For the second time in a week, the Department of Health and Human Services (HHS) has delayed the deadline requiring states to submit information for state-based exchanges. The most recent delay allows states to submit their letter of intent on December 14. In a letter sent yesterday to governors HHS says, "While submitting a letter of intent now will help us assist states in finalizing their application, a state may submit both a letter of intent and an application to operate its own Exchange by December 14." On December 9 HHS extended the blueprint application deadline from November 16 to December 14.   

At the time the letter was released yesterday, 8 states—Arizona, Idaho, New Jersey, Oklahoma, Pennsylvania, Tennessee, West Virginia, and Wisconsin—were undecided as to whether they would create their own exchange or leave the task up to the federal government, according to The Hill.

APTA members are invited to participate in the association's groundbreaking event, Innovation Summit: Collaborative Care Models. Join our live-streamed presentation on March 8 to watch your colleagues, physicians, large health systems, and policy makers as they explore the role of physical therapy in current and emerging integrated models of care.

The Innovation Summit offers a rare opportunity for leaders in health care who are participating in and at the decision-making helm of these models to gather for a series of discussions about models of care such as ACOs, medical homes, and bundled payment, and the role of physical therapy, with the goal of developing strategies for bolstering the involvement of physical therapists in these models.

Register today to be a virtual attendee for this very special event. Your participation makes you eligible for 1.0 CEU. Learn more about how the Innovation Summit can benefit you.

The November issue of PT in Motion Extra, APTA's mobile-friendly, interactive complement to PT in Motion has just been published. Check it out! 

This issue includes:

• a feature article on PTs at the rodeo  
• a quiz on topics discussed at PT2012  
• new technology in action and a chance to predict the future 
• an overview of 4 apps for physical therapists 

Read this month's edition of Extra and tell APTA what you think by filling out this 5-question reader survey. You'll be entered into a drawing to win APTA's newest publication—Adult Fitness Examination: A Physical Therapy Approach, by Dan Millrood, PT, EdM—plus a packet of accompanying fill-in worksheets and client handouts (an $80 value). 

To evaluate physical therapy interventions for adults with knee osteoarthritis (OA), investigators from the University of Minnesota School of Public Health, University of Minnesota Medical School, and Minnesota Evidence-based Practice Center searched MEDLINE, the Cochrane Library, the Physiotherapy Evidence Database, Scirus, Allied and Complementary Medicine, and the Health and Psychosocial Instruments bibliography database from 1970 to February 2012.

A total of 193 randomized, controlled trials (RCTs) published in English were included in the review. Means of outcomes, physical therapy interventions, and risk of bias were extracted to pool standardized mean differences. Disagreements between reviewers abstracting and checking data were resolved through discussion.

Meta-analyses of 84 RCTs provided evidence for 13 physical therapy interventions on pain (58 RCTs), physical function (36 RCTs), and disability (29 RCTs). Meta-analyses provided low-strength evidence that aerobic (11 RCTs) and aquatic (3 RCTs) exercise improved disability and that aerobic exercise (19 RCTs), strengthening exercise (17 RCTs), and ultrasonography (6 RCTs) reduced pain and improved function. Several individual RCTs demonstrated clinically important improvements in pain and disability with aerobic exercise. Other physical therapy interventions demonstrated no sustained benefit. Individual RCTs showed similar benefits with aerobic, aquatic, and strengthening exercise. Adverse events were uncommon and did not deter participants from continuing treatment.

Free full text of the article is available in Annals of Internal Medicine. A report on the review also is available from the Agency for Healthcare Research and Quality.  

APTA member Becky Jo Olson-Kellogg, PT, DPT, GCS, coauthored the article.

APTA will host its next Move Forward radio show November 19 at noon ET on Holiday Shopping for Children With Special Needs. Two popular mommy bloggers, Ellen Seidman of Love that Max and Jennifer Byde Myers, a founder and editor of The Thinking Person's Guide to Autism and blogger at www.jennyalice.com, will share their personal experiences raising children with special needs and tips for holiday shopping. They also will discuss the role of physical therapy in their children's development. Joan Bohmert, PT, MS,will share her expertise as a physical therapist and discuss the impact that physical therapy can have on children with communication disabilities and developmental delays. For more information about the show and this initiative, click here. APTA's press release on the show is available at www.apta.org/.       

A new report from the Institute of Medicine (IOM) proposes a framework to assess the value of community-based, nonclinical prevention policies and wellness strategies, especially those targeting the prevention of long-term, chronic diseases.

The report's authors conclude that a comprehensive framework for valuing community-based prevention programs and poli­cies should meet 3 major criteria. First, the framework should account for ben­efits and harms in physical and mental health, community well-being, and community process. The physical and mental health domain includes reductions in the incidence and prevalence of dis­ease, declines in mortality, and increases in health-related quality of life.

Second, the framework should consider the resources used and compare the benefits and harms associated with those resources. To effec­tively compare interventions, it is essential to quantify the magnitude of benefits in relation to the associated cost for each intervention.

Third, the framework must take into account differ­ences among communities that can affect the link between interventions and outcomes.

Because selecting 1 community-based prevention pol­icy or program over another can be difficult, the report recommends that decision makers weigh the ben­efits and harms to health, community well-being, and community process as they assign value to specific interventions.

The authors caution that although a community-based preven­tion action may improve the overall health of a community, it may achieve more strikingly positive results among citizens with a certain income level or occupation, exacerbating health disparities. If achieving health equity is at odds with improving overall community health, priorities will have to be determined, they say.  

The 25th annual Marquette Challenge officially launched at NSC 2012 and participating schools are holding various fundraising events around the country.

This year's goal is to raise $200,000 to help reach a total of $2.5 million raised in 25 years of the Marquette Challenge.

Make a Difference! Take the Challenge! Get started by learning more with the interactive Challenge kit.

Click here to see the schools that have already pledged this year.

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