Passive physical agents that aren’t part of an active treatment plan, under-dosed strength training for older adults, and the use of whirlpools for wound management are among the "5 Things That Physical Therapists and Patients Should Question," according to a list recently announced by APTA. The list, developed through member suggestions and refined by an expert panel, is now part of a national campaign that encourages patients and health care providers to talk about whether a given procedure is really necessary based on the patient's individual circumstances.
The list announced today is part of APTA's partnership with the Choosing Wisely® campaign from the American Board of Internal Medicine (ABIM) Foundation. The initiative aims to help consumers make informed health care choices by providing lists of procedures that tend to be done frequently, yet whose usefulness is called into question by evidence. APTA is the first nonphysician group to release a list, joining more than 50 medical specialty societies.
"A well-informed patient is a well-treated patient," said APTA President Paul A. Rockar Jr, PT, DPT, MS, in a news release. "The Choosing Wisely campaign addresses the patient's role in good health care, and we are happy to join this effort."
The 5 recommendations are:
The process for developing the list began with an open call for APTA members to submit their lists of questionable procedures. After receiving more than 170 submissions, APTA convened an expert group of physical therapists from a wide range of practice settings and areas of clinical expertise. The group reviewed all nominations and conducted extensive literature reviews to narrow down the list to 9 procedures. The list of 9 was presented to the 88,000 members of APTA, who voted on the final 5.
To help patients and clients understand what APTA’s Choosing Wisely recommendations mean for them, APTA has partnered with Consumer Reports to create a free consumer-friendly summary, which will also be made available in Spanish. Consumer Reports already has reached more than 100 million consumers with Choosing Wisely information through its network of consumer communications partners.
APTA's Choosing Wisely list is also the subject of a ProfessionWatch paper e-published ahead of print in Physical Therapy. The paper details the process of the list's development and provides professional context for APTA's decision to partner with the ABIM Foundation in Choosing Wisely.
The partnership is a component of the larger APTA Integrity in Practice campaign, an effort to support the profession of physical therapy as a leader in the elimination of fraud, abuse, and waste in health care. An APTA Center for Integrity in Practice has been created and will be developing resources throughout the course of the campaign, but already offers a primer on preventing fraud, abuse, and waste, and an online course on compliance and professional integrity.
"Care that is best for the patient has always been a priority for APTA," Rockar said. "Choosing Wisely is an outstanding effort, and its mission to foster better, more efficient care through informative dialogue between patients and health care providers dovetails perfectly with the goal of our Integrity in Practice campaign."
Physical therapy leader Otto D. Payton, PT, PhD, FAPTA, Catherine Worthingham fellow and author of the seminal Research in Clinical Practice, died September 4 in Richmond, Virginia. He was 84.
Professor emeritus of physical therapy at the Medical College of Virginia campus at Virginia Commonwealth University, Payton was an internationally known lecturer and author, as well as a practicing physical therapist for more than 50 years. He edited the Journal of Physical Therapy Education and served as chairman of the editorial board for the Clinics in Physical Therapy series of books throughout its 33-volume publication history.
In addition to Research in Clinical Practice, Payton authored or coauthored several texts including Patient Participation in Program Planning, Psychosocial Aspects of Clinical Practice, and Treatment Planning for Rehabilitation: A Patient-Centered Approach.
Payton received the Jules M. Rothstein Golden Pen Award for Scientific Writing from APTA in 1981 and the Lucy Blair Service Award in 1988. He became a Catherine Worthingham fellow in 1993.
In an oral history available for loan from APTA, Payton also mentions that he served on the Maryland physical therapist examining board with Florence and Henry Kendall, and was an early chair of the Physical Therapy Fund, the predecessor of the Foundation for Physical Therapy.
He is survived by his daughter, Colleen M. Payton, and granddaughters, Jane Yoon and Meredyth Yoon.
In recognition of Childhood Cancer Awareness Month, this week Move Forward Radio showcased the impact that physical therapists (PTs) can have on the lives of children with cancer by sharing the story of Mathias Giordano.
A 13-year-old with osteosarcoma, Mathias had his lower right leg amputated during his battle with cancer in the hopes of remaining as active as possible, and with the goal of returning to the soccer field.
Before the amputation, Mathias started seeing Mike Reing, PT, MSPT, OCS, and the 2 formed a special bond.
"I can't save anyone's life; that's not my role," Reing told Move Forward Radio. "But my job for Mathias is, 'All right, let's do everything we can to preserve his quality of life.' And my definition of [quality of life] doesn't really matter. What matters is his [definition]."
Mathias's mother, Roya Giordano, said that physical therapy has been "incredibly meaningful and important" in her son's journey.
"Having Mike on our team has been the biggest blessing of all, because Mathias and Mike established a relationship that no one else has," she said.
Move Forward Radio airs approximately twice a month. Episodes are featured and archived at MoveForwardPT.com, APTA's official consumer information website, and can be streamed online via Blog Talk Radio or downloaded as podcasts via iTunes.
APTA members are encouraged to alert their patients and clients to the radio series and other MoveForwardPT.com resources to help educate the public about the benefits of treatment by a PT. Ideas for future episodes and other feedback can be e-mailed to firstname.lastname@example.org.
Opportunities are now available for APTA members to serve on the Excellence in Physical Therapist Education and Scope of Practice task forces, but applications for the positions must be completed by October 2.
The first step is to fill out an interest profile on the Volunteer Interest Pool webpage. Once completed, click on the "Apply for Current Vacancies"button and select the task force you're interested in joining. Details on all volunteer groups can be found on APTA's Volunteer Groups webpage.
APTA relies heavily on its volunteers, who in turn gain valuable leadership and growth opportunities while working with some of the most outstanding physical therapists in the country.
An upcoming 30-minute "Lunch and Learn" free webinar from the Osteoarthritis Action Alliance (OAAA) will focus on the latest thinking around aquatic exercise interventions. The session will be held September 17 beginning at 12:00 pm ET.
The presentation will feature Dennis Dolny, PhD, and Eadric Bressel, PhD, professors in the department of health, physical education, and recreation at Utah State University. Dolny's work has included research on techniques to monitor skeletal muscle activity while walking and running in water. Bressel's biomechanics laboratory focuses on relationships between anatomical structures, mechanics, and injuries, with specific emphasis on aquatics-based research.
Registration for the event is available online, and the slide presentation for the webinar can be viewed in advance. OAAA archives its Lunch and Learn webinars for use at a later time. APTA is a member of OAAA.
More patients are willing than not to consider staying at home for video-based appointments with a health care provider, but the consumer demand for such an option still has a way to go before it could be characterized as overwhelming, according to a new study from the Mayo Clinic.
In a survey of 263 patients who recently received outpatient treatment at the Mayo Clinic Center, researchers found that about 66% of respondents said that they were "somewhat likely" (28.1%) or "very likely" (38%) to accept an invitation to meet with their provider by way of video from their homes. The survey included questions about familiarity with video calls, what kinds of technology patients owned, patient assessments of the value of video appointments, and costs of travel to the local institution, among other topics. Findings were published in the September issue of Telemedicine and e-HEALTH.
Not unexpectedly, researchers found a high correlation between a patient's willingness to consider a home-based video appointment and that patient's experience with video calls and the technology involved. Other drivers included age and distance from home to the health care institution—generally the younger and farther away, the more likely the patient was to consider a video appointment. Actual prevalence of the technology was less of an issue, with 75% of respondents reporting that they had a broadband Internet connection—although only 36% had a web camera.
The real problem, according to authors of the research, is that patients opposed to video appointments are unlikely to change their minds without some significant work on the part of health care providers and others—and that work may have to focus on issues beyond the technology itself. "Of the 4 primary concerns to address," authors write, "3 of the 4 express concern not about logistics of the connection, privacy, or security of the medium … but about the general preferences of face-to-face over video communication. To shift perceptions about the medium may require deploying a focused communication strategy … encouraging the use of the system on a trial basis, or simply allowing technology use behavior to catch up with what technology enables."
The study describes overall patient demand for video appointments as "nascent," and asserts that growth will be highly dependent on sensitivity to multiple patient factors—something that Matt Elrod, PT, DPT, MEd, NCS, senior practice specialist at APTA believes is crucial to telemedicine's success. "The technology behind telehealth is exciting and presents many opportunities for patients and providers," he said, "but the true benefits of telehealth are realized when it is used for the right patient at the right time and incorporates the patient's, wants, needs, and preferences."
More resources on telehealth and physical therapy practice can be found at APTA's Telehealth webpage.
It's no surprise that Medicare has changes in store for 2015 payment policies. But the changes themselves could be surprising if you're not prepared.
Physical therapists (PTs) in home health, rehabilitation, and skilled nursing facilities can get up to speed on the changes, many of which directly affect physical therapy in postacute care settings, by signing up for a 90-minute APTA webinar on what Medicare has in store for 2015. The program is set for October 16 beginning at 2:00 pm ET, and will cover new Medicare definitions, changes to how therapy minutes are recorded, changes to postacute care quality reporting, and more.
Participants in the live event will be able to pose questions to the presenters, and will also receive a preview of the upcoming 2014 APTA Postacute Care Compliance Seminar. Cost for the webinar is $99 for APTA members and $169 for nonmembers, which includes on-demand access to the webinar for later viewing. The session will provide 0.2 CEUs (2.0 contact hours/CCUs).
More information and registration instructions are available at the APTA Learning Center.
In the largest grassroots effort on concussions in APTA history, members, students, and patients sent a loud-and-clear message to members of Congress: greater attention needs to be paid to youth sports concussion, and physical therapists (PTs) and physical therapist assistants (PTAs) can play an important role in managing these injuries.
The concussion message was the focus of this year's Flash Action Strategy FAS), a student-led advocacy campaign that took place September 8-10. In the span of 72 hours, FAS participants sent letters to every member of Congress through APTA's Legislative Action Center (LAC) and Patient Action Center (PAC) asking them to support the Protecting Student Athletes from Concussions Act (H.R. 3532) and the Supporting Athletes, Families, and Educators to Protect the Lives of Athletic Youth Act (SAFE PLAY Act) (S. 2718/H.R. 5324). Organizers estimate that the FAS required about a minute of a participant's time.
Although the official FAS wrapped up on September 10, members and others interested in delivering messages to legislators can still get in the game by contacting legislators through the LAC and PAC.
"Once again the partnership between APTA and the APTA Student Assembly Board of Directors set the stage for a great advocacy effort," said Justin Moore, DPT, vice president, public policy, practice, and professional affairs at APTA. "We are grateful to all of the members, patients, and others who spoke out on this important issue. We've moved the ball down the field on concussion awareness."
Interested in getting involved in APTA’s advocacy efforts throughout the year? Join the PTeam online or on the APTA Action App. You can also support the PT-PAC by contributing to the $20 campaign.
Long bouts of sitting can have serious effects on blood flow that could increase risk of cardiovascular disease, but a new study proposes that lower extremity vascular damage can be prevented by walking as few as 5 minutes every hour—and not even at a particularly fast pace.
In a study e-published ahead of print in Medicine and Science in Sports and Exercise (abstract only available for free), researchers from Indiana University monitored the ways in which the superficial femoral artery reacted to 3 hours of sitting without leg movement, and compared those results with study participants who took 5-minute walks at 2 miles per hour every hour. What they found was that prolonged sitting does lead to a "significant impairment" in endothelial function, but that the short walks prevented the damage from taking place altogether.
The study was limited to 12 nonsmoking men in their 20s who did not meet the physical activity guidelines of the Centers for Disease Control and Prevention, and were not taking any anti-hypertensive, lipid lowering, or anti-diabetic medications. Assessments were based on measurements of mean shear rates and flow-mediated dilation of the superficial femoral artery just above the knee.
"Uninterrupted sitting leads to a progressive decline in antegrade and mean shear rate and corresponding impairment in endothelial function," authors write. "We can hypothesize that repeated bouts of prolonged sitting may contribute to vascular aging, at least in the lower extremities."
But walking made all the difference. "Even this very light-intensity physical activity prevented the decline … and may explain the protective effect against sitting-induced impairment," they write. "We believe our observations further the argument to have structured public health guidelines on limiting sitting time."
The study was featured in both the Washington Post and United Press International. Earlier research on the cardiovascular risks of prolonged sitting has been reported in Mayo Clinic Proceedings (.pdf) and elsewhere.
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.
Abstracts and poster proposals are now being accepted for the Movement is Life Caucus, a gathering that will focus on the role of early intervention in decreasing musculoskeletal health disparities among women and minorities.
The 2014 caucus will be held at the Washington Marriott Metro Center in Washington, DC, November 13–14. The submission deadline is October 1, and participants must register for the caucus to have their submissions considered for possible presentation. Registration is free.
Movement is Life's (MIL) mission is to decrease disparities by raising awareness of their impact on chronic disease management and quality of life. The organization works to slow musculoskeletal disease progression, reduce disability, and encourage physical activity and daily movement to improve the overall health of the nation. APTA is a member of the MIL steering committee.
For more information, contact Rene Malone.
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