Authors of a meta-analysis published in the Journal of Rehabilitation Medicine report that their findings indicate small, but significant, effects of physical therapy on balance in people with multiple sclerosis who have a mild to moderate level of disability.

A systematic literature search was conducted in Medline, Cinahl, Embase, and PEDro, both electronically and manually up to March 2011. The authors selected randomized controlled trials of physical therapy interventions in people with multiple sclerosis, with an outcome measure linked to the International Classification of Functioning, Disability and Health category "changing and maintaining body position." The quality of studies was determined by the van Tulder criteria. Meta-analyses were performed in subgroups according to the intervention.

Of the 233 full-text papers screened, 11 studies were included in a qualitative analysis and 7 in a meta-analysis. The methodological quality of the studies ranged from poor to moderate. Low evidence was found for the efficacy of specific balance exercises, physical therapy based on an individualized problem-solving approach, and resistance and aerobic exercises on improving balance among ambulatory people with multiple sclerosis.

APTA's  Fit After 50 campaign is officially under way. Launched in conjunction with National Physical Therapy Month, Fit After 50 is designed to reach Baby Boomers with the message that physical therapists play a vital role in helping people aged 50 and older remain active, fit, and mobile as they age.

Check out 50 Days, 50 Ways, a daily series of 50 tips for Baby Boomers from APTA members about how to prevent injury and maintain mobility by staying active and fit. Find the tips on www.moveforwardpt.com/FitAfter50, Twitter @MoveForwardPT, and Facebook.com/MoveForwardPT. Encourage your friends, family, colleagues, and community members who are 50 and older to visit the site and share the tips with their social networks.

Also check out the APTA Fit After 50 Member Challenge, an opportunity to nominate a deserving APTA member, including yourself, who is 50 years old or older and committed to being active and fit, and encourages others to be the same. Go to www.apta.org/FitAfter50/ to learn more about the campaign and submit your nomination.

If you are currently helping people aged 50 and older to remain active and fit as they age, let us know by contacting public-relations@apta.org.

Thanks to the many members who have joined the virtual town halls to discuss the House governance proposals! The discussions have been rich and the input very informative. Based on attendee feedback, 2 additional town halls have been scheduled for Thursday, October 18, and Tuesday, October 23; 1 session will be offered on each of those evenings at 9:00 pm-10:30 pm, ET. The topics will be chosen by you. What would you like to discuss? What topic have we missed? Let us know. Suggest ideas via the Additional Thoughts comment blog posted to www.apta.org/governancereview. Contact Amber Neil if you are interested in attending. Can't join a town hall? Have your voice heard via the comment blogs on the following topics: House constituency, House activity, and Resolutions Committee.

A study by The George Washington University School of Public Health and Health Services suggests that the higher the work-family conflict the greater the risk that health care workers will suffer from neck and other types of musculoskeletal pain. 

To examine if an association exists between work-family conflict and musculoskeletal pain among hospital patient care workers, researchers conducted a survey among 2,000 hospital workers who provided direct patient care in 2 large Boston hospitals. Nearly 80% of the workers took the survey. The research team included 1,199 patient care workers in the current analysis. The team assessed work-family conflict with 5 questions. Researchers asked workers if they agreed with statements such as "The amount of time my job takes up makes it difficult to fulfill family or personal responsibilities" and "My job produces strain that makes it difficult to fulfill my family or personal responsibilities."

In addition, the team used a questionnaire to assess how much the participants in the study experienced musculoskeletal pain during the previous 3 months. It also recorded factors that might affect the outcome of the study, such as the amount of on-the-job lifting or pulling.

The researchers discovered that nurses and other employees who reported high conflict between their job duties and obligations at home had about a 2 times greater chance of suffering from neck or shoulder pain in the last 3 months. Workers with the highest work-life imbalance had nearly a 3 times greater risk of reporting arm pain during that period.

The researchers found that workers who reported a lot of conflict had more than a 2 times greater chance of experiencing any kind of musculoskeletal pain. At the same time, the research found no lasting link between this kind of ongoing conflict and lower back pain, which might be caused when hospital workers lift heavy patients on a regular basis.

Lead author Seung-Sup Kim says that the work-home conflict might exacerbate shortages of key health professionals caused when burned-out nurses or other health professionals retire early or leave the field because of the stress. In addition, Kim says, workers distracted by issues at home or by ongoing muscular pain might be more likely to call in sick or if they do show up for work might provide less than attentive care.

On Monday, the therapy cap with an exceptions process went into effect for outpatient hospitals. In addition, the manual medical review exceptions process for claims exceeding $3,700 became effective for phase I providers. Originally, the Centers for Medicare and Medicaid Services (CMS) had announced that providers would know the dollar amount that their patients accrued toward the therapy cap on October 1. Due to some systems challenges, this information was not available. CMS announced this week that the information will be available October 8 through eligibility inquiries. Physical therapists (PTs) should check with their Medicare Administrative Contractors to determine the best way to obtain the dollar amounts accrued. When the data is available on October 8, PTs can then determine whether there is a need to seek an exception to the therapy cap.

To help PTs with the implementation of the cap and the manual medical review exceptions process, APTA has created a Medicare Therapy Cap Resources webpage. This webpage compiles relevant information available from APTA and CMS in 1 place.

In this month's Heard on the Hill podcast, Mike Matlack, APTA director of grassroots and political affairs, breaks down the races for the United States Senate and House of Representatives and discusses the toss-up states in the Senate and competitive seats in the House. He also explains how the Electoral College looks as the candidates head into the debates.

Source: National Journal 

Researchers at the European Association for the Study of Diabetes 2012 Meeting reported this week that higher levels of leisure-time physical activity cut the risk of cardiovascular and all-cause mortality in people with type 2 diabetes, says an article by Heartwire. People with diabetes who did little or no exercise at baseline and then substantially increased their leisure-time physical-activity levels over approximately 5 years cut their risk of death by almost two-thirds.

The researchers used data on leisure-time physical activity, recorded yearly, from more than 15,000 men and women with type 2 diabetes included in the Swedish National Diabetes Register. Participants were grouped as either "low physical activity" (no regular exercise or exercise once per week) or "regular exercise" (between 3 times per week and daily exercise). If patients died during the course of the study, their last recorded physical-activity level was used for the analysis.

Over a 5-year period, regular exercisers were significantly less likely to have a cardiovascular event or to die either from cardiovascular disease or any other cause.

The investigators also looked at patients who reported doing little or no physical activity at baseline but who increased their regular exercise to at least 3 times per week by the end of the study period (a mean of 4.8 years). Cardiovascular deaths among these patients dropped by 67% compared with patients who did not improve their exercise habits. Rates of all-cause mortality were reduced by almost the same degree.

Session moderator Nick Wareham, MD, stressed that the data "… should encourage us to focus on encouraging physical activity as part and parcel of medical care."