• News New Blog Banner

  • Advanced Cancer Patients Can Benefit From Structured Exercise, Say Researchers

    Incorporating structured exercise into supportive care can help improve the lives of patients with advanced cancer, say researchers in an article e-published ahead of print in the Archives of Physical Medicine and Rehabilitation (abstract only available for free). In an analysis of previous studies, authors found that both aerobic exercise and resistance training improved many cancer side effects.

    Authors evaluated 25 studies, for a total of 1,188 participants, that measured the efficacy of exercise interventions on physical function, quality of life, fatigue, body composition, psychosocial function, sleep quality, pain, and survival. All studies used more than 1 session of structured exercise as the primary intervention and specified the "frequency, intensity, time, or type" of exercise. More than 80% of participants in each study had been diagnosed with "advanced cancer that is unlikely to be cured." Some studies used control groups, and some did not.

    Their findings include:

    Physical function. In 83% of studies, participants who exercised experienced significant improvements in physical function, including exercise capacity, aerobic capacity, and muscle strength.

    Quality of life. In 55% of studies, exercise resulted in significant improvement in at least 1 measure of quality of life.

    Fatigue. Half of the studies reported that exercise improved at least 1 measure of fatigue.

    Psychosocial function. At least 1 measure of psychosocial or cognitive function was reported as having improved with exercise in 56% of studies.

    Body composition. In 56% of studies, exercise improved at least 1 measure of body composition, including lean body mass and body fat percentage, though not BMI, fat mass, or body mass.

    Sleep quality. In all 4 studies including this area, participants who exercised reported significant improvements compared with control groups.

    Pain.Of the studies measuring pain, 2 found significant improvements after exercise interventions.

    Survival. No studies examining survival rates found a significant improvement as a result of exercise.

    Because "decline in physical function has been reported as one of the most debilitating symptoms associated with advanced cancer," authors write, "interventions targeting improvements in this domain are of utmost importance."

    While authors note that exercise "appears to be an effective adjunct therapy in the advanced cancer context," they recommend that future studies use standardized protocols to report consistent outcomes measure assessment—one limitation they observed. Authors also suggest that future research should "compare different frequencies, intensities, durations, and types of exercise" to "determine the optimal exercise dose to enhance outcomes for specific cancer diagnoses."

    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.

    CDC: Falls-Related Deaths in the US Rose 31% in 10 Years

    Among US residents age 65 and older, the rate of death from falls continues to climb steadily, having increased by 31% between 2007 and 2016, and growing at a particularly rapid rate among those aged 85 and above. The latest statistics, included in a report from the US Centers for Disease Control and Prevention (CDC), point to a need for more widespread falls screening and prevention efforts including physical therapy, authors say.

    During the 10 years tracked in the study, falls-related deaths among US residents 65 and older rose from 18,334 to 29,668—in terms of rates of death from falls, that's an increase from 47 per 100,000 to 61.6 per 100,000 in that age group. Deaths climbed by about 3% per year, according to the report.

    In addition to overall totals and rates, CDC researchers looked at data in terms of demographics and state-by-state variables. Among their findings:

    • In 2016, falls-related deaths per 100,000 were highest among white non-Hispanic US residents (68.7) and the all-ethnicity 85-and-older group (257.9).
    • While death rates increased for all age groups, the 85-and-older category recorded the most dramatic rise between 2007 and 2016, from 9,188 deaths in 2007 to 16,454 in 2016. The 65-to-74 age group recorded 2,594 falls-related deaths in 2007 and 4,479 in 2016; the 75-to-84 age group saw an increase from 6,552 deaths in 2007 to 8,735 in 2016.
    • Men had higher rates of falls-related deaths than did women—73.2 per 100,000 men compared with 54 per 100,000 per women. Researchers believe the gap may be attributable to "differences in the circumstances of a fall," with men tending to experience falls that lead to more serious injuries, such as those sustained in a fall from a ladder or as the result of alcohol consumption.
    • Rates for deaths from falls in the 65-and-older age group varied among states, ranging from 142.7 per 100,000 in Wisconsin to 24.4 per 100,000 in Alabama. Authors aren't sure of the reasons for the variance but suspect that the numbers might be related to demographic variables including differing proportions of older white adults in various states. Another possible explanation cited in the report was the impact of who completes the death certificate: According to the CDC researchers, a 2012 study showed that coroners reported 14% fewer deaths from falls than did medical examiners.

    Authors of the report theorize that the rates of falls-related deaths may be climbing in part because of an aging population and longer survival rates after common diseases including heart disease, cancer, and stroke. Whatever the contributing factors, it's a trend that needs to be addressed, they write: even if the rate were to stabilize, an estimated 43,000 US residents would die from falls in 2030, and if the rate were to climb as it did from 2007 to 2016, some 59,000 individuals may die from falls in 2030.

    "As the US population aged [65 and older] increases, health care providers can address the rising number of deaths from falls in this age group by asking about fall occurrences, assessing gait and balance, reviewing medications, and prescribing interventions such as strength and balance exercises or physical therapy," the report states.

    Better prevention efforts also may result in health care cost savings as well: an earlier report estimated that expenditures on nonfatal falls in the US reached nearly $50 billion in 2015, with medical costs associated with fatal falls coming in at an estimated $754 million.

    APTA provides extensive resources on falls prevention at its Balance and Falls webpage. Offerings include consumer-focused information, online courses, and links to other sources of information, including the CDC and the National Council on Aging. In addition, APTA's PTNow evidence-based practice resource offers a unilateral vestibular hypofunction clinical summary, a summary on falls risk in community-dwelling elders, an osteoporosis clinical summary, and tests and measures such as a fracture risk assessment, a clinical test of sensory interaction and balance, and a self-paced walk test. The association's scientific journal, PTJ (Physical Therapy) has also published a clinical guidance statement from the APTA Academy of Geriatric Physical Therapy on management of falls in community-dwelling older adults.

    New Strategy Group Seeking Input on Physical Therapy PT, PTA Clinical Education Recommendations

    Sometimes, the journey is as important as the destination: that's the thinking guiding a partnership looking at the future of physical therapy (PT and PTA) clinical education.

    The Education Leadership Partnership (ELP), a group comprising representatives from APTA, the Academy of Physical Therapy Education (APTE—formerly the Education Section of APTA), and the American Council of Academic Physical Therapy (ACAPT), was formed in 2016 with a goal of eliminating unwarranted variation in practice by focusing on best practices in physical therapy education. This year, the partnership took another step toward its goal by forming a subgroup that will continue a dialogue with multiple stakeholders that began with the recent work of 2 APTA education-related task forces and an ACAPT Clinical Education Summit held in 2014.

    The new group, called the Clinical Education Strategy Group, is sponsoring an action-planning meeting this fall that will bring together representatives from multiple groups across the spectrum of physical therapy education. Topics for the meeting will include outcome measures, academic clinical partnerships, and essential resources to support clinical education. That meeting will help the strategy group to develop a clinical education research agenda to inform future steps, which likely will include projects and studies with further opportunities for input.

    "The ELP has been committed to transparency and engagement since its creation," said Steven Chesbro, PT, DPT, EdD, APTA vice president of education and task force staff. "The Clinical Education Strategy Group and the upcoming meeting are in keeping with those values and will help us move clinical education forward in ways that are informed by as many perspectives as possible."

    The strategy group was created after the APTA Board of Directors (Board) recommended in November 2017 that the ELP explore clinical education recommendations that a Board-appointed task force had developed. At the time of the board's decision, APTA President Sharon Dunn, PT, PhD, stated that there are "too many unknowns in need of further investigation, and too many factors beyond APTA's direct control" to commit to any recommendations from the APTA task force.

    The APTA Board does not have authority over the ELP and can't formally charge the ELP to take specific actions. Instead, the Board’s action was a demonstration of trust in the ELP and its approach, which involved receiving input from thousands of APTA members and nonmembers in the study leading up to the 2017 board decision. That input came from multiple in-person and online town halls, as well as an online survey, conducted by the ELP.

    That commitment to hearing from as many interested parties as possible is shared by the Clinical Education Strategy Group, according to the group’s co-chair, Donna Applebaum, PT, DPT.

    "As an educational community, we have invested a lot in our current practices around clinical education, with a collective commitment to best practices, and to figuring out when variations and historical practices are acceptable, and when they're problematic for the system," Applebaum said. "That's why it's crucial that we engage with as many stakeholders as possible. We want to get this right, and the only way to do that is by carefully listening, and then evaluating possibilities that balance our hopes for the future of education with the practicalities we face in the present."

    PT in Motion News will continue to follow the activities of the ELP and the strategy group, and will report on developments as they occur.

    $9.7 Million PCORI Grant Will Fund Research on Physical Therapy vs CBT for LBP

    A recently announced $74 million grants program includes a $9.7 million award for a project focused on comparing physical therapy with cognitive behavioral therapy in the treatment of chronic nonspecific low back pain. APTA member Julie Fritz, PT, PhD, is the principal investigator for the study.

    The grant to Fritz's research is part of another round of funding sponsored by the Patient-Centered Outcomes Research Institute (PCORI), an independent, nonprofit organization authorized by Congress in 2010. The most recent grants program is intended to support effectiveness research studies on conditions that "impose high burdens on patients, caregivers, and the health care system," according to PCORI.

    Research related to physical therapy remains of special interest to the institute. In 2016, PCORI awarded a $12.5 million grant to a project that is investigating the effectiveness of interdisciplinary teams that include a physical therapist (PT) in pain management, and, in 2015, the group awarded nearly $28 million in support for 2 research projects led by PTs.

    Study: Self-Reported vs Actual Levels of PA Usually Don't Match Up

    In news that may surprise exactly no one, researchers have found that people aged 50 years and older tend to overestimate the level of physical activity (PA) they accomplish—and Americans tend to be more generous with their estimations than people in other nations, or at least more so than people from England and the Netherlands.

    Those findings are part of a study, published in the BMJ Journal of Epidemiology and Community Health, aimed at better understanding the differences between subjective estimations of PA and PA data retrieved from wrist-worn accelerometers. Participants from England, the United States, and the Netherlands were recruited from 3 separate longitudinal studies that asked for self-reports on PA and had subjects wear a Genactiv wrist accelerometer 24 hours a day for 7 days. Researchers then compared the self-reported data on level and frequency of PA with the data recovered from the accelerometers. Here's what they found:

    Self-descriptions of PA levels were fairly consistent—just not very accurate, especially for Americans.
    When it came to describing themselves as "inactive," "mildly active," moderately active," "active," or "very active," all 3 groups reported similar levels of PA, with the Dutch and English slightly more inclined to avoid either extreme.

    But consistency and accuracy are 2 different things. All 3 groups tended overestimate their levels of PA when compared with accelerometer data, with the US participants registering generally larger differences. For example, only 10% of US participants reported being "inactive," while accelerometer data put that figure closer to 38%. Data from Dutch and English participants also showed a gap, though not quite as dramatic as the Americans’: 8% of participants in the Netherlands self-reported as "inactive" compared with an objective data estimate of 20%; 5% of English participants self-reported as "inactive" compared with an objective data estimate of 21%.

    “Very active” was the only activity level that didn't follow this pattern across all groups. In this category, participants tended to underestimate their activity levels, with 3% of the Dutch and English groups and 5% of the US group describing themselves as "very active" compared with objective data of 20%, 17%, and 14%, respectively.

    PA dropped off dramatically with age—and again, Americans led the way.
    Though researchers focused primarily on participants 50 and older, they did analyze self-reports and accelerometer data from ages 18 and up. They found mostly similar patterns in terms of self-reports and objective data related to levels of PA, but the differences became more stark with age, with participants 65 and older showing steep declines in PA levels. Data from the US revealed the most dramatic disparities, with 11% of participants over 65 self-reporting as "inactive," compared with objective data that put that figure at 60%.

    "It is clear that self-reports and objective measures tell vastly different stories," authors write. "Both across countries and across various socioeconomic and demographic age groups within countries, self-reports vary only moderately or not at all. At the same time accelerometry indicates large differences across certain groups."

    Researchers acknowledged the importance of self-reports, but described the goal of using such reports as a way to compare PA levels across groups as "largely elusive," regardless of whether the evaluation is a simple 5-option approach such as that used in the BMJ study, or any of a number of more complex self-report instruments.

    "The issue is not that simple self-reports of PA are less reliable than the more detailed questions for frequency of various levels of PA," authors write. "Rather the problem with both types of questions is that they are understood systematically differently by different groups…and hence are unsuitable for comparisons across these groups. For that purpose, the use of accelerometry appears indispensable."

    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.

    Vitamin D Takes a Tumble in New Falls Prevention Recommendations

    The US Preventive Services Task Force (USPSTF) has updated its recommendations for falls prevention in older adults, and this time around, vitamin D supplements are out of the picture, at least for adults aged 65 or older without osteoporosis or vitamin D deficiency.

    As in previous versions of the recommendations, exercise-based interventions still receive the highest support, with a B grade based on studies reviewed by USPSTF researchers. However, the use of vitamin D supplements didn't fare as well, falling from a B grade in the last version of the recommendations to D grade in the latest edition, meaning that the USPSTF recommends against its use.

    The drop is at least partially due to a decision by the task force to exclude studies that involved participants with vitamin D deficiency or insufficiency from its evaluation this time around.

    "With this revised scope of review, as well as newer evidence from trials reporting no benefit, the USPSTF found that vitamin D supplementation has no benefit in falls prevention in community-dwelling older adults not known to have vitamin D deficiency or insufficiency," the report states. The task force clarified that its recommendations around vitamin D also are not intended to apply to older adults with osteoporosis or a history of fractures.

    Conversely, exercise interventions continued to receive strong support due to the solid favorable evidence that continues to mount—even if the approach can't be narrowed to a single or few recommended interventions.

    "Effective exercise interventions include supervised individual and group classes and physical therapy, although most studies reviewed by the USPSTF included group exercise," the report states. "Given the heterogeneity of interventions reviewed by the USPSTF, it is difficult to identify specific components of exercise that are particularly efficacious." While the report does mention exploratory research that seems to indicate that greater falls reduction is achieved through group (vs individual) exercise, exercise with multiple components, and exercise that includes strength training, USPSTF authors write that these results should be "interpreted with caution."

    A third intervention, titled "multifactorial," received the same C grade it earned in the previous report. According to USPSTF, "multifactorial" interventions are customized approaches based on individual falls risk assessments and could include exercise, psychological interventions, nutrition therapy, medication management, social or community services, and referral to specialists such as a neurologist.

    Editor's note: Want more on falls prevention? Check out the falls-related resources at PTNow, including a unilateral vestibular hypofunction clinical summary, a summary on falls risk in community-dwelling elders, an osteoporosis clinical summary, and tests and measures such as a fracture risk assessment, a clinical test of sensory interaction and balance, and a self-paced walk test. APTA also offers resources on its Balance and Falls webpage.

    PTJ Special Issue Podcasts: Physical Therapy for Pain May Reduce Overall Costs, Opioid Use

    For some patients, physical therapy can both decrease overall health care utilization and save money down the road—especially if delivered sooner rather than later. These were the takeaways from 2 articles in a May 2018 special issue on nonpharmacological management of pain published by PTJ (Physical Therapy), APTA's scientific journal. PTJ Editor-in-Chief Alan Jette, PT, PhD, FAPTA, interviewed authors of each of the studies via podcast.

    One study, coauthored by Xinliang “Albert” Liu, PhD, examined the effect of timing of physical therapy on downstream health care use and costs for patients with acute low back pain (LBP) in New York state. The patients were categorized by whether and how soon they received physical therapy after seeing a physician for LBP: at 3 days, 4–14 days, 15–28 days, 29–90 days, and no physical therapy. Patients who received physical therapy within 3 days (30%) incurred the lowest costs and utilization rates, while those who didn’t see a PT at all saw the greatest of both.

    In the PTJ podcast, Liu observed that among those who did not receive physical therapy there was “greater variety in health care utilization and costs," pointing out that factors influencing costs include age, living in nonmetropolitan areas, type of insurance coverage, comorbidities, and whether they were prescribed opioids or other medications. He cautioned that “we don’t have the evidence” yet to say that all patients with LBP should be referred immediately to physical therapists, but he hopes that future research can “identify subgroups that would potentially benefit from physical therapy and lower their health care utilization and costs.”

    A separate study explored downstream health care utilization and costs for Veterans Affairs patients who received physical therapy, opioids, or both after hip surgery. After 2 years, patients who received only physical therapy had lower overall health care costs than those who only received opioids and had fewer return visits for surgical fixes or replacements. Among the 56% of patients who received both, those who received physical therapy first had lower costs, had fewer opioid prescriptions, and were less likely to use opioids long-term.

    Coauthor Daniel Rhon, PT, DPT, DSc, told Jette, “Perhaps when you see a physical therapist first, there is more appropriate pain education and pain management…and that sends the patient down this pathway that results in better outcomes. I think there’s a prevailing thought…that you need to be pain-free before you get to physical therapy, and that it’s going to be really painful, and some physicians and some patients might wait” to refer a patient to physical therapy.

    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.

    Foundation Announces 2018 Scholarship, Grant Opportunities

    The Foundation for Physical Therapy (Foundation) now is accepting applications for the 2018 Florence P. Kendall Doctoral Scholarships and the 2018 Research Grants.

    The Kendall Post-Professional Doctoral Scholarships assist physical therapists and physical therapist assistants with outstanding potential who are in their first year of postprofessional doctoral degree studies. The $5,000 awards are given to meet tuition expenses or academic fees associated with a doctoral program. Application deadline is August 2, 2018, at 12:00 pm ET.

    Grant opportunities include:

    • Magistro Family Foundation Research Grant: $100,000 for a research project investigating physical therapist interventions. Investigators at any level are welcome to apply regardless of funding history. A letter of intent is required; applicants will be invited to submit full applications based on content. Letter of intent is due May 31, 2018, at noon ET; full application is due August 2, 2018, at noon ET.
    • Foundation Research Grant: $40,000 for an investigator-initiated research project by an emerging investigator. Full application is due August 2, 2018, at noon ET.
    • Health Services Research Pipeline Grant: $50,000 awarded to support research that examines how patients obtain physical therapy-related health care, how much that care costs, and outcomes, with an emphasis on the most-effective ways to organize, manage, finance, and deliver high-quality physical therapy-related care while potentially reducing medical errors and improving safety for patients. Full application is due August 2, 2018, at noon ET.
    • Acute Care Research Grant: $40,000 to an emerging investigator seeking to advance the practice of acute care physical therapy. This grant is made possible by the Academy of Acute Care Physical Therapy. Full application is due August 2, 2018, at noon ET.
    • Paris Patla Musculoskeletal Grant: $240,000 to support research on the musculoskeletal system and manual therapy. This new funding mechanism will award $120,000 per year for 2 years with a possible third year of funding through a competitive renewal, providing funding up to $360,000 over a 3-year period. Investigators at any level are welcome to apply regardless of funding history. A letter of intent is required and is due May 31, 2018, at noon ET. Full application is due August 2, 2018, at noon ET.
    • Pediatrics Research Grant: $40,000 to an emerging investigator seeking to conduct research consistent with the current Academy of Pediatric Physical Therapy research agenda. This grant is made possible by the Academy of Pediatric Physical Therapy. Full application is due August 2, 2018, at noon ET.
    • Geriatric Research Grant: $40,000 to an emerging investigator for research focused on the development of interventions to address mobility in adults 75 years or older (or those 65-70 age range is justified) with multiple chronic health conditions. Full application is due August 2, 2018, at noon ET.
    • Orthopaedic Research Grant: $40,000 to an emerging investigator exploring clinical outcomes of physical therapist practice for patients with musculoskeletal conditions. This grant is made possible by the Orthopaedic Section Endowment Fund. Full application is due August 2, 2018, at noon ET.

    Questions? Email the Foundation, or call 800/875-1378.

    Note: Before starting your funding application, be sure to carefully read all eligibility guidelines, instructions, and information on funding mechanism deadlines. Also, it's a good idea to start the submission process early to allow for potential questions to be answered.

    PTJ: To Avoid Adverse Events, Rehab Facilities Need to Get to the Root of the Problem

    While rehabilitation services are “generally safe,” say Veterans Health Administration (VHA) researchers, “low risk does not mean no risk”—and adverse events still occur. A new study published in PTJ, APTA's scientific journal, outlines several concrete suggestions for improving patient safety that may apply to many civilian rehabilitation facilities.

    When serious adverse events are reported in the VHA, the facility often performs a root cause analysis to identify flawed systems, processes, or environmental conditions that need to be addressed. Authors examined 25 adverse event reports associated with physical therapy, occupational therapy, and speech-language pathology that occurred between 2009 and 2016.

    Researchers found that the most frequent adverse events were delays in care (32%) and falls (28%). Adverse events were most often caused by staff errors in policy and procedures (38.3%) and communications (25.5%).

    Authors also categorized the prescribed action plans as “strong,” “intermediate,” or “weak.” They concluded that 88% of action plans were strong, such as standardizing emergency terminology, or intermediate, such as improving documentation and verbal communication. The majority of recommendations, authors write, included changes in policy and procedures (48.8%) and staff training and education (21.3%).

    Authors' recommendations for mitigating risk of adverse events include:

    • Establishing clear emergency procedures and practicing them “at regular intervals with all staff”
    • Implementing strong actions to avoid adverse events, such as posting signs and standardizing terms for an emergency scenario
    • Ensuring that clinical staff have the skills to recognize “red flag” situations before they become emergencies
    • Using checklists to quickly identify patients at high risk of “deteriorating health” and those with acute illness who need immediate referral to another provider

    “Guidelines are beneficial, but unique clinics will need customized strong actions to optimize patient safety,” authors note. “Rehab departments can strengthen their safety record by developing practices and strong actions to ensure that all staff are prepared for an emergency response.”

    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.

    Researchers Say Frequent TV-Watching Comes With VTE Risk That Can't Be Eliminated Through Physical Activity

    Dedicated binge-watchers take note: a new study has found that in addition to its link to other well-established negative health effects, regular long periods of television viewing can also increase risk for venous thromboembolism (VTE)—and it's a risk that isn't dramatically offset by increased levels of physical activity (PA).

    The study tracked the self-reported television viewing and PA habits of 15,792 participants aged 45-64 over a series of surveys that began in 1987-1989, with follow-ups every 3 years after that, through 2011. Participants were part of the Atherosclerosis Risk in Communities (ARIC) research initiative administered in Washington County, Maryland; Forsyth County, North Carolina; Jackson, Mississippi; and suburbs of Minneapolis. Researchers excluded participants who reported baseline VTE or anticoagulant use.

    Participants were asked to rate their television viewing habits during leisure time as "never," "seldom," "sometimes," "often," or "very often" at baseline, visit 3 (1993-1995), and visit 5 (2009-2011). Researchers also tracked estimates of physical activity using the Baecke physical activity questionnaire, which asks respondents to estimate the duration and intensity of PA during the previous year. Demographic variables and body mass index (BMI) also were recorded. Results were published in The Journal of Thrombosis and Thrombolysis (abstract only available for free).

    For purposes of the study, researchers divided PA responses into 3 levels based on American Heart Association recommendations: "recommended" (75 or more minutes per week of vigorous intensity PA or 150 or more minutes of a combination of moderate and vigorous intensity PA), "intermediate" (up to 74 minutes per week of vigorous intensity PA or up to 149 minutes per week of a combination of moderate and vigorous intensity PA), and "poor" (no reported vigorous or moderate PA). They also reduced television-viewing categories from 5 to 4 after finding that no participant reported "never" watching television. Here's what they found:

    • Among all participants, 18.6% reported watching television "seldom," 46.8% reported watching "sometimes," 26.5% reported watching "often," and 8.1% reported watching "very often."
    • Age, sex, and race-adjusted models showed a positive dose-response correlation between frequency of television viewing and VTE incidence (a total of 691 events during the study period), with participants who watched television very often having a 1.71 times higher risk of VTE than those reporting "seldom" watching television.
    • The relationship of VTE risk to television viewing remained in place despite levels of PA. Participants who reported "recommended" levels of PA and watching television "very often" were found to have a 1.8 times greater risk of VTE than the seldom-watch group—a risk rating not much different from the 2.07 times increased risk associated with the group that reported watching television very often and having no PA.
    • BMI did play a role. Obese individuals who reported watching television "very often" were found to have a 3.7 times higher risk of VTE than normal-weight individuals who reported watching television “seldom.” However, authors note that higher BMI did not explain the associations observed between television viewing and PA.

    The relationship between sedentary behavior and poorer health may be well-known, but authors of this study believe they've added a new dynamic—the inability of PA to counteract the risk for VTE caused by prolonged sitting.

    "These results suggest that sedentary behavior is not just the opposite issue from [PA]," authors write. While they acknowledge that individuals who engaged in more PA did lower their risk of VTE independent of television viewing frequency, the researchers also point out that "even individuals who met the…recommended level of [PA], when they viewed TV very often, had an increased risk of VTE compared with those who met the recommended level and seldom watched TV."

    The results echo findings in a study from 2017 that concluded that risk of a mobility disability increased relative to television-viewing time, regardless of hours spent in PA.

    [Editor's note: for more information on the role of the physical therapist in the treatment of individuals diagnosed with VTE, check out this clinical practice guideline available at PTNow.]

    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.