• News New Blog Banner

  • Laser Therapy a Slight Winner in Analysis of Electrotherapy Modalities for Adhesive Capsulitis

    It could be that low-level laser therapy (LLLT) is a useful electrotherapy modality for treatment of adhesive capsulitis, but the effects are marginal and evidence is a long way from conclusive, according to a new Cochrane review of randomized controlled and controlled clinical trials (abstract here). The study is part of a larger update of a Cochrane review on physical therapy interventions for shoulder pain.

    Researchers hoped to evaluate the effectiveness of a range of electrotherapy interventions in addition to LLLT, including pulsed electromagnetic field therapy, therapeutic ultrasound, interferential current, and transcutaneous electrical nerve stimulation, both in relation to placebos and other interventions and in relation to each other.

    What they found was that evidence was lacking in nearly all parameters, and nothing conclusive could be drawn from the 19-trial, 1,249-participant review they studied—with 1 possible exception.

    Although authors provided plenty of qualifications to their findings, they did acknowledge low- to moderate-quality support for the use of LLLT in a few ways: it may be slightly better than placebo "in terms of global treatment" at 6 days; and it may be "an effective adjunct" to exercise in reduction of pain up to 4 weeks, and increase in function up to 4 months.

    Authors were not able to render any conclusions beyond those related to LLLT, mostly because of design flaws in trials, all but one of which were downgraded to "low" or "very low" quality primarily because of unclear allocation concealment, lack of blinding, and small sample sizes. In fact, they write, even findings that pointed to possible benefits may change if and when better quality research is conducted. "Further high-quality trials may show even smaller effect estimates than those summarized in this review," they write.

    In the article, authors call for further high-quality research that compares various electrotherapy modalities, evaluates effectiveness versus placebo, and analyzes their use in combination with manual therapy and exercise. Authors also point out a need for studies that examine long-term effects of the modalities, citing the fact that most of the trials they studied "have only assessed outcomes during treatment or in the weeks following cessation."

    APTA members have access to the complete article through PTNow ArticleSearch.

    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.

    List of Hospitals Penalized for Readmissions Grows

    The US Centers for Medicare and Medicaid (CMS) has added about 400 hospitals to its list of facilities that will be penalized in 2015 for having what CMS feels are excessive numbers of patients returning to the hospital fewer than 30 days after being discharged. The revised list now includes 2,610 hospitals and covers readmissions for heart attack, heart failure, pneumonia, chronic obstructive pulmonary disease, total hip replacements, and total knee replacements.

    According to an article in Modern Healthcare (free access with one-time registration) 39 of the most recently listed hospitals will face the maximum 3% reduction in Medicare reimbursements.

    The readmissions penalty program began in 2013 as part of a quality improvement effort in the Patient Protection and Affordable Care Act. According to the Modern Healthcare report, "policy experts are increasingly raising concerns that hospitals in poor communities are unfairly punished by the program after observing that safety net providers were more likely to receive penalties in the first 2 years of the program."

    A complete listing of all penalized hospitals is included in the Modern Healthcare article.

    APTA Board Honors State Advocates

    Physical therapist leaders from Oklahoma, Washington, Arizona, and Arkansas were honored for their successful efforts dedicated to state legislation that advances the physical therapy profession at last month's State Policy and Payment Forum in Seattle, Washington.

    The APTA Board of Directors awarded the 2014 State Legislative Leadership Award to Brandon Trachman, PT, MPT, OCS, of the Oklahoma Chapter for his work on legislation this year making Oklahoma the 49th direct access state; Robin Schoenfeld, PT, OMT, of the Washington Chapter for her work on legislation that removed a 25-year-old prohibition on PTs performing spinal manipulation; and Sean Flannagan, PT, DPT, Cert SMT, Cert DN of the Arizona Chapter for his work on legislation that added dry needling to that state's physical therapy practice act.

    In recognition of his long-term commitment to their chapters' state advocacy activities, the APTA Board of Directors awarded the 2014 State Legislative Commitment Award to Steve Forbush, PT, PhD, OCS, of the Arkansas Chapter.

    Be sure to check out the Storify with video highlights from this year’s APTA State Policy Forum. And don't miss next year's event scheduled for September 12-14, 2015, in Denver, Colorado.