• Thursday, October 30, 2014RSS Feed

    Exercise Can Help Ease Fibromyalgia Symptoms, But No Clear Winner Between Aquatic and Land-Based Programs

    Exercise therapy can improve some symptoms of fibromyalgia, but conclusive evidence favoring aquatic or land-based programs as the best way to achieve those improvements is still lacking, according to a new Cochrane review of randomized controlled trials (article available through the Cochrane Database of Systematic Reviews in PTNow ArticleSearch). The study is part of a larger update of a Cochrane review on exercise for treating fibromyalgia syndrome.

    In an effort to determine how aquatic exercise training stacked up both to no exercise and land-based programs, researchers analyzed 16 aquatic training studies that included 866 women and 15 men. Aquatic exercise was compared with a non-exercise control group in 9 studies, and compared with land-based programs in 5 studies. In 2 studies, different types of aquatic exercise were compared with each other.

    When it comes to the benefits of aquatic exercise compared with no exercise, researchers found that individuals with fibromyalgia who participated in the aquatic programs reported improvements in physical function, pain, and stiffness. The studies also noted improvements in muscle strength and cardiovascular fitness. Although improvements were characterized as statistically significant across all measures, only stiffness and muscle strength met researchers' 15% threshold for clinical relevance. In general, authors described the evidence as "low to moderate quality" in favor of aquatic training.

    Comparisons of aquatic programs with land-based exercise yielded no clinically relevant differences between the 2, according to the study's authors, with evidence characterized as "very low to low quality."

    The final analysis is that there can't really be a final analysis when it comes to an assessment of aquatic vs land-based exercise for improvement of fibromyalgia symptoms, according to the review. "As so few studies have been done so far, we are very uncertain about the results," authors write.

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

    Thursday, October 30, 2014RSS Feed

    Video of McMillan Lecture Ready for Viewing

    Those who heard the 45th Mary McMillan Lecture at the 2014 NEXT Conference and Exposition have been talking about it ever since. Now's your chance to see why.

    "If Greatness Is a Goal," by James Gordon, PT, EdD, FAPTA, is now available to watch on APTA’s website.

    In his lecture, Gordon called for fewer physical therapy programs. These programs, he said, should consist of faculties committed to a 3-part academic mission of research, education, and clinical practice.

    Members can also read Gordon’s lecture in the October issue of PTJ, as well as view a NEXT dispatch interview. A PTJ podcast discussion with Gordon, Editor-in-Chief Rebecca Craik, PT, PhD, FAPTA, and other participants will be available in December at PTJ’s Podcast Central.

    The McMillan Lecture is part of the APTA Honors and Awards program now seeking nominees for recognition in 2015. Visit the Honors and Awards webpage to learn more. Nominations close December 1.

    Thursday, October 30, 2014RSS Feed

    How Did You Celebrate National Physical Therapy Month

    What did you do for National Physical Therapy Month (NPTM) this year? Time to share it with the world!

    Whether you participated in the "7 Myths" campaign or created your own ways to honor the profession, APTA would like to know. Share your NPTM 2014 celebration images and descriptions by using the #PTmonth hashtag on Twitter, Facebook, and Instagram, or by e-mailing us at public-relations@apta.org.

    Wednesday, October 29, 2014RSS Feed

    CDC Still Looking for Answers to Condition Producing Paralysis in Children

    The US Centers for Disease Control and Prevention (CDC) is still trying to identify the cause of an illness that has now resulted in various degrees of paralysis among 51 children in 23 states as of October 23. The agency began asking states to track the condition after a cluster of cases were reported in Colorado in August and September.

    The New York Times reports that CDC officials continue to describe the cases as "extremely rare," and they are not supporting a connection between the polio-like condition and respiratory virus enterovirus 68, although some doctors "suspect a link." The NYT article quotes Mark Pallansch, director of the division of viral diseases at CDC, as saying, "We don't have a single clear hypothesis that's the leading one at this point."

    Early reports cited the condition as appearing in 40 states. Since those initial reports, CDC ruled out several cases that do not meet its definitions for inclusion, which require the presence of spinal lesions largely in the gray matter, among other factors.

    The condition seems to strike younger children and advances rapidly, becoming most acute within 1-3 days of initial symptoms of weakness. The paralysis varies in severity, and most recovery is made within the first 2 months, with a slowdown in gains as time progresses. A pediatric neurologist quoted in the NYT story describes recovery as "highly variable," saying that "some patients recover very well, others not."

    CDC updates case tallies every Thursday, and continues to ask state and local health departments to report cases that meet its criteria for inclusion: sudden-onset acute limb weakness experienced in August or after in a patient 21 or younger, and the presence of a spinal cord lesion largely restricted to gray matter. The agency has also posted a report on its investigation into the cluster of cases in Colorado in August and September.

    Wednesday, October 29, 2014RSS Feed

    PTNow Blog: Good Research Needs More Than Good Stats

    In the latest PTNow Blog, a self-described "research geek" says that when it comes to evaluating research results, it's time for rehabilitation clinicians to move toward a nuanced approach that takes things such as confidence intervals, effect sizes, and clinical judgment into account.

    A clinical commentary authored by Phil Page, PT, PdD, ATC, CSCS, FACSM, is the subject of the new post, which describes Page's efforts to bring attention to so-called "magnitude-based inferences" that rely less on a simple black-or-white analysis of statistical significance, and more on an evaluative process that factors in whether and how that intervention will benefit the patient in a meaningful way.

    Along the way, the blog reports, Page also encourages physical therapists to take little for granted and never assume that research is good simply because it appears in a respected journal.

    Check out the blog, follow the link to Page's article, and join the conversation.

    Wednesday, October 29, 2014RSS Feed

    Slides, Video From IOM/NRC Workshop on Future of Home Health Now Available

    Presentation slides and videos from an innovative Institute on Medicine (IOM) and National Research Council (NRC) workshop on the future of home health care are now available for download at the IOM website. APTA was among the sponsors of the 2-day event.

    The workshop, held September 30 through October 1, brought together leaders in health care, academia, and the federal government to talk about the present and future of home health care, with particular emphasis on how data can inform and improve outcomes. Highlights of the workshop were featured in US News & World Report.

    The workshop touched on issues that affect the entire home health system, including innovation, the role of social support, silos in postacute care settings, customized technologies, and the creation of a standard definition that combines skilled, unskilled, and caregiver services. Cindy Krafft, PT, COS-C, president of APTA's Home Health Section, participated in the workshop along with APTA staff.

    The Alliance for Home Health Quality and Innovation will hold a follow-up symposium on January 13 in Washington, DC. Registration information will be posted on the Future of Home Health website.

    Tuesday, October 28, 2014RSS Feed

    New Study: Steroid Treatments Shouldn't Be the 'First-Line Stand-Alone' Approach to Neck Pain

    Authors of a new study say that epidural steroid injections used as a stand-alone treatment should not be a "first line" approach to cervical radicular pain, and instead suggest that a combination of treatments including physical therapy may offer the best chances for improvement.

    In a multicenter, randomized study published in the November issue of Anesthesiology, researchers tracked treatment outcomes for 3 groups of patients with neck pain that radiated through the shoulders and arms. A total of 55 patients received epidural steroid injection (ESI); 59 received pain medication and physical therapy; and 55 had both treatments. The study measured pain scores at outset, and 1, 3, and 6 months after treatments began.

    What researchers found was that both the conservative and steroid-only treatment groups improved at the same rate, and that while patients in the combination group reported greater rates of pain reduction, "the difference reached statistical significance only at 3 months." At that measurement point, 56.9% of the combination group reported decreased arm pain, compared with 36.7% of the steroid-only group and 26.8% of the conservative treatment group.

    "The main finding is that although the combination group experienced superior results for some outcome measures compared with stand-alone therapies, most differences generally fell shy of statistical significance, including for the primary outcome measure," authors write. "On the basis of these findings and the risks associated with ESI, one might reasonably conclude that ESI should not be a first-line, stand-alone treatment for cervical radiculopathy."

    Although authors did acknowledge that the combination group seemed to fare better than the stand-alone groups, they noted that "the effect size was more modest than we anticipated." Still, they offer several explanations for the differences, including the ways the treatments may enhance each other, the potential placebo effect of experiencing all treatments offered in the study, and the possibility that ESI treatments "provide significant short-term pain relief that allows optimal participation in [physical therapy], which provides long-term benefit."

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

    Tuesday, October 28, 2014RSS Feed

    APTA Candidate Nominations Due by November 3

    APTA's strong and diverse leadership can continue—but only with your help.

    The APTA Nominating Committee is seeking candidates for the 2015 slate for the open positions of president, vice president, 3 directors, and a Nominating Committee member. The committee encourages APTA members to fill out an online nomination form (NC1) to identify leaders eager to serve in a national position. Deadline is November 3.

    But don't stop there. Once you've submitted your nominations, be sure to reach out to your nominees to encourage them and tell them exactly why you think they have what it takes to help APTA achieve its vision of transforming society.

    Tuesday, October 28, 2014RSS Feed

    Time to Pick the Next PT in Motion Cover

    It's time once again for members to help PT in Motion magazine decide the design to be used on the cover of the upcoming issue. For December/January, editorial staff is proposing 3 designs and asking members to vote on their favorite cover to illustrate the concept of "pioneering PTs." The design that receives the most votes will be the next cover.

    Take the quick and simple survey by November 3. Just pick the design you think is likely to get you to open up the magazine, and then check out the December/January issue to see which cover was most popular.

    Tuesday, October 28, 2014RSS Feed

    Don't Miss Miami – Marquette Challenge Student Social at NSC

    Attending the National Student Conclave October 30 – November 3 in Milwaukee? Don't miss the Miami – Marquette Challenge Student Social on Thursday 7:00 pm–10:00 pm.

    There's no admission charge. If you submitted your RSVP, a brown ticket to the event will be included with your conference badge then head over to Buckhead Saloon, 1044 Old World 3rd Street, to hang out, catch up, see, be seen, and get excited about this year's Challenge to benefit physical therapy research. For those who didn't RSVP, additional tickets will be given out onsite to the first 100 students arriving.

    Need more incentive? Free drink tickets will be handed out to the first 350 students who arrive. Buckhead Saloon is also offering $2 drink specials throughout the evening.