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  • Are You Fall-Savvy? Take This Quick Quiz

    Falls Prevention Awareness Day is set for September 22, making now a great time to check out falls-related resources on APTA's recently updated Balance and Falls webpage. But before you do, see how you score on this 8-question quiz on falls statistics and screening (scroll down for answers). Good luck!

    1. According to the US Centers for Disease Control and Prevention (CDC), approximately how many Americans aged 65 and older experience a fall every year?
    A. 1 in 3
    B. 1 in 4
    C. 1 in 5
    D. 1 in 6

    2. According to a clinical guideline statement from the APTA Academy of Geriatric Physical Therapy (AGPT), what question should physical therapists (PTs) routinely ask older adult patients?
    A. "What medications are you currently taking?"
    B. "Are you experiencing feelings of dizziness?"
    C. "Have you been diagnosed with diabetes?"
    D. "Have you had any falls in the last 12 months?"

    3. Between 2007 and 2016, death rates due to falls in the US increased by what percentage?
    A. 3%
    B. 15%
    C. 24%
    D. 31%

    4. Authors of a 2012 study in the Journal of Aging and Physical Activity studied a particular activity and found that adults who engaged in this activity had a reduced risk for falls. Which activity did researchers target?
    A. Gardening
    B. Driving a car
    C. Shopping
    D. Light household chores

    5. A recent study in the American Journal of Preventive Medicine found that the falls risk factor affecting the largest number of adults 65 and over is:
    A. Visual impairments
    B. Medication interaction
    C. Home hazards
    D. Vitamin D deficiency

    6. A recent CDC study ranked US states according to older adult death rates due to falls in 2016. At 142.7 per 100,000 individuals, which state reported the highest death rate?
    A. Alabama
    B. Florida
    C. Arizona
    D. Wisconsin

    7. According to the CDC, among men and women aged 65 and older, which group has the highest rate of nonfatal falls, and which has the highest rate of fatal falls?
    A. Men have the highest rates of both fatal and nonfatal falls.
    B. Women have the highest rates of both fatal and nonfatal falls.
    C. Women have higher rates of nonfatal falls; men have higher rates of fatal falls.
    D. Men have higher rates of nonfatal falls; women have higher rates of fatal falls.

    8. According to a survey of emergency department physicians in the US and Canada, the bathroom is the most risky location for a fall in the home among adults 65 and older, with 69% of home falls occurring in that space. Which area comes in second?
    A. Kitchen
    B. Bedroom
    C. Stairs
    D. Living room

    ANSWERS:

    1. B - About 24% of older Americans fall each year—the leading cause of fatal and nonfatal injuries among older Americans, according to the CDC.

    2. D - There are of course many questions that may be appropriate for providers to ask (including some of the choices listed here), but the question that should never be skipped is whether the patient has experienced any falls in the past 12 months, according to the AGPT guidelines. Previous falls are 1 of the strongest falls risk factors, and should never be ignored.

    3. D - Falls-related deaths rose by 31% between 2007 and 2016, according to the CDC. During the 10 years tracked in the study, falls-related deaths among US residents 65 and older rose from 18,334 to 29,668—in terms of rates of death from falls, that's an increase from 47 per 100,000 to 61.6 per 100,000 in that age group. Deaths climbed by about 3% per year, according to the report.

    4. A - In the study, researchers focused on gardening, and concluded that "gardeners reported significantly better balance and gait speed and had fewer chronic conditions and functional limitations than nongardners." They believed the findings "suggest that gardening may be a potential activity to incorporate into future fall-prevention programs."

    5. C  - Home hazards were the leader in terms of falls risk factors, but that isn't to say other factors don't come into play as well, say authors of the study.

    6. DAccording to the CDC, Wisconsin had the highest falls-related death rate among adults 65 and older, at 142.7 per 100,000. Authors aren't sure of the reasons for the variance but suspect that the numbers might be related to demographic variables including differing proportions of older white adults in various states. Another possible explanation: the impact of who completes the death certificate.: According to the CDC researchers, a 2012 study showed that coroners reported 14% fewer deaths from falls than did medical examiners.

    7. C - Women have higher rates for falls, but men have higher death rates related to falls, according to the CDC. Authors of the study speculate that the higher fatality rate "might have resulted from differences in the circumstances of a fall (e.g., from a ladder or while drinking), leading to more serious injuries."

    8. B - Caregiverstress.com reports that at 13%, bedrooms are the second-most-likely place for a fall, followed by kitchens and stairs.

    Donations Now Being Accepted for Florence Relief

    An online giving program established last year to help hurricane victims in Texas, Florida, and Puerto Rico is now focusing its efforts on providing aid to people affected by Hurricane Florence, which recently inflicted billions in damage in the Carolinas.

    Now's your chance to help.

    "Rehab Therapists Give Back," an online giving program designed to provide physical therapists, physical therapist assistants, and other rehabilitation professionals with an opportunity to come together as a unified community to help those in need, is now accepting donations for Florence relief. Accessible through a GlobalGiving website, the initiative allows donors to contribute any amount. Electronic medical records system vendor WebPT and APTA were founding funders of the program.

    Questions? Contact RTGB@webpt.com.

    State-Level PT Advocates Honored at 2018 Policy and Payment Forum

    Recognition of the importance of nonpharmacological pain therapies, adoption of the physical therapy licensure compact, a higher-profile role for physical therapists (PTs) in concussion management, and improving the legal scope of practice for physical therapists were among the accomplishments of this year's APTA State Legislative Leadership and Legislative Commitment Award winners recognized at the association's recent State Policy and Payment Forum in Kansas City, Missouri. The event was co-hosted by the Missouri and Kansas chapters of APTA.

    This year, 4 PTs were honored for their service to the profession at the state level:

    Mark Bishop, PT, PhD, FAPTA, was presented with an APTA State Legislative Leadership Award for his work in Florida to address the opioid crisis. Bishop's leadership and expertise was instrumental in the Florida Physical Therapy Association's development of a legislative amendment, adopted into the Florida Substance Abuse Act, that requires prescribers of controlled substances to complete a 2-hour continuing education course on prescribing controlled substances that must include information on nonpharmacological therapies.

    Cynthia Driskell, PT, also earned an APTA State Legislative Leadership Award in recognition of her achievements over 8 years as state legislative chair for the Arizona Chapter of APTA. Driskell's skills at facilitation were most recently brought to bear on a multisession effort to include PTs among the providers empowered to make return-to-play decisions for athletes and a successful push to include PTs with a sports specialty certification to participate in a concussion management pilot program.

    Derek Gerber, PT, DPT, of Idaho, was the third recipient of a State Legislative Leadership Award. Gerber led a successful push to eliminate the state's prohibition on dry needling by PTs, a change that was signed into law in March. Thanks to Gerber's extensive involvement in the effort, Idaho now allows PTs to practice dry needling after they have completed specified education and training requirements.

    Emilie Jones, PT, DPT, was honored with the APTA State Legislative Commitment Award. Jones, who served 3 years as legislative committee chair for the Washington Chapter of APTA, was instrumental in addressing several crucial issues in the state, including assistive personnel revisions, progress on dry needling, and the adoption of the physical therapy licensure compact.

    The APTA State Policy and Payment Forum focuses on advocacy and legislative issues at the state level. Check out pictures from the event here.

    State Forum Awards
    This year's state legislative award winners (from left): Emilie Jones, PT, DPT; Derek Gerber, PT, DPT; and Cynthia Driskell, PT. Not pictured: Mark Bishop, PT, PhD, FAPTA. Jones, Driskell, and Bishop received State Legislative Leadership Awards; Gerber received a State Legislative Commitment Award.

    The Good Stuff: Members and the Profession in the Media, September 2018

    "The Good Stuff," is an occasional series that highlights recent media coverage of physical therapy and APTA members, with an emphasis on good news and stories of how individual PTs and PTAs are transforming health care and society every day. Enjoy!

    Bringing the PT voice to the table: Amee Seitz, PT, DPT, PhD, is representing APTA on the American Academy of Orthopaedic Surgeons work group developing clinical guidelines for management of rotator cuff injuries. (Northwestern University Medicine News)

    Addressing a pain feedback system gone "haywire": Tara Legar, PT, explains how physical therapy can help people with chronic pain avoid opioids. (Pike County, Ohio, News Watchman)

    Quotable: "All too often, people get the advice to stop everything that they're doing, rest, take some opioid medication. And we know now that's the wrong treatment." –Judith Turner, pain management specialist, on the importance of physical therapy for low back pain. (KABC-7 Eyewitness News, Los Angeles)

    Friend of the court: Julie Moon, PT, has a very special patient—her father, a retired chief justice of the Hawaii Supreme Court. (KHON 2 News, Honolulu)

    Pilates for neurological conditions: Kelsey Garcia PT, DPT, leads a 5-week program that delivers “Pilates-based” physical therapy to individuals with PD, MS, spinal cord injury, and more. (Miami's Community Newspapers group)

    A Special Olympics health leader: Jen Roberts, PT, DPT, was named the winner of a Special Olympics North Carolina "Golisano Health Leadership Award." (Charlotte-Raleigh citybizlist)

    It's manely about physical therapy: John Payne, PT, discusses the benefits of hippotherapy. (Tacoma, Washington, News-Tribune)

    Pelvic floor health: Jaime Rogers, PT, says people shouldn't be hesitant to discuss pelvic disorders with their health care providers. (Lawrence, Kansas, Journal-World)

    The right way to reduce back pain: Karen Joubert, PT, DPT, discusses the best ways to get relief from back, neck, and shoulder pain. (KTLA 5 News, Los Angeles)

    A groundbreaker: Dan Hatch, PT, DPT, was named 1 of Newport, Rhode Island's top 10 "Groundbreakers" for his value-based, cash-based practice.(Providence, Rhode Island, Journal)

    A balanced approach to vertigo: DuPree Zumbro, PT, DPT, outlines 5 things to know about vertigo. (Wilmington, North Carolina, Star News)

    Preventing the first fall: Lori Schrodt, PT, PhD, explains the importance of balance and falls-risk screenings. (Asheville, North Carolina, Mountain Express)

    Quotable: "I know that physical therapy is worth it in the end. It helps me SAFELY continue going about my life. I have never finished a session and thought, 'Well, that was a bad decision.'” – Kendall Harvey, who has Friedreich's ataxia, on the importance of physical therapy in her life. (Friedreich's Ataxia News)

    Got some good stuff? Let us know. Send a link to troyelliott@apta.org.

    Women in Physical Therapy Summit: Fueling Change in the Profession

    2018 - 09 - 19 - Women in PT Summit
    This year's Women in PT Summit is expected to draw more than 100 attendees.

    Next professional conference you go to, take a look around. Chances are you'll see a disproportionate number of men at podiums, on panels, and walking around with all those extra ribbons on their ID badges—even when the profession itself is supposedly "female dominated." It's a symptom of a bigger problem that many people, including Karen Litzy, PT, DPT, would like to change.

    Litzy will be the first to admit that there's much work to be done. But as the organizer of the Women in Physical Therapy Summit, now in its third year, Litzy can take some pride in knowing that when it comes to at least 1 conference, the problem has been turned on its head.

    The 2-day summit, coming up on September 21 at John Jay College in New York City, focuses on the contributions women have made and the ways they can have an even greater impact. Men are of course welcome (and do attend), but the emphasis is on women—not just as speakers, but as sources of inspiration, insight, and experience. The event is sponsored in part by APTA.

    The summit provides attendees with something different from the usual professional physical therapist (PT) gathering: rather than focusing on research, interventions, and other aspects of providing care, it focuses on the providers themselves and how their perspectives as women in the profession can be brought to the table.

    "There's an incredible depth of knowledge, creativity, and passion that exists among the women in the physical therapy profession," Litzy said. "It seems that, oftentimes, speakers and panels at large conferences are vary male-dominated, and we wanted to give the opportunity for smart, successful women to share their stories and expertise."

    Keynote speakers for this year’s event include Emma Stokes, president of the World Confederation of Physical Therapy; disabilities activist, comedian, actress, and TED speaker Maysoon Zayed; and Eleanor Bergstein, a writer, director, and producer of, among other movies, Dirty Dancing. You might say that when it comes to speakers, nobody puts the summit in a corner.

    In addition to the keynotes, the summit also includes panel discussions and—new this year—a series of 4 workshops, 1 each on public speaking, marketing, diversity, and negotiation.

    "I hope attendees will walk away knowing they have a supportive group behind them who will give them honest advice and do what they can to help them succeed," Litzy said. "This year in particular, I want the attendees to know that they have so much to share, and that we can help provide them with the tools to get their ideas out into the world."

    Getting those ideas out into the world of physical therapy can be a challenge, even though the profession is described as "female-dominated." Actually, Litzy says, that whole "female-dominated profession" concept is tricky to begin with.

    "From a sheer numbers standpoint, of course—there are clearly more female PTs than there are male," Litzy said. "But if you close your eyes and ask someone to describe a leader or CEO in the physical therapy profession, I believe many people would think of a man first. This isn't something unique to physical therapy, of course—it's true of most professions in the world. But it's something I'd love to see change."

    Litzy does see some movement. "I've seen many more women using social media to make changes in the profession and to help establish themselves as thought leaders in physical therapy and beyond," Litzy said. "And I've been seeing more and more women calling out inequities, such as conferences or courses with all-male or mostly male faculty. I know that may sound petty, but if you're a younger PT and you see people that look like you on a panel or speaking at a conference, it does mean a lot."

    It's a trend that Litzy also sees on a more universal level, even within the time since the first summit.

    "Times have changed somewhat for women in the world in general over the past 2 years, with movements like Time's Up and #Metoo supporting women to speak out—not just about sexual assault but about the inequities they may be facing in their personal or professional lives," Litzy said.

    Litzy brings her own experience to the conference as well. The owner of a concierge physical therapy practice in New York, she's also host of the "Healthy, Wealthy, and Smart" podcast series that provides clinical information and business strategies from thought leaders in physical therapy, wellness, and entrepreneurship. She hopes that the summit will make it easier for other PTs to find their own ways to grow in the profession.

    "We want to create a space where physical therapists feel supported to take on any challenge and get inspiration from each other," Litzy said. "We want attendees to come away ready to reach for goals they thought they could never achieve."

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    APTA, Other Health Care Leaders Call for CMS to Rethink Evaluation and Management Payment Plan

    APTA has joined with more than 150 other health care organizations to let the US Centers for Medicare and Medicaid Services (CMS) know that while its "Patients Over Paperwork" efforts are appreciated, one CMS attempt to reduce administrative burdens is likely to result in reduced access to care for some of the sickest Medicare beneficiaries.

    The concerns center around a provision related to evaluation and management (E/M) visits included in the 2019 physician fee schedule rule proposed by CMS over the summer. The change, ostensibly intended to reduce paperwork, would collapse E/M payment rates currently based on a 5-level complexity system for new and established patients into what would amount to a 2-level system—combining levels 1-3 and levels 2-5. CMS acknowledges that the change would result in higher payments for E/M visits at the 1-3 levels while levels 4 and 5 will see reductions based on the 2019 proposed relative value units. However, CMS argues, the reduced paperwork burden would offset the payment drop.

    In a letter sent to CMS last month, APTA and other cosigners praise CMS for its initiative to reduce provider paperwork, but question the wisdom of the E/M plan, arguing that the change would unfairly impact providers who see sicker patients, "ultimately jeopardizing patients' access to care."

    The group also is pushing back against a related plan to reduce payment for multiple services delivered on the same day, something that they argue was already accounted for in previous valuations of the relevant codes.

    As an alternative, the group urges CMS to collaborate with an American Medical Association-sponsored crossdisciplinary work group. That work group has been charged with analyzing E/M coding and developing a better alternative than the one presented by CMS. APTA will be monitoring the work of this group and participating in future meetings.

    APTA Provides CMS With Extensive Comments on Proposed 2019 Medicare Fee Schedule Rule

    APTA delivered a set of comments on the US Centers for Medicare and Medicaid Services' (CMS) proposed 2019 physician fee schedule that were as wide-ranging as the proposal itself, including qualifications on the proposal to extend the Merit-based Incentive Payment System (MIPS) to physical therapists (PT) and clear opposition to a CMS move to lower payment for services provided "in part" by a physical therapist assistant (PTA) or occupational therapy assistant (OTA). Also in the association's comments: recommendations that CMS could strengthen its role in the fight against opioid abuse by better supporting nonpharmacological approaches to pain management, including physical therapy, through payment and education improvements.

    The extensive comments were developed in response to a rule that, if implemented, would include some of the most far-reaching changes in payment and reporting to date, moving PTs into the Quality Payment Program (QPP) and ending functional limitation reporting (FLR) requirements. But that's just 1 facet of the proposal: the rule touches on everything from the use of telehealth to additional current procedural terminology (CPT) codes. APTA's comments addressed both big-picture issues and some of the nuts-and-bolts of the proposal.

    PTs in MIPS: a move that needs to be carefully implemented.
    APTA provided extensive comments to CMS on its proposal to include PTs in QPP—and more specifically in MIPS—characterizing the change as an acknowledgement that PTs "act as integral members of the health care delivery team in outpatient settings."

    APTA's comments outlined a number of concerns and issues, mostly centered on the association's concern that PTs could face serious barriers to participation in MIPS unless CMS provides "certain amnesties." The association also recommends that CMS adopt more flexible approaches when it comes to PTs opting in to MIPS participation, as well as the measures CMS would accept should facility-based PTs be required to participate in MIPS in the future (the current proposed rule only includes PTs in private practice settings).

    APTA also went on record to support a proposed "Physical and Occupational Therapy Specialty Measure Set" within MIPS, and the continued efforts by CMS to eliminate measures that are "topped-out" through high levels of compliance.

    CMS has it all wrong when it comes to adjusting payment for services provided "in part" by a PTA.
    Some of the association's strongest criticism of the proposed rule is aimed at CMS efforts to establish payment differentials, set to go into effect in 2022, based on the extent of a PTA's or OTA’s role in a visit. That criticism is centered on what APTA believes is the impossibility of accurately defining when a PTA or OTA has sufficiently provided services "in part" to trigger a payment differential, and the dangers of creating a rule stating that any PTA involvement constitutes an excuse for lower payment rates.

    While APTA acknowledges that CMS is bound by law to establish a PTA modifier, the association asserts that CMS isn't obligated to go down the definitional rabbit hole associated with pinning down what constitutes care delivered "in whole or in part" by a PTA. In its comments, the association lays out a multipoint case against establishing rules based on terminology that isn't a term of art or statutorily defined, warning that drawing a line on what constitutes "in part" could quickly lead to confusion and loss of access to care, particularly among beneficiaries in rural areas.

    APTA recommends that CMS take more time to reexamine the potential problems and wait until next year's rulemaking to address the "in part" issue. Alternatively, should CMS insist on moving ahead in this rule, the association suggests either of 2 more-straightforward approaches: the so-called "midpoint rule" that would pin 100% reimbursement to whether the majority of services are furnished by the PT; or a "blended rate" approach that splits the fee schedule amount for a code in half and then applies the 100% PT rate to one half, and an 85% rate to the other half, thereby avoiding a single trigger that would shift payment to a lower rate, simply because a PTA provided care "in part."

    Should CMS continue down the PTA payment differential path, APTA strongly recommends CMS exempt rural areas, health professional shortage areas, and medically underserved areas from the proposed policy, due to concerns of how it could affect patient access. Earlier this summer, CMS indicated to APTA and the American Occupational Therapy Association (AOTA) that it did not have the statutory authority to exempt these areas. APTA is investigating whether that's true, and APTA and AOTA also are advocating for Congress to commission a US Government Accountability Office study to examine how access to physical therapy and occupational therapy will be impacted by the payment differential.

    "Given that a [PT] and PTA frequently deliver team-based care, we have serious concerns that requiring the modifier to be applied if any minute of outpatient therapy is delivered by the PTA has serious implications for beneficiary access to care," APTA writes. "Physical therapists and PTAs serve a critical role in the health and vitality of this nation. It is imperative that Medicare beneficiaries continue to have access to high-quality physical therapy services."

    More can be done to fight the opioid crisis if CMS would provide stronger support of (and better payment for) nonpharmacological approaches to pain management.
    APTA recommends that CMS not only step up its promotion of access to team-based nondrug pain management, but that it back up this support with "subregulatory revisions" that could increase patient access through changed payment models. The association also recommends that CMS reduce or eliminate copays for nonpharmacological pain treatments, and that the agency increase efforts to educate both prescribers and the public on the effectiveness and availability of approaches to pain that don't involve the use of opioids.

    Additionally, APTA has a suggestion for providers who continue to prescribe opioids for pain: make a referral to physical therapy a requirement.

    "CMS and other stakeholders must ensure that not only is education for providers enhanced, but that a clear, direct path exists for patients in pain to access all treatment options, including physical therapy," APTA writes. "Given that [the US Centers for Disease Control and Prevention] has concluded that there is insufficient evidence that opioid usage alone improve functional outcomes for those in pain, we recommend that clinicians who prescribe an opioid for pain also must be required to refer a patient to physical therapy."

    Other provisions in the proposed rule didn't escape APTA's notice.
    As is usually the case, the proposed fee schedule covered a lot of regulatory ground. APTA took an equally comprehensive approach in its comments, touching on these additional areas:

    • Barriers to PTs participating in alternative payment models (APMs). While PTs technically are allowed to participate in APMs, APTA argues that from a practical standpoint, the profession is at a disadvantage thanks to barriers thrown up by CMS around the use of certified electronic health record technology (CEHRT). CMS requires at least 75% of all eligible clinicians to use CEHRT—the problem is, PTs have been exempt from "meaningful use" criteria promoting interoperability, and there is a lack of physical therapy-specific CEHRT. The result? "[PTs] are essentially barred from participating in advanced APMs," APTA writes. The association is also advocating to Congress to require CMS to develop physical therapy-specific certification criteria for electronic health record vendors.
    • Payment for technology-based communications. APTA supports CMS efforts to provide payment for physician communications provided via technology and has asked CMS to clarify whether PTs are included in the list of eligible providers. If not, APTA says, CMS should study that possibility and consider expanding provisions in the fut
    • Qualified Clinical Data Registry (QCDR) proposals. Because QCDRs such as APTA's Physical Therapy Outcomes Registry could play such an important role in future value-based care models, the association is paying particular attention to CMS proposals for who gets to be included as a QCDR, and the nature of the relationship between a QCDR and CMS. Specifically, APTA supports a CMS plan to require a QCDR entity to have clinical expertise in medicine and measure development, and it backs the measures selection criteria proposed by CMS. However, the association isn't on board with a CMS proposal that beginning in the 2021 payment year, all approved QCDRs must enter into a licensing agreement with CMS that would allow any QCDR to report on any MIPS measure.
    • Price transparency. In response to a CMS request for perspectives on price transparency, APTA stated its general support for greater transparency but recommended that CMS study state-level initiatives first. The association also cautioned CMS to be careful about how it defines "cost" from a consumer perspective and to avoid divorcing issues of cost from concepts of quality. Additionally, APTA recommended that any price transparency effort be accompanied by extensive public education efforts.

    APTA has additional information and resources on the proposed 2019 physician fee schedule, including fact sheets on the proposal and links to pages with specific information on QPP, MIPS, and APMs. Start with the Medicare Physician Fee Schedule webpage, and sign up for the upcoming webinar, "Everything you need to know about the Quality Payment Program."

    From PTJ: Getting at the Risk Factors for Falls Post-TKA

    Up to a third of patients with total knee arthroplasty (TKA) experience a fall within 6 months to a year after surgery, but a new study suggests that physical therapists (PTs) can reduce this risk by targeting specific deficits for intervention.

    Researchers followed 134 individuals at a Hong Kong hospital for 6 months after TKA to determine falls frequency, circumstances, and risk factors. All patients had been referred for outpatient rehabilitation. The individuals were all between the ages of 50 and 85 with a primary diagnosis of knee osteoarthritis (OA). Results were published in the September issue of PTJ (Physical Therapy).

    Participants attended physical therapy 1-2 times per week for 8-10 weeks, beginning 2 weeks after surgery. Sessions included electrotherapy, mobilizing and strengthening exercises, and gait and balance training. At 4 weeks postsurgery, PTs evaluated knee proprioception, balance, knee pain, knee extension and flexion muscle strength, range of motion, and balance confidence. Patients also were given a log book to record any falls. After the evaluation, authors followed up monthly to ask participants about any falls they may have experienced.

    Researchers found that 23 (17.2%) participants had fallen at least once, with a total of 31 falls. Most occurred in the afternoon (58%) and while walking (67.7%). Most fallers (87.1%) were not using a walking aid when they fell. Falls were most frequently caused by slipping (35.5%) and tripping (35.5%).

    In contrast to previous research, nearly half of falls occurred at home, and nearly a third occurred in “another indoor environment.” These findings, write authors, “highlight the importance in reducing hazards in the home that could cause slipping or tripping, especially in the early stages of recovery from TKA.”

    Fallers were significantly more likely than non-fallers to have had more severe pain and reduced proprioception in the operated knee, and to have poorer sensory orientation prior to the fall. Authors write that “Deficits in knee proprioception, coupled with age-related declines in vestibular and somatosensory function, may challenge the ability to effectively reweight information from different sensory subsystems that maintain body equilibrium.”

    Surprisingly, fallers also were more likely to be younger. “Younger participants may have been more physically active and subsequently more likely to engage in risky behaviors than our older counterparts," authors write.

    Authors note that—outside of age—these factors are modifiable and “warrant greater attention” in falls risk assessment, education, prevention, and intervention for individuals with TKA.

    [Editor's note: for more on the PT's role in TKA, check out this clinical summary that includes sections on prehabilitation and accelerated rehabilitation.]

    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.

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    APTA Honors and Awards Nominations Now Open

    Members of the physical therapy profession do amazing things for people every day, and not just inside the walls of a clinic. Now's the time to honor those contributions by nominating an APTA member for national recognition through the APTA Honors & Awards program.

    The APTA Honors & Awards program is now accepting nominations for the 2019 awards cycle, an annual effort aimed at celebrating members' outstanding achievements in the areas of education, practice and service, publications, research, academic excellence, humanitarian work, and societal impact. The program also includes the Catherine Worthingham Fellows of APTA, the Mary McMillan Lecture Award, and the John H.P. Maley Lecture Award.

    Detailed award descriptions, eligibility information, and nomination instructions for these and the many other awards and honors in the program are available on the APTA Honors & Awards webpage. Deadline for nominations is December 1.

    Award winners will be recognized at the 2019 NEXT Conference and Exhibition, set for June 12-15 in Chicago. For more information, email Alissa Patanarut.

    Help Aging Communities 'Go4Life' in September

    Physical therapists (PTs), physical therapist assistants (PTAs), students, and supporters of the profession shouldn't wait until National Physical Therapy Month in October to spread the word about the importance of mobility and physical activity—September is Go4Life month, a National Institutes of Health (NIH)-sponsored campaign that provides plenty of opportunities to educate the public on the ways older Americans can stay healthy through maintaining or increasing endurance, strength, balance, and flexibility.

    Strongly supported by APTA, Go4Life is an ongoing effort to connect the public and health care providers with information and resources related to healthy aging. In addition to information on how exercise improves health, the Go4Life website includes suggested exercises, workout videos, fitness tracking resources, and access to printed materials including infographics, posters, bookmarks, and postcards, all available for free. The program also offers a free "Speaker's Toolkit" to help providers develop presentations to target audiences—available by emailing Go4Life@mail.nih.gov.

    During September, the campaign offers special resources that include a weekly planning guide and a Facebook Live event set for Thursday, September 13, at 2:00 pm ET. The campaign is an effort from NIH's National Institute on Aging, and can be followed on Twitter through @NIAGo4Life.