annual review and revision of the association strategic plan conducted in late
2012 by the APTA Board of Directors has resulted in a revised plan for
2013. Members can access the plan and
related materials on the website at this link. The strategic plan
represents the highest priorities of the Board of Directors as it manages the
work of the association and was informed by member and external stakeholder
In a follow-up of a randomized
controlled trial, a strategy of rehabilitation plus early acute anterior
cruciate ligament (ACL) reconstruction did not provide
better results at 5 years than a strategy of initial rehabilitation with the
option of having a later ACL reconstruction. Results did not differ between
knees surgically reconstructed early or late and those treated with rehabilitation
alone. These results should encourage clinicians and young active adult
patients to consider rehabilitation as a primary treatment option after an
acute ACL tear, say the authors in their article published this month in BMJ.
This study included 121 young,
active adults (mean age 26 years) with acute ACL injury to a previously
uninjured knee. All patients received similar structured rehabilitation. In
addition to rehabilitation, 62 patients were assigned to early ACL
reconstruction and 59 were assigned to the option of having a delayed ACL
reconstruction if needed. One patient was lost to 5-year follow-up.
The main outcome was the change from
baseline to 5 years in the mean value of 4 of the 5 subscales of the knee
injury and osteoarthritis outcome score (KOOS4). Other outcomes included the
absolute KOOS(4) score, all 5 KOOS subscale scores, SF-36, Tegner activity
scale, meniscal surgery, and radiographic osteoarthritis at 5 years.
Thirty (51%) patients assigned to
optional delayed ACL reconstruction had delayed ACL reconstruction (7 between 2
and 5 years). The mean change in KOOS4 score from baseline to 5 years was
42.9 points for those assigned to rehabilitation plus early ACL reconstruction
and 44.9 for those assigned to rehabilitation plus optional delayed
reconstruction (between group difference 2.0 points after adjustment for
baseline score). At 5 years, no significant between-group differences were seen
in KOOS4, any of the KOOS subscales, SF-36, Tegner activity scale, or
incident radiographic osteoarthritis of the index knee. No between-group
differences were seen in the number of knees having meniscus surgery or in a
time-to-event analysis of the proportion of meniscuses operated on. The results
were similar when analyzed by treatment actually received.
If you are interested in leadership development, collaborating
with colleagues, and lending your expertise to APTA, then you need to join the Volunteer Interest Pool. Current opportunities include all awards
subcommittees: Advocacy, Catherine Worthingham Fellows, Education,
Lecture, Practice and Service, Publications, Research, and Scholarship.
To answer the call for these opportunities, you must first
complete a volunteer interest profile. Creating this profile allows you to
include your preferred level of involvement, willingness to travel, current
availability, and interest/experience in a variety of areas. You only need to
create the volunteer profile once. It can be updated at any time. Once you
have created a profile, you will need to review the current opportunities and
answer the questions specific to each committee.
Deadlines will vary by group, so don't delay in checking out these
opportunities! To learn more about the Volunteer Interest Pool, please
contact Angela Boyd.
new report that seeks to move the nation from "sick care" to
"health care" encourages all employers, including federal, state, and
local governments, to provide effective, evidence-based workplace wellness
Trust for America's Health's
(TFAH) A Healthier America 2013: Strategies to Move from Sick Care to Health
Care in Four Years outlines top policy approaches to respond to studies
that show that (1) more than half of Americans are living with 1 or more
serious, chronic diseases, a majority of which could have been prevented; and (2)
today's children could be on track to be the first in US history to live
shorter, less healthy lives than their parents.
The Healthier America report stresses the importance of taking innovative approaches and
building partnerships with a wide range of sectors in order to be
effective. Some recommendations include:
Healthier America features
more than 15 case studies from across the country that show the report's
recommendations in action. It also includes recommendations for a series of 10
key public health issues.
After the report's release, economic
experts came out against TFAH's position on preventive care's role in
reducing health care spending. (See related article posted in News Now titled "Experts Say
Preventive Care Produces Limited Savings.")
While some disease-prevention
programs do produce net savings, such as childhood immunizations and counseling
adults about using baby aspirin to prevent cardiovascular disease, most preventive
care does not save money, says an article by Reuters
Following the release yesterday of a
new report from Trust for America's Health (TFAH) that calls for putting more
resources into preventive care, economic experts challenged TFAH's position on preventive
care's role in reducing health care spending. (See related article posted in News Now tilted "TFAH Releases
Strategies to Improve Nation's Health in 4 Years.")
"Preventive care is more about
the right thing to do" because it spares people the misery of illness,
economist Austin Frakt of Boston University told Reuters. "But it's not plausible to think you can cut health care
spending through preventive care. This is widely misunderstood."
2010 study in Health Affairs, for
instance, calculated that if 90% of the US population used proven preventive
services, more than do now, it would save only 0.2% of health care spending.
One reason why preventive care does
not save money, say health economists, is that some of the best-known forms
don't actually improve someone's health. These low- or no-benefit measures
include annual physicals for healthy adults.
The second reason preventive care
brings so few cost savings is the large number of people who need to receive a
particular preventive service in order to avert a single expensive illness.
A promising approach is to target preventive care at those most likely to
develop a chronic disease, not at low-risk people. Such "smart"
prevention increases the chances of preventing expensive diseases and saving
In contrast, unthinking expansion of preventive medicine is the wrong
prescription, the article says.