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  • CDC Still Looking for Answers to Condition Producing Paralysis in Children

    The US Centers for Disease Control and Prevention (CDC) is still trying to identify the cause of an illness that has now resulted in various degrees of paralysis among 51 children in 23 states as of October 23. The agency began asking states to track the condition after a cluster of cases were reported in Colorado in August and September.

    The New York Times reports that CDC officials continue to describe the cases as "extremely rare," and they are not supporting a connection between the polio-like condition and respiratory virus enterovirus 68, although some doctors "suspect a link." The NYT article quotes Mark Pallansch, director of the division of viral diseases at CDC, as saying, "We don't have a single clear hypothesis that's the leading one at this point."

    Early reports cited the condition as appearing in 40 states. Since those initial reports, CDC ruled out several cases that do not meet its definitions for inclusion, which require the presence of spinal lesions largely in the gray matter, among other factors.

    The condition seems to strike younger children and advances rapidly, becoming most acute within 1-3 days of initial symptoms of weakness. The paralysis varies in severity, and most recovery is made within the first 2 months, with a slowdown in gains as time progresses. A pediatric neurologist quoted in the NYT story describes recovery as "highly variable," saying that "some patients recover very well, others not."

    CDC updates case tallies every Thursday, and continues to ask state and local health departments to report cases that meet its criteria for inclusion: sudden-onset acute limb weakness experienced in August or after in a patient 21 or younger, and the presence of a spinal cord lesion largely restricted to gray matter. The agency has also posted a report on its investigation into the cluster of cases in Colorado in August and September.

    PTNow Blog: Good Research Needs More Than Good Stats

    In the latest PTNow Blog, a self-described "research geek" says that when it comes to evaluating research results, it's time for rehabilitation clinicians to move toward a nuanced approach that takes things such as confidence intervals, effect sizes, and clinical judgment into account.

    A clinical commentary authored by Phil Page, PT, PdD, ATC, CSCS, FACSM, is the subject of the new post, which describes Page's efforts to bring attention to so-called "magnitude-based inferences" that rely less on a simple black-or-white analysis of statistical significance, and more on an evaluative process that factors in whether and how that intervention will benefit the patient in a meaningful way.

    Along the way, the blog reports, Page also encourages physical therapists to take little for granted and never assume that research is good simply because it appears in a respected journal.

    Check out the blog, follow the link to Page's article, and join the conversation.

    Slides, Video From IOM/NRC Workshop on Future of Home Health Now Available

    Presentation slides and videos from an innovative Institute on Medicine (IOM) and National Research Council (NRC) workshop on the future of home health care are now available for download at the IOM website. APTA was among the sponsors of the 2-day event.

    The workshop, held September 30 through October 1, brought together leaders in health care, academia, and the federal government to talk about the present and future of home health care, with particular emphasis on how data can inform and improve outcomes. Highlights of the workshop were featured in US News & World Report.

    The workshop touched on issues that affect the entire home health system, including innovation, the role of social support, silos in postacute care settings, customized technologies, and the creation of a standard definition that combines skilled, unskilled, and caregiver services. Cindy Krafft, PT, COS-C, president of APTA's Home Health Section, participated in the workshop along with APTA staff.

    The Alliance for Home Health Quality and Innovation will hold a follow-up symposium on January 13 in Washington, DC. Registration information will be posted on the Future of Home Health website.