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  • Hawaii Chapter Helps Thwart Cuts to Outpatient Rehab Under QUEST

    Advocacy efforts by the Hawaii Chapter successfully helped prevent cuts in outpatient rehabilitation benefits under Hawaii's Medicaid program, known as QUEST.

    Gov Neil Abercrombie's office recently announced that the state "will still tighten income eligibility for adults in QUEST starting in July, which means about 3,500 adults could lose health insurance coverage, but will cancel limits on hospital stays and the elimination of outpatient rehabilitation, optometry services and prosthetics." The administration announced last month that it would cancel cuts for durable medical equipment, such as wheelchairs and oxygen tanks.

    "We're extremely pleased with the Abercrombie administration's decision to keep outpatient rehabilitation benefits intact for QUEST beneficiaries," said Art Lum, PT, MA, president of the Hawaii Chapter. "This victory could not have been possible without the support of our chapter's membership and APTA staff, and the work of the chapter's legislative team."

    Evidence Insufficient for Multidisciplinary Postacute Rehabilitation for Adults With TBI

    Authors of a comparative effectiveness review released by the Agency for Healthcare Research and Quality report that the "body of evidence is not informative" regarding effectiveness or comparative effectiveness of multidisciplinary postacute rehabilitation for adults with moderate to severe traumatic brain injury (TBI).

    Multidisciplinary Postacute Rehabilitation for Moderate to Severe Traumatic Brain Injury in Adults examines 5 key questions related to characterizing the interventions, effectiveness and comparative effectiveness, minimal clinically important differences, sustainability of intervention effectiveness, and adverse events. The authors state that, "Although we found stronger evidence on the comparative effectiveness of different approaches to multidisciplinary postacute rehabilitation for participation outcomes, we found a limited number of eligible studies and no clear demonstration that one approach was superior to another."

    The authors call for further research to "address methodological flaws common in these studies and further address effectiveness research questions."

    APTA member Douglas E. Bidelspach, PT, MPT, served on the expert technical panel. Bidelspach also served as a peer reviewer with APTA member Karen Lohmann Siegel, PT, MA

    APTA has additional information available about evaluation and treatment of people postbrain injury on its TBI webpage.

    New in the Literature: Exercise and Physical Therapy in Children With CF (Pediatr Pulmonol. 2012 May 2. [Epub ahead of print])

    Supervised outpatient exercise and physical therapy are associated with improvements in quality of life and exercise tolerance, a reduction in IV antibiotic days, and a trend toward reducing lung function decline in children with cystic fibrosis (CF), say authors of an article published in Pediatric Pulmonology. The cost of IV antibiotics was reduced by $104,000 in 2010 when compared with 2009. Such cost benefit may have implications for workforce planning and service provision, they add.

    Twelve children (6 girls) with CF aged 10 years or older (mean age 13.3 years) who had received 4 or more courses of IV antibiotics in 2009 were enrolled in the study. The children participated in supervised exercise and physical therapy once every 2 weeks throughout 2010. In addition, they were expected to exercise 3 times weekly. If unwell, the children completed additional physical therapy sessions to usual chest physical therapy. Assessments of exercise capacity using the Modified Shuttle Test (MST) and quality of life (QOL; CFQ-UK) were recorded at baseline and after 1 year. Regular spirometry was performed before and throughout the study. Data were collected on IV antibiotic days.

    A significant reduction in IV antibiotic days from 60 days in 2009 to 50 in 2010 was noted, along with improved MST distance (735 vs 943) and level attained (9.4 vs 11.1).

    Significant improvements in CFQ-UK scores for physical (59 vs 83), emotional (63 vs 84), treatment (41 vs 61), and respiratory (54 vs 76) domains were noted. The mean rate of change of FEV(1) was -4 (-18, +10)% in 2009, but was +6 (-2, +13)% in 2010, although this did not reach statistical significance.

    PT 2012 Images Now Online

    Order your PT 2012 images and downloads today. Go to David Braun Photography Inc and click on APTA PT 2012-All. Enter password: seashell2012, click the GO button, and select any day or event gallery link. Click on thumbnails to view larger images. Use the drop-down menu on the upper right to change between daily galleries. Prices for prints appear on the right when viewing an image. To order file downloads, click on the Digital Products link below the print prices.  

    CDC: More Adults Meeting Physical Activity Guidelines

    Slightly more than 48% of adults aged 18 and older met the 2008 federal physical activity guidelines for aerobic activity in 2011, the highest percentage ever reported, says the early release of estimates for 15 selected health measures by the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS).

    As age increased, the percentage of men and women who met the guidelines decreased. In all age categories, women were less likely than men to meet the recommendations. In addition, just over 20% of adults met the guidelines for both aerobic and muscle-strengthening activities. 

    For 2011, 8.9% of adults aged 18 and older reported having been diagnosed with diabetes, which was not significantly different from the 2010 estimate of 9.2%. The prevalence of diagnosed diabetes increased with age for men and women combined. For the age groups 55-64 and 65 and older, men had a higher prevalence of diagnosed diabetes than women. The age-sex-adjusted prevalence of diagnosed diabetes was 12.4% for non-Hispanic black people, 12.0% for Hispanic people, and 7.0% for non-Hispanic white people.  

    Other measures in the report include lack of health insurance coverage and type of coverage, having a usual place to go for medical care, obtaining needed medical care prevalence of smoking and alcohol consumption, and receipt of vaccinations.  

    CDC published the measures prior to final data editing and final weighting to provide access to the most recent information from the 2011 National Health Interview Survey (NHIS). The estimates will be updated as each new quarter of NHIS data becomes available.