Self-reported function, hip range of motion (HROM), and patient-perceived improvement occurred after an 8-week program of exercise therapy (ET) for patients with hip osteoarthritis (OA), say authors of an article published in Archives of Physical Medicine and Rehabilitation. Manual therapy (MT) as an adjunct provided no further benefit, except for achieving higher patient satisfaction, they add.

For this investigation, 131 patients with hip OA recruited from general practitioners, rheumatologists, orthopedic surgeons, and other hospital consultants in Dublin, Ireland, were randomized to 1 of 3 groups: ET (n=45), ET+MT (n=43), and wait-list control (n=43).

Participants in both ET and ET+MT groups received up to 8 treatments over 8 weeks. Control group participants were rerandomized into either the ET or ET+MT group after the 9 week follow-up. Their data were pooled with original treatment group data—ET (n=66) and ET+MT (n=65).

The primary outcome was the WOMAC physical function (PF) subscale. Secondary outcomes included physical performance, pain, HROM, anxiety/depression, quality of life, medication usage, patient-perceived change, and patient satisfaction.

There was no significant difference in WOMAC PF between ET (n=66) and ET+MT (n=65) groups at 9 weeks (mean difference 0.09) or at 18 weeks (mean difference 0.42), or other outcomes, except "patient satisfaction with outcome," which was higher in the ET+MT group. Improvements in WOMAC, HROM, and patient-perceived change occurred in both treatment groups compared with the control group.

Physical therapists (PTs) should consider a number of details before contracting with payers, whether private or public. View APTA's new Managed Care Contracting Toolkit today to learn valuable information about joining a managed care plan, and securing and tracking contracts. A chapter on "doing the math" can help you decide which fee schedules, patient populations, and payment methodologies are best suited to your practice. The toolkit also breaks down the pros and cons of common methodologies that third-party payers use to pay for physical therapy services and offers information on negotiating contracts.   

APTA's Payment and Practice Management Department created the member-only toolkit to help PTs make informed decisions about joining a provider network.

An analysis of clinical practice guidelines archived on the National Guideline Clearinghouse (NGC) website as of June 2011 demonstrated poor compliance with Institute of Medicine (IOM) standards, with little if any improvement over the past 2 decades, say authors of an article published this month in Archives of Medicine. 

For the study, 2 reviewers independently screened 130 guidelines selected at random from NGC's website for compliance with 18 of 25 IOM standards.

The overall median number of IOM standards satisfied (out of 18) was 8 (44.4%). Fewer than half of the guidelines surveyed met more than 50% of IOM standards. Barely a third of the guidelines produced by subspecialty societies satisfied more than 50% of the IOM standards surveyed.

Information on conflicts of interest was given in fewer than half of the guidelines surveyed. Non-English literature, unpublished data, and/or abstracts were rarely considered in developing guidelines. Differences of opinion among committee members generally were not aired in guidelines. Benefits of recommendations were enumerated more often than potential harms. Guidelines published from 2006 through 2011 varied little with regard to average number of IOM standards satisfied.

"Everybody everywhere is developing guidelines and there is no real quality control," lead author Philip A. Mackowiak, MD, told Reuters News. "There is no good oversight of who actually develops the guidelines or what criteria need to be met in order for them to be published."

IOM's standards were not published until 2011. Mackowiak acknowledges that the experts who developed the guidelines reviewed by his team would not have been able to use IOM's standards.  However, he added that similar standards have been published before and that they were basic enough that they should have been followed, says Reuters.

E-mail photos and brief descriptions of your events to public-relations@apta.org and we will consider them for our NPTM Celebrations webpage.

Nominate a deserving APTA member who is 50 years or older, 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 to nominate yourself or another deserving 50+ year old.

"APTA applauds the proposed legal settlement of the nationwide class action lawsuit directed toward ensuring Medicare coverage of reasonable and necessary therapy and nursing services for people with chronic and degenerative health conditions," says APTA President Paul A. Rockar Jr, PT, DPT, MS, in a statement issued today regarding the lawsuit Glenda Jimmo, et. al vs. Kathleen Sebelius. Plaintiffs in the lawsuit alleged that the US Department of Health and Human Services, Medicare contractors, and administrative review boards were arbitrarily limiting coverage for patients who did not show long-term improvement in their conditions, even though official Centers for Medicare and Medicaid Services rules state these services should be covered.

Under this proposed agreement, Medicare would pay for skilled therapy and nursing services if they are needed to maintain the patient's current condition or prevent or slow further deterioration.

The New York Times highlighted how the policy change will result in significant cost savings in the long term by allowing patients to receive physical therapy and other services in community-based settings and avoiding expensive care in hospitals and nursing homes.

APTA will continue its efforts to ensure access to appropriate physical therapy services. The association also will work with the Centers for Medicare and Medicaid Services and its contractors to ensure accurate and fair incorporation of revisions to the current Medicare manuals and regulations that reflect this significant change. In addition, the association will continue to analyze the proposed settlement for potential impact on Medicare policies regarding the reporting of functional limitations on the claim for outpatient therapy and the requirement to complete a functional reassessment at defined intervals under the Home Health Part A benefit.

APTA plans to actively educate members to ensure proper understanding and application of the newly revised Medicare regulations.

Although 66% of online American adults use social networking sites, according to a 2012 Pew Internet Project study, many users remain skeptical about using social media for professional purposes. To demonstrate some of the potential benefits of social media, APTA hosted an online roundtable discussion Monday with 5 physical therapists and 1 student of physical therapy, all of whom actively use Twitter and other social media tools to network about physical therapy issues.

The 53-minute discussion, conducted using Google+ Hangouts and archived via YouTube, covers the weekly #SolvePT tweetchat, ways that social media are effective in advocacy efforts, benefits of social media for physical therapy educators and students, and the challenges of discussing critical issues in a social media environment, among other topics.

Participating in the panel were Allan Besselink, PT, Dip MDT, Christopher Bise, PT, DPT, MS, OCS, physical therapist student Matt DeBole, Selena Horner, PT, MS, GCS, Eric Robertson, PT, DPT, OCS, and Ann Wendel, PT, ATC, CMTPT.

The roundtable is available on the Social Media Tips & Best Practices webpage of APTA.org, which includes links to APTA's policy on social media, a new video tutorial for Twitter, and other resources.

Before National Physical Therapy Month ends, take the time to acknowledge your colleagues or students with an APTA 2013 Honor or Award nomination. By nominating the person or people you feel are most deserving of an honor or award, you can help APTA celebrate their many contributions to the physical therapy profession. 

Your participation in the nominating process is extremely important. It's quick, easy—and in keeping with APTA's green initiative, all APTA national Honors and Awards applications are available for electronic submission.   

Go to APTAs Honors and Awards page and submit your nominations online. All submissions must be received by December 1.

E-mail questions to honorsandawards@apta.org or call 800/999-2782, ext 3233, for more information.

Time is running out to nominate yourself or an APTA-member colleague to national office. The online Nomination Form (NC 1) is available on APTA's website under "Leadership and Governance" and then "Elections and Nominations." The APTA Nominating Committee is seeking recommendations for the 2013 Slate of Candidates for the following positions: secretary, vice speaker, 3 directors, and 2 Nominating Committee members.