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  • New in the Literature: Acute Postburn Rehabilitation (J Burn Care Res. 2011 Oct 5. [Epub ahead of print])

    In patients with burns, using the Nintento Wii appears to improve anxiety, active range of motion (AROM), function, and enjoyment at a faster rate compared with patients who do not use the gaming device, say authors of an article published in Journal of Burn Care & Research. Presence (immersion into a virtual environment) minimally changed between successive treatment sessions for those in the Wii group, they add.

    For this study, participants were alternated and stratified based on the location of burn into Wii or control treatment groups. Joints of interest with limited AROM were the shoulder, elbow, wrist, hip, knee, and ankle. All participants received 3 consecutive sessions of passive range of motion and predetermined joint-specific exercises. This was followed by either designated Wii games or therapist-chosen interventions (control). Data from 23 participants aged 20 to 78 years were analyzed.

    The difference in mean slopes suggested that the Wii group experienced less pain than the control group over time. Although statistical significance was not reached in any category, feasibility was supported, and the overall pattern for outcomes was positive for the Wii group, the most favorable being for pain reduction. Future research with larger sample sizes is warranted to explore best practice with video game technology throughout the continuum of burn rehabilitation with appropriate prescriptions, say the authors.

    Fitness More Important Than Weight in Lowering Death Risks

    In a study of more than 14,000 people, maintaining or improving fitness was associated with a lower death risk even after controlling for Body Mass Index (BMI) change, according to the American Heart Association.

    Researchers used maximal treadmill tests to estimate physical fitness (maximal metabolic equivalent of task [METs]), and used height and weight measurements to calculate BMI. They recorded changes in BMI and physical fitness over 6 years. After more than 11 years of follow-up, researchers determined the relative risks of dying among men who lost, maintained, or gained fitness over 6 years. They accounted for other factors that can affect outcomes, including BMI change, age, family history of heart disease, beginning fitness level, changes in lifestyle factors, and medical conditions.

    The authors found:

    • Every unit of increased fitness (MET,) over 6 years was associated with a 19% lower risk of heart disease and stroke-related deaths and a 15% lower risk of death from any cause.
    • Becoming less fit was linked to higher death risk, regardless of BMI changes.
    • BMI change was not associated with death risks.

    One possible explanation for these results, says AHA, is that about 90% of the men were either normal weight or overweight at the beginning of the study. Among people who are obese, changes in BMI might have a significant effect on death risks. It's unclear whether these results would apply to people who are severely obese.

    Because the study was mostly done in white middle- and upper-class men, it's difficult to know whether the results apply to other racial and socioeconomic groups. Women would likely have similar results as the men in the study, said lead author Duck-chul Lee, PhD.

    The study is published in Circulation: Journal of the American Heart Association. 

    CMS Enhances Online Presence

    The Centers for Medicare and Medicaid Services (CMS) relaunched its Website, www.cms.gov, yesterday, making information more accessible for patients, partners, providers, states, advocates, and others who interact with the agency. The site is anticipated to be more user-friendly and has enhanced search capabilities. The Center for Medicaid and Chip Services also launched www.medicaid.gov, which focuses on policies related to Medicaid and the Children's Health Insurance Program. The Affordable Care Act (ACA) mandates Health and Human Service agency transparency, and the Web site serves to demonstrate this through information sharing and program information freely accessible to individuals, states, and other stakeholders. The Web site includes federal policy guidance, ACA implementation status, lists of state-approved and pending waivers, and state-specific data and program information. 

    CMS is asking for public input on how to improve the site. Physical therapists are encouraged to submit ideas or comments to CMS's Idea Factory.

    Improving Adolescent and Young Adult Health Through Healthy People 2020

    On December 13, noon to 1:30 pm ET, the US Department of Health and Human Services will present an overview of the adolescent health topic area in Healthy People 2020, the connection between Healthy People 2020 and education, and action steps that health care and public health professionals can take to improve adolescent health. 

    Register to attend the Webinar to learn about and discuss issues surrounding the Healthy People 2020 adolescent health topic area and related objectives.