of a study that investigated the
comparative effectiveness of early use of thrust manipulation (TM) and
nonthrust manipulation (NTM) in patients with mechanical low back pain (LBP)
suggest that there is no difference between early use of TM or NTM, and, secondarily,
that personal equipoise affects study outcome. Intra-group changes were
significant for both groups, say authors and APTA members Chad Cook, PT, PhD, MBA, FAAOMPT, Kenneth Learman, PT, PhD, OCS, COMT, Christopher Showalter, PT, OCS, FAAOMPT, Vincent Kabbaz, PT, and Bryan
O'Halloran, PT, OCS, SCS.
trial, patients aged 18 and older with mechanically reproducible LBP were
randomized into 2 treatment groups. The main outcome measures were the Oswestry
Disability Index (ODI) and a Numeric Pain Rating Scale, with secondary measures
of rate of recovery, total visits and days in care, and the work subscale of
the Fears Avoidance Beliefs Questionnaire work subscale.
of 149 subjects completed the trial and received care over an average of 35
days. There were no significant differences between TM and NTM at the second
visit follow-up or at discharge with any of the outcomes categories. Personal
equipoise was significantly associated with ODI and pain.
deadline to submit nominations to participate in APTA's Innovation Summit
2013: Collaborative Care Models is October 22.
Summit will bring together innovators and thought leaders from physical
therapy, health policy, payment, and other health professions to explore the
role of physical therapists in new models of health care delivery and payment.
Participation in the Summit will be available to all members through live web
streaming. Attendance onsite will be limited to speakers, panelists, and
invited attendees, including the member innovators selected through this
sections, chapters, and the Student Assembly are each invited to nominate a
member who is involved in an innovative model of care to attend the March 7-8,
2013, onsite meeting in Alexandria, Virginia. A panel of member experts will
select 20 member innovators to share their innovative practice models as a part
of the Summit. Those selected will receive free registration and a stipend
for travel and lodging expenses. Chapters and sections whose nominees are
selected will receive special recognition during the Summit.
Members involved in innovative
models of care or payment may want to contact their chapter or section directly
to ask to be nominated to attend the Summit.
and nomination materials are available at this link.
Components may direct questions about the nomination process to firstname.lastname@example.org.
your last chance to weigh in on the topics to be covered in the final House
proposal town hall scheduled for Tuesday, October 23, 9:00 pm-10:30 pm, ET.
What would you like to discuss? What topic have we missed? Let us know. Suggest
ideas via the Additional
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
activity, and Resolutions
With Older Adults: An Evidence-Based Review of What Really Works," the
latest report from The Gerontological Society of America,
provides 40 pages of recommended guidelines for health care providers
interacting with the fastest-growing age segment of America's population.
The report provides 29 specific recommendations in 4 categories: general tips
for improving interactions with older adults, general tips for improving
face-to-face communication with older adults, tips for optimizing interactions
between health care professionals and older patients, and tips for
communicating with older adults with dementia.
the specific steps outlined in the report, providers are encouraged to avoid
speech that might be seen as patronizing to an older person, verify listener
comprehension during a conversation, and pay close attention to sentence
structure when conveying critical information.
The recommendations were contributed by experts
in the fields of gerontology and communications. Each is accompanied by a brief
explanation of the rationale, tips for implementing the recommendation in busy
health care settings, and selected references for further reading. The
objective is to encourage behaviors that consider the unique abilities and
challenges of older adult patients and produce positive, effective interactions
among everyone involved.
Encourage your Spanish-speaking patients to visit Ejercicioy estado físico, a comprehensive web resource from MedlinePlus that
offers tips on becoming and staying active based on the Department of Health
and Human Services' 2008 Physical Activity Guidelines for Americans, the latest news on the benefits of
physical activity, and information on exercise-specific topics—such as strength
training, aerobics, and interval training. Users can find links to a heart rate
calculator, food tracker, and calories-burned calculator. Tutorials and videos,
information tailored to women, and patient handouts also are available.
The role of
family caregivers has dramatically expanded to include performing
medical/nursing tasks once only provided in hospitals, says a new report by the AARP Public Policy Institute and the United Hospital Fund.
The report is based on a nationally representative population-based online
survey of 1,677 family caregivers to determine what medical/nursing tasks they
(46%) of caregivers performed medical/nursing tasks for family members with
multiple chronic physical and cognitive conditions. Three out of 4 (78%) family
caregivers who provided medical/nursing tasks were managing medications,
including administering intravenous fluids and injections. Caregivers
reported finding wound care very challenging; more than a third (38%) wanted
The report reveals the complexity and difficulty of
specific tasks, the lack of support and training family caregivers receive, and
the effect on their quality of life. It makes 10 recommendations, including:
profession or health care provider is solely responsible for ensuring that
family caregivers who
take on these daunting responsibilities are trained and supported," the
authors write. "This effort requires the coordinated efforts of all
sectors—hospitals, home care agencies, community agencies, nursing homes,
hospices, and physician and other clinician practices—and a level of teamwork
that challenges attitudes and behaviors so firmly entrenched in the current system."
The Centers for Medicare and Medicaid Services (CMS) will hold
a special open door forum (ODF) on October 22, 2:00
pm-3:30 pm ET, to allow providers to ask
questions about the manual medical review of therapy services that exceed
During this special ODF
(conference call only), CMS will discuss therapy documentation requirements and
answer any questions providers may have. CMS requests that providers who order
or provide therapy services nationally participate in the call. The therapy cap
applies to all Part B outpatient therapy settings and providers in:
Participants may submit
questions prior to the special ODF to email@example.com.
participate, call 866/ 501-5502 and enter conference ID 44803009.
newest publication, Adult Fitness Examination: A Physical Therapy Approach,
brings together a series of tests and measures that enables physical therapists
to build lifelong health and wellness plans with their asymptomatic adult
by APTA member Dan Millrood, PT, MEd,
and Charlotte Chua, PT, DPT, this groundbreaking assessment tool contains the
ready-to-use instructions and resources PTs need to identify, quantify, and qualify
key components of physical health and wellness.
educators, it's a textbook that addresses educational objectives related toprevention,
health promotion, fitness, and wellness.
Adult Fitness Examination includes:
Adult Fitness Examination (AFE-001, $34.99 for APTA members) from APTA's online bookstore.
foot ulceration (DFU) is associated with a nearly 2-fold increased risk for
all-cause mortality above that of diabetes alone, says a Medscape Medical News article based on a meta-analysis published in Diabetologia.
authors included 8 studies in their analysis. The studies were published
between 1996 and 2011 and reported on a total 17,830 patients with 81,116
patient-years of follow-up. Patients with both type 1 and type 2 diabetes were
included in all but 1 study, in which all patients had type 2 diabetes.
3,095 patients with DFU had a significantly longer duration of diabetes (12.72
years) compared with the 14,735 patients without DFU (7.19 years). The
prevalence of coronary artery disease was significantly higher among patients with
DFU (31.4% vs 14.7%), as was that of both hypertension (57.6% vs 35.7%) and
hypercholesterolemia (47.6% vs 11.1%).
follow-up, there were a total 3,619 deaths from any cause. The population with
DFU had a 1.89 pooled relative risk for all-cause mortality compared with the
patients with diabetes without DFU. Unadjusted rates of all-cause mortality
were 99.9 per 1,000 person-years for the population with DFU vs 41.6/1,000 in
the group with diabetes only.
analysis of 3,138 patients in 4 studies for whom information on cardiovascular
mortality was available showed that rates of fatal myocardial infarction and
fatal stroke also were higher among patients with DFU. However, the overall
proportion of deaths resulting from cardiovascular causes was almost the same
in the DFU and non-DFU groups—43.6% of the 117 DFU patients and 44.2% of the
952 diabetes-only patients.
higher mortality rate in patients with DFU may also "relate to their more
advanced stage of diabetes, with greater overall disease burden and
noncardiovascular complications of foot ulceration such as sepsis," Medscape says.