The clinical summary on Down syndrome available on PTNow is not only a great resource on its own, it's also a great springboard for lively discussion. See for yourself by checking out the video from a recent Google+ "hangout" sponsored by PTNow.
In a discussion that ranged from the use of to the need for "culture change" in attitudes about physical activity and obesity, to the importance of communicating appropriate motor milestones to the families of children with Down syndrome, moderator Mary Tischio Blackinton, PT, EdD, CEEAA, GCS, clinical summary author Kathy Martin, PT, DHS, and pediatric physical therapist and educator Tracy Stoner, PT, DPT, PCS, connected the dots between evidence resources and day-to-day practice.
The panel answered presubmitted questions, but also set aside time to provide an overview of the summary, and the ways the summary's content is enriched through PTNow, which allows readers to access references and other supporting materials while reading the summary itself. More on the discussion—including information about a future presentation focused on orthotics—can be found at the PTNow blog.
Physical therapists (PTs) and physical therapist assistants (PTAs) have an opportunity to learn how 2 emerging issues can intersect during an upcoming webinar on prevention curricula in interprofessional education.
The September 9 webinar, sponsored by the federal government's Healthy People 2020 initiative, will focus on ways to access resources for developing curricula and collaborative learning experiences to improve prevention and population health education across various health professions. Faculty from the University of Texas Medical Branch and Duke University will be on hand to discuss their own experiences with expanding education in these areas. The 90-minute presentation will begin at 1 pm ET.
The webinar is free, and participants can register online. Healthy People 2020 also archives its webinars for viewing at a later time.
A new method being tested in Chicago aims to "vaccinate" individuals who are elderly against falls—by tripping them.
Actually it's not as weird as it sounds. The Associated Press (AP) reports that University of Illinois-Chicago researcher and physical therapy professor Clive Pai, PT, PhD is using a specially-built moving walkway that can suddenly shift under a user's feet, tripping them up and—Pai hopes—triggering subconscious learning that will help prevent future falls. Users are outfitted with a special harness that prevents them from actually falling during the training.
The AP story quotes Pai as saying that the approach could work as a kind of "vaccine against falls."
Pai's preliminary research on the approach was published in the September 2013 issue of the Journal of Biomechanics (abstract only available for free). In that study, he exposed 73 community-dwelling older adults to 24 slip exposures, and concluded that the "perturbation training did alter [their] spontaneous gait pattern," which "enabled them to improve their volitional control of stability and their resistance to unpredictable and unpreventable slip-related postural disturbance."
Pai's research is continuing under a 5-year grant from the National Institute on Aging, according to the AP report. The grant-funded project aims to include 300 participants.
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.
Health care utilization and cost data released in the name of "transparency" continue to make headlines, and physical therapists (PTs) need to have a solid grasp of what's already out there—and what's to come—in order to help patients, clients, and other stakeholders understand what all the information means in context. The September issue of APTA's members-only PT in Motion magazine provides a starting point for getting a handle on this fast-growing trend.
In this issue's "Compliance Matters" section, Gayle Lee, JD, APTA senior director of health finance and quality provides a quick history of the push for transparency and an analysis of one of the most dramatic data releases to date—2012 Medicare payment figures for some 880,000 health care professionals, including nearly 38,000 PTs, searchable by provider name and National Provider Identifier (NPI) number.
Lee asserts that "the dataset is insufficient to draw meaningful conclusions about the billing practices or quality of care of individual PTs," and provides a list of limitations that prevent the presentation of complete picture. The article also looks at PT payments in particular and includes a chart showing the top 10 procedures in physical medicine and rehabilitation services in 2012 by total payments.
"It is clear that consumer outcry for price transparency will not abate," Lee writes. "Not only will the federal government release more information in the future, but private insurers are expected to follow suit."
Hardcopy versions of PT in Motion are mailed to all members who have not opted out; digital versions are available online ahead of print to members.
A newly published meta-analysis of randomized controlled trials (RCTs) supports the use of constraint-induced movement therapy (CIMT) for children with cerebral palsy as an effective intervention for upper-limb function, albeit one whose effectiveness isn't necessarily a slam dunk over other dose-equivalent approaches.
The study, e-published ahead of print in Clinical Rehabilitation (abstract only available for free) looked at 27 RCTs between 2004 and 2014 that included 894 participants with cerebral palsy ranging in age from 2.4 to 10.7 years. The majority of studies focused on a 5 day per-week intervention over the course of 2 to 3 weeks, and restraints included slings, gloves, mittens, and casts.
Authors write that the studies showed a medium effect of CIMT on arm function—results that they describe as "similar to the effect of [CIMT] when used in adults with stroke." When they applied the International Classification of Functioning, Disability and Health (ICF) model to the results, they found that CIMT resulted in medium improvements to activity level immediately after the intervention and to participation level during follow-up.
Effectiveness was also affected by location of the intervention, according to the study, with home-based settings producing better results than clinic or camp-based settings. "The natural environment … offered less distress during [CIMT] practice for both children with cerebral palsy and their parents," authors write. "Further the training schedule can be tailored to fit into the family's daily routine."
The CIMT approach didn't fare as well when a longer follow-up time was used, authors write, "consistent with the logical assumption that the [CMIT] effect could not be maintained over time." Additionally, when compared to dose-equivalent groups, the groups receiving CIMT showed only "slightly better" results, as opposed to the "large effect" noted when compared to interventions that were not dose equivalent.
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
Think those claims that dietary supplements can help speed concussion recovery sound too good to be true? You're right. And the US Food and Drug Administration (FDA) agrees.
This week, the FDA released a consumer update on companies that market dietary supplements that purport to heal—and in some cases prevent—concussions. The advertising has received more attention with the start of fall school sports, and the agency is stepping up its enforcement actions to warn companies when their claims are false.
"We're very concerned that false assurances of faster recovery will convince athletes of all ages, coaches, and even parents that someone suffering from a concussion is ready to resume activities before they are really ready," said Gary Coody, FDA's national health fraud coordinator. "Also, watch for claims that these products can prevent or lessen the severity of concussions or [traumatic brain injuries]."
Because the dietary supplement market is a crowded one that requires no product registration, "products making false claims can slip through, at least for a time," according to the FDA.
The supplements are available in some retail outlets, but companies also rely heavily on social media for their advertising. Frequently, the supplements include tumeric and high levels of omega-3 fatty acids.
The bottom line, according to Coody, is that "there is no dietary supplement that has been shown to prevent or treat [concussion]. If someone tells you otherwise, walk away."
Keep up with APTA's work on concussion and TBI: check out the association's position on the role of physical therapists in concussion management, visit APTA's Concussions webpage, connect with resources on the Traumatic Brain Injury webpage, and direct patients to the Physical Therapist's Guide to Concussion, located on APTA's MoveForwardPT.com consumer website.
Behavioral counseling that promotes physical activity and a healthy diet has been found to be beneficial for adults who are overweight or obese with a risk of cardiovascular disease (CVD), according to a recent report from the US Preventive Services Task Force (USPSTF).
In an article published August 26, the USPSTF cited "adequate evidence" that behavioral interventions "have a moderate net benefit" for this group, and that potential harm is "small to none." The conclusions were reached after the task force reviewed 74 clinical trials, most of which studied combined counseling on diet and activity through multiple contacts over 9 to 12 months. The interventions were not focused specifically on weight loss, and trials conducted exclusively with persons who have diabetes were excluded.
The USPSTF review of intermediate and longer-term health outcomes found that behavioral counseling resulted in "small but important changes in health behavior outcomes and selected clinical outcomes after 12 to 24 months." These clinical outcomes included decreases in total and LDL cholesterol, blood pressure, fasting glucose levels, and weight. Additionally, authors write, "the reduction in glucose levels was large enough to decrease the incidence of a diabetes diagnosis."
The interventions studied by USPSTF for the most part included educational and supportive components, with a focus on behavior change through individualized plans. The counseling was performed by "specially trained professionals" that included "dietitians or nutritionists, physiotherapists or exercise professionals, health educators, and psychologists," according to the report. The interventions could be applied to a large portion of the US population—according to the USPSTF report, nearly half of all Americans have at least 1 CVD risk factor, and 70% are overweight or obese.
The task force writes that more research is needed on the effectiveness of less intensive counseling, as well as the ways the interventions affect outcomes and behavior after 2 to 3 years. Other needed areas of study include the effectiveness of interventions for physical activity alone, and "trials examining the interaction or potentiation of clinical counseling and community-based lifestyle interventions," authors write.
Check out APTA resources that emphasize the importance of collaborative approaches to behavior change in patients and clients at the behavior change webpage, including podcasts, measures, and guidance on how to facilitate the change process.
The Centers for Medicare and Medicaid Services (CMS) will move ahead with awarding new contracts to Recovery Audit Contractors (RACs) now that the US Court of Federal Claims has ruled against the last standing protest opposing the new arrangements. The protest, leveled by CGI Federal, Inc, led CMS to suspend RAC reviews while the case was being decided.
The new RAC contracts are expected to contain changes to the audit process announced in February. According to CMS, the changes are designed to "result in a more effective and efficient program, including improved accuracy, less provider burden, and more program transparency." Planned changes include a mandatory 30-day wait for discussion before a claim is sent to Medicare Administrative Contractors (MACs) for collection, a requirement that RAC contingency fees will only be awarded after the second level of appeal has been exhausted, and a rule that additional documentation request (ADR) limits be adjusted based on the provider's compliance rate.
According to a recent article in Inside Health Policy, several protests were launched against the CMS effort to award new contracts, with all but the CGI protest being dismissed or withdrawn. Initially, CMS moved to wind down activities of the current RACs, but as the CGI protest lingered, the agency announced that it would restart the program under the current auditors. The Inside Health Policy article reports that those restarted program contracts had not yet been signed when the court ruled in favor of CMS, allowing CMS to refocus on awarding new contracts.
APTA is working with CMS officials to produce more effective review systems that would reduce administrative burden, improve communication among their contractors, focus investigation and review efforts on the highest risk cases, and minimize disruption to providers. APTA expects to receive more information from CMS in the coming weeks on how and when RAC reviews will resume, including specific information on therapy cap manual medical review.
WebMD and APTA are working together to make it easier than ever for the public to understand how physical therapists (PTs) and physical therapist assistants (PTAs) can help address a wide range of health issues.
Under a new content partnership, APTA members and APTA Media Corps experts will provide content to WebMD's "Answers" page, a popular area of the WebMD website that allows consumers to post questions and connect with relevant health information. APTA will provide new content to the page at least once a month, and will link content to the association's MoveForwardPT.com consumer-focused site.
APTA has partnered with WebMD in other efforts, including providing WebMD with PT experts to serve in the fibromyalgia, multiple sclerosis, pain management, and sports medicine communities. WebMD also offers a page focused on physical therapy and pain management.
Minutes of the 2014 House of Delegates (House) have been posted on the House webpage and within the 2014 Archive folder of the House community. The minutes provide information on how the House revised and voted on all motions and bylaw amendments brought forward this year.
Newly adopted or amended House policies, standing rules, and bylaws will be posted to the Policies and Bylaws area of the APTA website in September.
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