the Kentucky and Louisiana chapters, including on APTA's Nominating
Committee, as Louisiana Chapter president, and as chair of the legislative
committees for both the Louisiana and Kentucky chapters. Most recently, he was
elected in June 2011 by APTA's House of Delegates to serve on the Board of
Directors. Pariser received numerous awards in recognition of his service,
including the Dave Warner Award for Distinguished Service (Physical Therapist
of the Year) from the Louisiana Chapter (2001) and induction into the chapter's
“Hall of Fame” in 2006 for career achievement.
Rockar's full statement on APTA's website.
has created a tribute page for members of
the physical therapy community and others to share their memories about
Centers for Medicare and Medicaid Services (CMS) recently released a proposed rule that has important
implications for Medicaid beneficiaries who require rehabilitative and
habilitative services and devices.
the rule, CMS proposes changes to provide states more flexibility to coordinate
Medicaid and the Children's Health Insurance Program (CHIP) eligibility
notices, appeals, and other related administrative procedures with similar
procedures used by other health coverage programs authorized under the
Affordable Care Act (ACA), such as coordination of benefits between Medicaid
and health plans offered in the health insurance exchanges (Exchanges).
CMS is soliciting comments on whether the habilitative benefit should be
offered in parity with the rehabilitative benefit under the Medicaid program
(as they must be under the Exchanges). Additionally, CMS requests input on
whether the state defined habilitative benefit definition for the Exchanges
should apply to Medicaid or states should be allowed to separately define
habilitative services for Medicaid. Habilitative and rehabilitative benefits
are part of the mandatory essential health benefits (EHB) established by the
ACA to ensure that certain health plans offered in Exchanges provide this
baseline of coverage, benefits, and services to their enrollees.
December 2012, CMS released guidance
to help states align Alternative Benefit Plans under Medicaid programs with the
EHB requirements. In that guidance, CMS stated that it intended for the provisions
of the EHB proposed rule, released on November 20, generally to
apply to Medicaid, but noted that it would address EHB in future rulemaking.
newly released proposed rule also proposes to update and simplify the complex
Medicaid premiums and cost-sharing requirements, to promote the most effective
use of services, and to assist states in identifying cost-sharing flexibilities.
will comment on the proposed rule. Comments are due February 13.
a study evaluating the
financial impact of providing early physical therapy for intensive care
patients, researchers at Johns Hopkins found that the
up-front costs are outweighed by the financial savings generated by earlier
discharges from the intensive care unit (ICU) and shorter hospital stays
"The evidence is growing that
providing early physical and occupational therapy for intensive care patients—even
when they are on life support—leads to better outcomes," says Dale M.
Needham, MD, PhD, senior author of the study. "Patients are stronger and
more able to care for themselves when they are discharged."
Hospital administrators' concerns
about costs have been cited as barriers to implementing early rehab programs in
the ICU. "However, our study shows that a relatively low investment up
front can produce a significant overall reduction in the cost of hospital care
for these patients," Needham says. "Such programs are an example of
how we can save money and improve care at the same time."
For the study, the researchers
developed a financial model based on actual experience at The Johns Hopkins
Hospital's medical intensive care unit (MICU) and projections for hospitals of
different sizes with variable lengths of stay.
The Johns Hopkins MICU admits about
900 patients each year. In 2008, the hospital created an early rehabilitation
program with dedicated physical therapists and occupational therapists, which
added about $358,000 to the cost of care annually. However, by 2009, the length
of stay in the MICU had decreased an average of 23%, down from 6.5 days to 5 days,
while the time spent by those same patients as they transitioned to
less-intensive hospital units fell 18%. Using their financial model, the
authors estimated a net cost saving for the hospital of about $818,000 per
year, even after factoring in the up-front costs.
The researchers then analyzed the
potential impact of early rehabilitation services in 24 different scenarios,
accounting for variations in the number of ICU admissions, cost savings per day
and reductions in length of stay.
found that in 20 out of the 24 scenarios, hospitals would have an overall cost
savings by providing early rehabilitation to patients in the ICU, and in the 4
remaining scenarios, using the most conservative assumptions, there was a
modest net cost increase of up to $88,000 per year.
APTA member Michael
Friedman, PT, MBA, is a coauthor of the study.
innovative models of care video series includes an interview with a physical
therapist who was instrumental in starting an early physical therapy program
for patients in a Houston hospital's ICU.
new policy statement by the American
Heart Association (AHA) encourages clinicians to assess cardiorespiratory
fitness with the hope that researchers can gather more information on aerobic
fitness and its related variables to identify individuals who might be at risk
for adverse clinical outcomes.
AHA writing committee also advocates for the creation of a national registry
that includes data on cardiorespiratory fitness that would allow researchers to
track aerobic fitness over long periods of time, just as is being done with
other variables such as cholesterol, blood pressure, physical activity levels,
and body weight, among others. It also would provide more information on
normative aerobic fitness levels in subsets of the population.
According to a Heartwire article, one of the goals of the national
registry is to increase awareness about the importance of cardiorespiratory
fitness. Many of the assessments are performed in exercise centers and research
settings, but not as frequently in clinical practice.
While information is available in
pockets of the country, including data from the Aerobics Center Longitudinal Study, the hope is more information
would allow researchers to determine normative cardiorespiratory fitness
levels, via direct measurements of VO2, in groups stratified by age,
gender, and body composition in large samples representative of the US
The registry also would help define
normative values of aerobic fitness across strata of physical activity levels.
of the AHA policy statement, Leonard
Kaminsky, PhD, told Heartwire that "physical activity is simply a behavior, and while
both are inversely associated with the risk of cardiovascular disease, there
are factors that contribute to aerobic fitness than other physical activity
levels, including age and genetics. In addition, cardiorespiratory fitness is a
more clinically meaningful measure than self-reported physical-activity levels,
which are prone to considerable error."
APTA member Ross
Arena, PT, PhD, is a coauthor of the statement, which was published online
ahead of print January
7 in Circulation.
A new APTA podcast that focuses on
screening for physical inactivity distinguishes between physical activity and
physical fitness, explains the use of physical activity to screen for issues of
impaired physical fitness, and provides information on what to do with the
results of the screen. It also gives examples illustrating various types of
patients and the role that physical activity plays in their overall