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  • Government Reopens Under Short-Term Deal That Leaves Medicare Patients in Limbo

    After an approximate 36-hour shutdown, the US government is back in business, which means the push is on to get a permanent repeal of the Medicare therapy cap over the finish line.

    On Monday, January 22, the US House and Senate agreed to fund the federal government through February 8. The deal fully funds the Children's Health Insurance Program (CHIP) for 6 years, and was accompanied by a compromise to bring a vote on the Deferred Action for Childhood Arrivals (DACA) legislation if a deal on immigration is not reached by February 8. What the deal does not include is a repeal of the hard cap on therapy services under Medicare, despite intense lobbying, grassroots, and social media efforts by APTA and members of the Repeal the Therapy Cap Coalition. Also missing from the deal: fixes to a host of Medicare-related critical issues affecting millions of Americans.

    Essentially, the short-term spending bill is intended to buy legislators time to agree on a longer-term funding plan—one that APTA is pushing to include a repeal of the hard Medicare therapy cap now in place. It's an idea supported by several legislators including Sen Ben Cardin (MD), who took to the Senate floor to call for action on the cap by the February 8 deadline.

    For the physical therapy profession, patients, and stakeholders, it's now time to work harder than ever before to make it clear to lawmakers that the hard cap must end.

    Although APTA's efforts to push for passage of a bicameral, bipartisan deal on the therapy cap never let up, the association plans to turn up the heat even more over the next few weeks. APTA is developing a special campaign that will involve physical therapists and patients across the country, and will contact members in the coming days about opportunities for participation. In the meantime, members and supporters are being urged to continue to contact members of Congress via email, phone, and social media, and tell them to pass the therapy cap permanent fix as soon as possible.

    "The time has come for resolution of this unacceptable situation," said Justin Elliott, APTA's vice president of government affairs."A person who is recovering from a stroke or other serious condition may be days away from hitting the hard cap and having Medicare no longer pay for essential physical and speech therapy. Therapy can’t wait—neither can Congress. There is a bipartisan solution to permanently address the hard cap, and Congress must act on it now."


    Visit APTA's Medicare Therapy Cap webpage for more information, download the APTA Action App to keep up-to-date on action alerts, and be sure to stay tuned for additional updates.

    Study Contradicts Popular 'Text Neck' Theory

    Is there a connection between "text neck" and neck pain in young adults? Researchers from Brazil don't think so.

    Authors of a new study of 150 18-21 year-olds in Rio de Janeiro claim they found no connection between handheld device use posture and the presence or frequency of neck pain—a conclusion that runs counter to popular media reports that "text neck" is contributing to increased rates of neck pain worldwide. Results were published in the European Spine Journal (abstract only available for free).

    To study the possible connection, researchers asked the participants about the amount of time they spent "reading, writing, or playing" on their mobile phones, and then asked them to identify what they believed their texting posture was based on a series of 4 drawings: 2 that were dubbed by researchers to be "no text neck" (phones held higher, farther away from the body, resulting in a less tilted head position), and 2 labeled as "text neck" positions (phones held lower and closer to the body, forcing a greater head drop).

    Next, participants were photographed in profile while texting to establish a more objective view of texting posture. The photographs were analyzed by 3 physiotherapists and individual texting postures rated as "normal," "acceptable," "inappropriate," or "excessively inappropriate." Finally, participants were asked about the occurrence and frequency of neck pain and the degree to which they worry about body posture.

    While the physiotherapists identified 40% of the participants as demonstrating text neck, in the end, authors of the study found no association between reported neck pain and text neck—whether self-perceived or identified in photographs. "Unquestionably, there is an awkward neck position to be found in many mobile phone users but this does not, according to our results, imply an association with neck pain," authors write.

    That's not to say that handheld device use is harmless—or even that the use is not linked in some way to neck pain, researchers say. With 76.6% of participants reporting that they spend 5 hours or more day "reading, texting, and playing" on their mobile phones, authors believe it's entirely possible for problems to develop, even if they're not directly related to posture.

    "The high percentage of participants who use a mobile phone more than 4 hours per day…is a concern, since the time spent with this device seems to be a risk factor for hand/finger symptoms," authors write. "Furthermore, an excess of screen time could lead to physical inactivity which is associated with neck and back pain in young adults."

    Just don't pin that pain on posture, according to the study's authors, who write that the findings of their admittedly limited study "challenge the belief that inappropriate neck posture during mobile phone texting is the leading cause of the growing prevalence of neck pain."

    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.