Editor and PTJ Editorial Board Member
Patricia Ohtake, PT, PhD, joins
Editor in Chief Rebecca Craik, PT, PhD,
FAPTA, in this month's Craikcast, which highlights the articles
in the December issue Special Series on Rehabilitation for People With Critical
Illness. Ohtake summarizes the articles, and Craik adds her thoughts on
important research conducted by established authors in the field, including
physical therapists from across the United States and from Australia. Ohtake
also discusses a 2-fold challenge of the critical care and rehabilitation
communities—to continue to develop effective rehabilitation interventions and
to increase awareness of postintensive care syndrome.
special series will be published in 2 issues—December 2012 and February 2013.
Department of Veterans Affairs (VA) published a proposed rule on December 10 to amend
regulations regarding certain service-connected conditions associated with
traumatic brain injury (TBI). Under the amendment, veterans who have a
service-connected TBI and are also diagnosed with Parkinsonism, dementia
(pre-senility, Alzheimer type), unprovoked seizures, hypopituitarism, or
depression will have those diagnoses classified as service-connected secondary
conditions if they manifest within 3 years of a moderate to severe TBI or
within 12 months of mild TBI. Diseases related to hypothalamo-pitutitary
changes must manifest within 12 months of moderate to severe TBI. This new
service-connected diagnoses may impact disability status and related VA
Yesterday, the Department of Health and Human Services (HHS) released an FAQ document on state health insurance Exchanges, other market reforms, and Medicaid expansion. The document includes a section on what states should expect if they opt for a federally operated Exchange, including how states can work with the federal government to ensure the needs of a particular state are being met. HHS reiterates that there is no deadline for a state to declare to the federal government its intention to participate in Medicaid expansion to individuals at and below 133% of the federal poverty level (FPL) and that states have flexibility to start and stop the expansion. However, the federal match rates for medical
assistance to states for this expansion population are tied to specific calendar years by law (eg, 100% support for newly eligible adults in 2014, 2015, and 2016). Additionally, HHS clarified that the law does not provide for a phased-in or partial expansion to less than 133% of the FPL, something some states had been considering but were unsure if it was an allowable option.
support of APTA's Fit After 50 campaign, spokesperson Patrice Winter, PT, DPT, MHA, FAAOMPT, blogs
on Boomer Café about how she manages to stay active and fit as she nears age 60.
A new study finds that knee replacement surgery may
raise a person's risk of gaining weight, says a Reuters
News article based on a study published in Arthritis Care & Research.
For this study, lead investigator Daniel
Riddle, PT, PhD, FAPTA, and his group used a patient registry from the Mayo
Clinic in Rochester, Minnesota, which collected information on 917 knee
replacement patients before and after their procedures.
The researchers found that 5 years after surgery, 30% of patients had gained
at least 5% of their weight at the time of the surgery.
In contrast, fewer than 20% of those in a comparison group of similar people
who had not had surgery gained equivalent amounts of weight in the same period.
Riddle's team said that this degree of weight gain can lead to
"meaningful effects on cardiovascular and diabetes-related risk as well as
pain and function."
One possible explanation for the counter-intuitive results, experts said, is
that if people have spent years adapting to knee pain by taking it easy, they
don't automatically change their habits when the pain is reduced, reports
"After knee replacement we get them stronger and moving better, but
they don't seem to take advantage of the functional gains," said Joseph
Zeni, PT, PhD, a physical therapy professor at the University of Delaware, who
was not part of the study. "I think that has to do with the fact that we
don't address the behavioral modifications that have happened during the course
of arthritis before the surgery."
Part of the explanation for the weight gain could be the age at which
patients get surgery. People in their 50s and 60s tend to gain weight, anyway.
Still, in light of the lower rates of weight gain in the comparison group,
which was also middle aged and older, Riddle said something else may also be at
In fact, the team found that patients who had lost weight before their
surgery were slightly more likely to gain weight afterwards—perhaps because
when people lose weight in anticipation of an event, such as surgery, they are
more likely to put it back on after they're achieved the goal, says the
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