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  • 2018 McMillan, Maley Lecturers Announced

    APTA honored recipients of its 2017 awards program on June 22, and set the stage for next year by announcing the 2018 Mary McMillan and John H. P. Maley lecturers.

    Laurita M. (Laurie) Hack, PT, DPT, PhD, MBA, FAPTA, has been named the 49th McMillan lecturer, and Robert J. Palisano, PT, ScD, FAPTA, was announced as the 23rd Maley lecturer. These popular, high-profile lectures will be delivered as part of the 2018 NEXT Conference and Exposition.

    In addition to the lecturer announcements, APTA officially honored members who have made outstanding contributions to the physical therapy profession. The honorees include newly named Catherine Worthingham Fellows as well as recipients of the Lucy Blair Service Award. APTA also announced award recipients for excellence in education, practice, service, publications, research, and academic achievement. View or download a full list of the 2017 recipients (.pdf) from APTA's website.

    Nominations for the 2018 Honors and Awards Program will open September 2017.

    Check out the history of APTA's honors and awards recipients.

    News at NEXT: 2016-2017 VCU-Marquette Challenge Raises Over $340,000 for the Foundation

    Students from across the country were recognized June 22 during the Foundation for Physical Therapy's (Foundation) first annual PT Party, formerly known as the Foundation's Annual Gala, for their participation in the 2016-2017 VCU-Marquette Challenge—which for 2017-2018 will be called the Mercer-Marquette Challenge. Mercer University pulled ahead of its competitors this year after a second place finish in last year's competition to win the title, literally, as the challenge now takes on Mercer's name along with Marquette University as part of the contest's tradition. Mercer raised $45,220.

    Earning second place was last year's winner Virginia Commonwealth University ($37,834), and coming in third was the University of Pittsburgh ($24,449). The Foundation also recognized Marquette University students for their financial commitment to the challenge in raising over $20,000.

    The annual challenge is a grassroots fundraising effort coordinated and carried out by student physical therapists and physical therapist assistants across the country.

    This year, 146 schools nationwide participated in creative efforts to support the Foundation, raising a total of $340,986. A record number of schools returned to participate this year, yielding a 70% retention rate. Since its inception, 269 schools have contributed to the challenge, raising over $3.7 million for physical therapy research.

    The Foundation annually awards a research grant and a Promotion of Doctoral Studies Scholarship (PODS) in the name of the challenge to deserving researchers. Since 2002, the challenge has specifically funded more than 23 research grants and scholarships and also partially funded the $300,000 Clagett Family Research Grant in 2010.

    To view the complete list of participating schools visit Foundation4PT.org.

    News at NEXT: Foundation Service Awardees Recognized at NEXT

    Friends and donors of the Foundation for Physical Therapy (Foundation) recognized the achievements of several people and groups at the Foundation's inaugural awards luncheon on June 22. The event honored annual service award recipients and celebrated the efforts of students in the 2016-2017 VCU-Marquette Challenge.

    "Foundation Service Awards are presented to individuals and groups who have demonstrated their commitment to supporting the Foundation and advancing our mission to fund physical therapy research," said Foundation Board of Trustees Vice President Michael J. Mueller, PT, PhD, FAPTA, at the luncheon. "We are certain that the future of the Foundation, and more important our profession, lay bright, so long as there remains support to fund evidence-based practice."

    The 2017 service awards were presented to 4 deserving contributors.

    The 2017 Robert C. Bartlett Trustee Recognition Service Award was presented to past trustee and current honorary trustee Barbara Connolly, PT, DPT, EdD, FAPTA. This award is presented to trustees whose personal service and commitment has helped develop and sustain activities that promote the funding of physical therapy research and education programs.

    Section President William H. Staples, PT, DPT, DHSc, accepted the 2017 Premier Partner in Research Award on behalf of the Academy of Geriatric Physical Therapy. Over the years, the Foundation has presented this award to a select few who have made generous and longstanding contributions, which are critical to the success of the Foundation and its mission.

    The 2017 Charles M. Magistro Distinguished Service Award was presented to Nancy E. Byl, PT, MPH, PhD, FAPTA. This award, named for the first president and chair of the Foundation, is presented annually to individuals for outstanding service and steadfast commitment toward promoting the Foundation's goals.

    The 2017 Spirit of Philanthropy Award was presented to Patricia A. Traynor, PT. Since 2005, this award has been presented annually to donors who exhibit enthusiastic support and dedication to the growth of the Foundation and its mission.

    Later that evening, the Foundation held the Boston PT Party, a nontraditional twist on the former annual gala. During the event, further tribute was paid to the Foundation's service award recipients, and the winners of this year's VCU-Marquette Challenge were announced. Mercer University took top honors and will succeed VCU in being co-eponym of the challenge with Marquette University for 2017-2018.

    Special thanks go to this year's event sponsors: HPSO/CNA, the Boston PT Party title sponsor for the 17th consecutive year; NuStep, producer sponsor; Tri W-G, dessert sponsor; and Performance Health, awards luncheon sponsor.

    News From NEXT: Physical Therapy and Movement Are Key to Slowing the Aging Process, Contends McMillan Lecturer

    Physical therapy may not be a souped-up DeLorean, a table-top machine, or a twistable pendant that takes its users backward in time, but unlike the fictional Doc Brown, Time Traveler, or Hermione Granger, physical therapists can use real-life tools to at least slow it down. Richard Shields, PT, PhD, FAPTA, in his delivery of the 48th Mary McMillan Lecture on June 22, said that as physical therapists (PTs) "we change time. We routinely turn over the hourglass" and through interventions "reset the aging clock of the human body."

    Discussing the future of the physical therapy profession at "micro" and "macro" levels, Shields said that for much of the profession's history PTs have remained in the center of this continuum. "But the frontiers of our profession lie at the extremes. Those are the places we must travel if we wish to truly transform society by optimizing movement," he said, alluding to APTA's vision for the profession—"Transforming society by optimizing movement to improve the human experience."

    On the micro level, Shields said that physical therapist interventions "are powerful regulators of genes that activate the energy systems" that can reduce the rate at which cells and tissues age. These movement-based interventions trigger cellular changes "in ways that the pharmaceutical industry"—if not Doc and Hermione—"can only dream about."

    Shields explained how, upon contraction, skeletal muscle is more than "a mere force vector." It also releases proteins known as myokines into the blood stream, where they regulate genes in cells throughout the body.

    Frequent movement, then, promotes the expression of healthy genes and represses the expression of genes that can damage tissues. And while the effect is to slow biological aging in cells and tissue, the benefits are not for only the already aged; they can be applied across the lifespan. Shields said that although PTs and PTAs "most often think about strength, endurance, coordination, and function; the cellular changes that we trigger are the most fundamental ways that we improve the health and well-being of humankind."

    Shields explained that it's possible to estimate how many healthy genes are being blocked as a function of a person's age, injury, immobility, or disease. "It is our role as physical therapists to prescribe interventions that unblock the genes that are health-promoting," Shields said.

    Further, he said, repeated movement creates a "molecular memory" that perpetuates the healthy genes' activity. Physical therapy, with its emphasis on continued movement and activity, is a catalyst for this molecular memory.

    Given current knowledge about the human genome, coupled with ever-improving methods of individual data collection, doses of movement can be customized for each patient, based on biological genetic regulators, environmental factors, and lifestyle influences that affect frequency, duration, and types of treatment prescribed. As a result, Shields predicted that "precision physical therapy will emerge side-by-side with precision medicine."

    Turning to the macro level of physical therapist practice—the impact on the human experience—Shields warned against treatments that are "more about the therapist or the technology owned by an institution than about the experience of the patient." He continued that using new attention-grabbing treatments that often involve technology may be at the cost of teaching the patient a needed skill for continued long-term mobility, "even something as simple as [manually] wheeling a chair" instead of using a motorized one.

    Using an airline flight for illustration, Shields explained how a patient's experience is affected by nuances of expectation. He asked: "How many of you wished you arrived in Boston 45 minutes early? How many expected to arrive on time? How many would have viewed the flight as a success if you arrived safely, even if delayed for a few hours? How many would have deemed the flight a failure if you had been carried off the plane because they needed your seat?"

    There is a difference, he said, between what you wish for, what you expect, and what you would view as either a successful or failed experience. He said patient satisfaction should be viewed and measured from all 3 tiers of expectation, with a standard tool (he suggested an "Experience Efficiency Index") with the goal of reducing the number of unmet patient expectations.

    "The idea of a central outcome measure about patient experience … is new but necessary, as growth can create silos that emphasize differences rather than commonalities," he said.

    Senate Health Care Reform Bill Contains Provisions Opposed by APTA

    Despite some changes designed to appeal to a wider range of US senators, the newly released Senate version of health care reform still contains provisions that concern APTA: namely, a loosening of required "essential health benefits" (EHBs) that include rehabilitation services, and changes to Medicaid that could reduce the range of available benefits. Changes are still possible, however, and APTA has plans to reemphasize its positions as the Senate considers the bill.

    The bill, technically a substitute for the American Health Care Act (AHCA) approved by the House of Representatives in May, is characterized as less extensive in its effort to repeal and replace the Affordable Care Act (ACA), but it contains several of the same features as the House legislation, including plans to cap and then reduce Medicaid appropriations, transition Medicaid to a block grant system, and change EHB requirements-features that APTA has publicly opposed.

    Like the AHCA, the Senate substitute bill weakens the power of federally mandated EHBs—which include physical therapy—by allowing states to apply for waivers to reduce the requirements or eliminate them entirely. The result, according to APTA, is a likely reduction in access to habilitative and rehabilitative services for millions of Americans that could have lasting societal effects. In a statement on the AHCA, APTA President Sharon Dunn, PT, PhD, wrote that the EHB change and other provisions set the stage for a health care system that would create "unneeded barriers to care and reduce the access to care for millions of Americans."

    The bill has yet to undergo review by the Congressional Budget Office (CBO) and could be altered based on the CBO analysis or compromise efforts within the Senate.

    Meanwhile, APTA is not sitting still. On June 27, association representatives will participate in a congressional briefing on Capitol Hill aimed at educating lawmakers and staff on the value of rehabilitation and habilitation services and devices in American's health care system. The event is sponsored by the Independence Through Enhancement of Medicare and Medicaid, the Habilitation Benefits Coalition, and the Coalition to Preserve Rehabilitation. APTA is a member of all 3 groups.

    APTA will continue to analyze and monitor the bill and report on potential effects.

    From the 2017 House of Delegates: Setting a Course for the Profession's Future

    As far as APTA's House of Delegates (House) is concerned, the future is now.

    During her address to the 2017 House that opened the 3-day meeting held June 19-21, APTA President Sharon Dunn, PT, PhD, challenged delegates to make "bold moves" that would define where physical therapy would go in its next 100 years. The House delivered, passing motions—several unanimously—that articulated the physical therapist’s (PT's) professional scope of practice and its place within the PT’s overall scope of practice, set in motion an investigation into the ways APTA might facilitate a physical therapy "innovation centers" program, and made commitments to increasing diversity and inclusiveness in the profession, among other policies. The common thread: nearly every approved motion had implications for the future of the profession.

    One notable moment in the meeting came when the House adopted a definition of the PT professional scope of practice, the culmination of a multiyear effort with the ambitious goal of capturing all that PTs do without resorting to a list of activities that risked missing something or quickly growing outdated. The definition, which passed by a unanimous vote of the more than 400 participating delegates, gets the job done in 2 paragraphs:

    "The professional scope of physical therapist practice is grounded in basic, behavioral, and clinical sciences. It is supported by education, based on a body of evidence, and linked to existing and emerging practice frameworks. The professional scope evolves in response to innovation, research, collaboration, and changes in societal needs.

    The professional scope consists of patient and client management, which includes diagnosis and prognosis, to optimize physical function, movement, performance, health and quality of life across the lifespan. Additionally, the professional scope includes contributions to public health services aimed at improving the human experience."

    The adoption of the definition completes the association's effort to recharacterize how the profession thinks about scope-of-practice issues under 3 domains: personal scope (what the PT is educated, trained, and personally competent to perform), jurisdictional scope (the activities associated with physical therapy in state practice acts), and the professional, a more global description of the practice of physical therapy.

    While the scope decision established a here-and-now waypoint to the future, other House actions set sights on how the profession could evolve. One example: a motion directing the APTA Board of Directors to explore models for "innovation centers" for PTs with creative ideas for bringing novel practice concepts to market. The models could include freestanding "incubators," industry partnerships, or partnerships within health systems, and the board is charged with investigating which, if any, alone or in combination, offer the most promise to help move practice forward.

    The House also looked to the future in terms of not just what PTs do but the makeup of PTs doing it. In another unanimous vote, delegates approved a charge to APTA to do whatever it takes to "implement best practice strategies to advance diversity and inclusion within the profession of physical therapy." It's an effort that delegates acknowledged will take more than the association alone, and could include work with education programs, employers, and even pre-DPT public and private academic institutions.

    Other actions taken by the 2017 House include:

    • Instructions to the APTA Board of Directors to develop a plan to help ameliorate the administrative burdens placed on PTs
    • A charge to the APTA Board of Directors to develop and adopt a new mission statement for APTA
    • Expansion of an existing policy to emphasize the PT’s role in disability evaluation and determination for purposes such as transportation, employment, and insurance
    • The establishment of a committee to review all House documents
    • A bylaws change that would permit chapters to assign full representation to representatives of physical therapy assistants (PTAs), PTA lifetime members, and retired PTA members
    • A bylaws change that would allow more chapter membership flexibility for APTA members who are uniformed personnel, or whose spouses or partners are in the uniformed services
    • Awarding honorary APTA membership to prominent researcher T. Richard Nichols, PhD.

    APTA members can view videos of all open sessions of the 2017 House of Delegates online. Final language for all actions taken by the House will be available by September after the minutes have been approved.

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    #ChoosePT Named 1 of the Country's Top Public Awareness Campaigns

    As APTA's #ChoosePT national opioid awareness campaign continues to gain momentum, it's also gaining recognition, most recently by earning a highly prestigious "Power of A" gold award from the American Society of Association Executives (ASAE).

    The Power of A awards "highlight the association community's valuable contributions to society on the local, national and global level," according to ASAE. "They honor the outstanding accomplishments of associations and industry professionals in the areas of strengthening lives, forging a more trained and highly competitive workforce, enhancing the economy, driving innovation and making a better world." The Power of A awards are among the highest honors given out by the society.

    According to APTA Chief Executive Officer Justin Moore, PT, DPT, the Power of A award is particularly special.

    "The Power of A awards recognize efforts to make the world a better place," Moore said. "This award is perfectly aligned with our profession's vision to transform society. We are proud that the #ChoosePT campaign is highlighting the ability of physical therapists to be positive change agents in this national drug crisis."

    This isn't the first honor the #ChoosePT campaign has received: in April, the #ChoosePT public service announcement was named Best Video of the Year by ASAE; and in early June, the Kentucky state senate issued a proclamation lauding the campaign and APTA's "phenomenal" members.

    ASAE includes more than 35,000 members representing nearly 7,500 organizations across the country. APTA will be formally recognized at the 18th Annual Summit Awards Dinner October 4 at the National Building Museum in Washington, DC.

    Want to support the #ChoosePT campaign? Access the campaign toolkit or contact APTA public relations staff to find out how you can get involved.

    CMS Proposes 2018 Quality Payment Program Rule: Here's What PTs Need to Know

    The US Centers for Medicare and Medicaid Services (CMS) may have slowed down the pace at which it is implementing the move toward quality-based payment, but that doesn't mean physical therapists (PTs) should be taking a business-as-usual attitude.

    With the release of its 2018 proposed rule for quality payment, CMS is taking some of the pressure off clinicians and groups with smaller practices or low numbers of Medicare patients to meet Merit-Based Incentive Payment System (MIPS) requirements. Still, the shift away from fee-for-service models continues, and even though PT participation in MIPS is still voluntary next year, it's almost a given that PTs will be mandatorily included as early as 2019.

    Details on the proposed rule are available from CMS, but here are a PT's 4 most important takeaways:

    1. Get involved in alternative payment models (APMs) now.
      Participating in an advanced APM could give you a 5% incentive payment with every year of successful participation. CMS offers a webpage specifically devoted to learning more about participating in APMs.
    2. APMs: They aren't just about Medicare.
      Don't limit your participation in APMs to only Medicare-based programs. According to CMS, beginning in 2019—the year PTs could be required to participate in MIPS—becoming a qualified provider through the "all payer combination option" will require the provider to participate in APMs with both CMS as well as an "other payer."
    3. Take MIPS for a test drive.
      PTs aren't formally included in MIPS, meaning reporting scores won't yet affect future payment adjustments. But you can report under MIPs voluntarily, which will help prepare you for future years when PTs are likely to be required to participate.
    4. Get with the technology.
      As health care moves to outcomes-based payment, it will be critical for PTs to have access to real-time clinical data to understand how they perform, identify areas to improve quality, and manage patient populations. Without data physical therapists will be unable to receive future incentive payments. APTA's Physical Therapy Outcomes Registry will have the ability to extract information from electronic health records, allowing your clinical data to be readily usable and actionable.

    From the APTA House of Delegates: Richard Nichols Named Honorary APTA Member

    T. Richard Nichols, PhD, became an honorary member of the American Physical Therapy Association (APTA) on June 21 by a unanimous vote of the APTA House of Delegates. Nichols is an internationally recognized scholar whose research has contributed to the advancement of scientific knowledge related to the control of movement. Per the proclamation proposing his honorary membership, Nichols has been "a stalwart advisor" to the association and to academic programs "that teach future physical therapists and advanced physical therapist clinicians."

    Look for more news from the just-concluded 2017 House of Delegates later this week, and view video-recorded sessions at www.apta.org/Livestream/.

    New at PTJ: Open-Access 'Best of the Best' Collection Focuses on LBP and Neck Pain

    As far as APTA's science journal Physical Therapy (PTJ) is concerned, "greatest hits" collections aren't just for musicians—and it's proving that point by issuing a special collection of PTJ articles on low back pain (LBP) and neck pain, all free to the public.

    Now available from PTJ: a new online-only "best of the best" issue that gathers PTJ articles from the past 2 years focused on conditions that loom large in both health care costs and clinician time. Articles reflect a range of themes and approaches, and include opinion pieces, cohort studies, and randomized controlled trials.

    Some of the hits include:

    Treatment-based classification systems for low back pain should include triage and consider psychosocial comorbidities. In this "Perspective" article, authors present a new and improved version of the treatment-based classification system included in the APTA clinical practice guidelines for LBP. Authors advocate for a 2-level triage process as well as the need to evaluate a patient’s psychosocial status.

    Taping isn’t shown to be effective for managing spinal pain . Based on the limited research available, authors find no real support for any type of taping for a variety of spinal pain diagnoses.

    Global postural re-education (GPR) can reduce pain and disability for neck pain .The randomized controlled trial found that GPR was more effective than manual therapy for patients with chronic, nonspecific neck pain.

    Cognitive functional therapy is a "promising" intervention for nonspecific chronic low back pain . In a cohort study, researchers found significant reductions in pain, functional disability, and a number of psychosocial outcomes.

    Trauma, osteoporosis, a back pain intensity score of ≥7, and thoracic pain are "red flags" for vertebral fracture in older adults . In patients over 75 years of age, trauma had the highest predictive value for a vertebral fracture diagnosis by their general practitioner.

    The Godelieve Denys-Struyf (GDS) method was better than standard interventions for low back pain . Researchers in Spain found that this motor control intervention improved disability scores more than a control group receiving transcutaneous electrical nerve stimulation, microwave treatment, and standardized exercises.