Intensive rehabilitative therapy significantly promotes physical and psychological function with pain reduction in older patients, say authors of an article published online in Archives of Gerontology and Geriatrics. 

Researchers enrolled all patients with functional decline after an acute illness admitted to the post-acute care (PAC) unit of a community hospital in Taiwan between July 2007 and December 2010. Patients enrolled before April 2009 received usual rehabilitation (40 minutes per day 5 days per week). Patients enrolled after April 2009 received increased rehabilitation (80 minutes per day 5 days per week). Researchers measured functional improvement by comprehensive geriatric assessment (CGA) at admission and 4 weeks after admission to the PAC unit.

Overall, 458 patients (mean age: 83.4±5.5 years, all males) completed PAC services. Compared with all dimensions in CGA, increased dosage of rehabilitative therapy showed significantly better improvement in daily living activities (Barthel index 28.8±18.4 vs 20.0±14.6), depressive mood (geriatric depression score short form -0.5±1.0 vs -0.1±0.5), and pain reduction (numerical rating scale -2.0±2.2 vs -0.9±2.1), but not in cognitive function (mini-mental status examination 2.9±3.3 vs 3.3.±5.2) and nutritional status (body mass index 0.3±0.9 vs 0.3±2.5).  

A new APTA Web page contains resources to help physical therapists transition to HIPAA Version 5010. In addition to implementation information, the association has designed an online complaint form for members who are having issues transitioning to the new standards. After the form is completed and submitted online, APTA will forward the issue to the Centers for Medicare and Medicaid Services.

The official deadline to adopt Version 5010 was January 1. CMS will begin enforcement of the standards April 1.

As part of its ongoing efforts to educate members about Accountable Care Organizations (ACOs) and the opportunities to become a part of this new model of care, APTA is creating a list of ACOs throughout the country. This listing may not be all inclusive as ACOs develop and change their status through the expiration of contracts, or because APTA has not been notified of their existence. Updates will be added as new information is made available to the association.

If you have information regarding ACOs in your area, or have questions regarding how to participate in an ACO, e-mail advocacy@apta.org.

February 27 is the deadline to submit nominations for 2 advocacy awards that will be presented in April at the Federal Government Affairs Forum.      

The Federal Government Affairs Leadership Award is presented annually to an active APTA member who has made significant individual contributions to APTA's Federal Government Affairs efforts and has shown exemplary leadership in furthering the association's objectives in the federal arena. The Public Service Award is presented annually to 1 or more individuals who have demonstrated unique support for the physical therapy profession at a national level. Individuals from the following categories are eligible for nomination: members of Congress/congressional staff members; members of a state legislature; federal agency officials; health/legislative association staff; and celebrities or other public figures. APTA's Board of Directors will choose award recipients in March. Award presentations will be held at the Federal Government Affairs Forum in Washington, DC. This year's Federal Advocacy Forum will be held in conjunction with a larger event, APTA's Leadership Forum, which integrates APTA's Board of Directors meeting, the Leadership Symposium for New Component President and Executive Teams, and the Federal Advocacy Forum. Participation at other events is not required to attend the Federal Advocacy Forum. Submit nominations by February 27 to Angela Boyd or fax to 703/706-8519. If you need a nomination form or have questions, call Angela Boyd at 800/999-2782, ext 3256.

Register before March 19 and get the best rates for PT 2012, APTA's Annual Conference & Exposition, June 6-9 in Tampa, Florida. PT 2012 offers more than 90 educational programs in 14 tracks, and includes the popular McMillan and Maley lectures and the Oxford Debate. Attendees can earn up to 21 contact hours.

Register today and connect! Join your peers, recognized experts, and leaders for 3 days of valuable, relevant, invigorating professional development and networking.

Duke University researchers who found that osteoarthritic knees, but not hips, are in a constant state of repair say that knee and hip osteoarthritis may need different treatment approaches.

"This suggests the knee has capacity for repair we didn't know about and the main treatment strategy probably would need to focus on turning off the breakdown of knee tissue," says Virginia Kraus, MD, PhD, professor of Rheumatology and Immunology at Duke.

The findings, published in Journal of Biological Chemistry, suggest that for hips, however, halting the degenerative process might not be enough. The hips would need a treatment to both stop degeneration and stimulate factors that could help to begin repair.

The knee is very accessible for injections, so it would make sense to inject the knee with agents that could turn off the degradative processes, and these could be delivered periodically with close monitoring, Kraus said. A cocktail of drugs might be needed for the hip, however, both to halt the degradation and to stimulate the right type of reparative elements.

Kraus and her team discovered a biomarker that is a measure of an altered (deaminated) protein, called D-COMP. In the circulation it signals hip degeneration and in cartilage it provides insight into the repair response of joint tissues. Kraus said this is the first biomarker specific to a particular joint site, and may be developed into a monitoring tool for hip-joint breakdown.

The next step is to understand the reasons for the difference between knees and hips and also to use new tools to analyze the ankle for its level of repair response.

Abstracts for a topical meeting of the American Society for Bone and Mineral Research (ASBMR), a founding member of the United States Bone and Joint Initiative, will be accepted until February 29. The meeting on bone and skeletal muscle interactions, July 17-18  in Kansas City, Missouri, will draw together leading muscle and bone researchers to exchange ideas, develop new collaborations, and accelerate the emerging scientific discoveries in the area of muscle and bone interactions. Information on abstract categories and submission criteria can be found on ASMBR's Web site. 

Contact ASBMR for further information by e-mail or at 202/367-1161.

To improve the quality of life for people with chronic illnesses, models of chronic disease care should align the resources of community-based organizations, the health care delivery system, employers and businesses, the media, and the academic community, says a new report from the Institute of Medicine (IOM).

Living Well with Chronic Illness: A Call for Public Action lays out a framework to guide the development and implementation of cross-cutting strategies that reduce the individual and societal burdens of chronic illness by helping people with chronic illnesses live well.

Key findings of the report include:

• All chronic illnesses hold the potential to worsen the overall health of the nation by limiting an individual's capacity to live well.
• Evidence-based interventions aimed at preventing chronic disease (such as ending smoking, eating nutritious food, and limiting weight gain) need to be studied in people with 1 or more chronic illnesses to assess their effectiveness.
• While a range of public policies have helped people with chronic illnesses, it is important to design and implement new public policies or explore promising approaches to further promote living well with chronic illnesses.
• Enhanced collaboration among the public health, health care, and community nonhealth care sectors could produce better prevention and treatment outcomes for people living with chronic disease.

IOM does not recommend a specific set of illnesses on which to focus public health action. Instead, it identifies 9 “exemplar” conditions that are diverse yet have various factors in common, including significant effects on the nation's health and economy. The conditions are arthritis, cancer survivorship, chronic pain, dementia, depression, type 2 diabetes, posttraumatic disabling conditions, schizophrenia, and vision and hearing loss.

Two education sessions at PT 2012 will address the management of chronic illness. The Role of Physical Therapists in Public Health: Prevention and Management of Chronic Disease and Disability will be held June 8, 1 pm-3pm. The Management of Older Individuals With Chronic Illness: A Case-based Approach will be held June 8, 3 pm-5 pm.