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  • New in the Literature: Eccentric Strengthening for Achilles Tendinopathy (Am J Phys Med Rehabil. 2012. Oct 5. [Epub ahead of print])

    Eccentric strengthening was more effective than concentric strengthening in reducing pain and improving function in patients with Achilles tendinopathy, say authors of an article published online in American Journal of Physical Medicine & Rehabilitation.

    Thirty-two men with Achilles tendinopathy were assigned to either the experimental group (n = 16) that performed eccentric strengthening or the control group (n = 16) that performed concentric strengthening for 8 weeks (50 minutes per day, 3 times per week). A visual analog scale, isokinetic muscle testing equipment, the side-step test, and the Sargent jump test were used to assess pain, muscle strength, endurance, and functional fitness factors before and after the intervention.

    In comparison with the control group, the experimental group showed significant improvement in pain, ankle dorsiflexion endurance, total balance index, and agility after the intervention. However, there was no significant difference in dexterity between the 2 groups.

    New Podcast: Using Evidence in a Private Outpatient Setting

    In a new podcast titled "Using Evidence in a Private Outpatient Setting," Jason Grandeo, PT, DPT, OCS, shares the 3 main strategies that he and his colleagues at Body Dynamics Inc in Falls Church, Virginia, use to incorporate evidence in practice: monthly journal clubs, grand rounds focused on the hands-on examination and treatment aspect of physical therapy, and Physicians' Information and Education Resource (PIER) summaries. PIER summaries are completed when a physician or other health care provider comes to the facility to discuss an area in which he or she specializes.   

    Grandeo also offers tips for physical therapists who have not yet incorporated evidence in their practice. "Make a pitch for using 1 of the strategies we use, such as a journal club, or doing it as a group. If there is no interest, you may need to ask yourself if you are working at the best place to support your career growth."

    This recording is part of the Research to Practice podcast series, which provides practical information on implementing the use of research as part of evidence-based practice in the physical therapy clinic.

    PT Innovators: Contact Your Chapter or Section for Nomination to Summit

    Are you involved in an innovative model of care delivery such as an accountable care organization or pay for performance? If so, contact your chapter or section and ask your leadership to nominate you to attend APTA's Innovation Summit: 2013: Collaborative Care Models. 

    The Summit will bring together innovators and thought leaders from physical therapy, health policy, payment, and other health professions to explore the role of physical therapists in new models of health care delivery and payment. Participation in the summit will be available to all members through live web streaming. Attendance onsite will be limited to speakers, panelists, and invited attendees, including the member innovators selected through this nomination process.

    APTA sections, chapters, and the Student Assembly are each invited to nominate a member who is involved in an innovative model of care to attend and participate in the Summit, to be held March 7-8, 2013, in the Washington, DC area. A panel of member experts will select 20 member innovators to share their innovative practice models as a part of the Summit. Those selected will receive free registration and a stipend for travel and lodging expenses. Chapters and sections whose nominees are selected will receive special recognition during the Summit.

    The deadline for nominations is Monday, October 22. More information about the Summit is available at www.apta.org/innovationsummit. Components can direct questions about the nomination process to innovationsummit2013@apta.org.

    Stroke Incident Rates for Young Adults Increasing

    In a study of the Greater Cincinnati/Northern Kentucky region, researchers found that the rate of strokes among adults younger than 55 years of age increased from 12.9% in 1993/1994 to 18.6% in 2005.

    Stroke incidence rates in people aged 20 to 54 were significantly increased in both black and white patients in 2005 compared with earlier periods. The investigators also found that the mean age at stroke significantly decreased from 71.2 years in 1993/1994 to 69.2 years in 2005.

    Possible explanations for the increase could be that physicians are detecting strokes in young people more often, both as a result of better imaging technology and more vigilant screenings, says a Reuters Health article.

    "But I really don't think that's the major reason," lead researcher Brett Kissela told Reuters. "We're definitely seeing a higher incidence of risk factors for stroke now."

    With people developing obesity, diabetes, and high blood pressure at a younger age, they also are increasing their risk of stroke at a younger age.

    "This is of great public health significance because strokes in younger patients carry the potential for greater lifetime burden of disability and because some potential contributors identified for this trend are modifiable," the authors write.

    The study is published in Neurology.   

    APTA Seeks Members' Suggestions for Topics for Additional House Proposal Town Halls

    Don't forget to weigh in on the topics to be covered in the next House proposal town halls scheduled for Thursday, October 18, and Tuesday, October 23; 1 session will be offered on each of those evenings at 9:00 pm-10:30 pm, ET. What would you like to discuss? What topic have we missed? Let us know. Suggest ideas via the Additional Thoughts comment blog posted to www.apta.org/governancereview. Contact Amber Neil if you are interested in attending. Can't join a town hall? Have your voice heard via the comment blogs on the following topics: House constituency, House activity, and Resolutions Committee.

    Health Information Breaches Affect 13K Medicare Beneficiaries in 2-year Period

    More than 13,000 Medicare beneficiaries were affected by 14 breaches of protected health information between September 23, 2009, and December 31, 2011, requiring notification under the American Recovery and Reinvestment Act, according to a new report by the Department of Health and Human Services' Office of Inspector General (OIG).

    For the most part the breaches involved beneficiaries' names, Medicare identification numbers, dates of birth, diagnoses, and services received. One breach affected 13,412 beneficiaries. This breach involved a Medicare Summary Notice printing error by a Centers for Medicare and Medicaid Services' (CMS) contractor, which caused the notices to be sent to incorrect addresses. Ten breaches resulted from other mismailings or from loss of documents during transit. In another 2 breaches, beneficiary information was posted online. In the remaining breach, a CMS contractor employee was arrested for stealing beneficiary information.

    Although CMS notified all beneficiaries affected by the 14 breaches, it failed to meet the Recovery Act’s standard for timeliness for 7 of them. Notification letters for 6 of the breaches did not explain how the contractors were investigating the breach, mitigating losses, or protecting against further breaches. Moreover, notification letters for half the breaches, including the largest breach, were missing either the date the breach occurred or the date it was discovered. Notification letters for 3 breaches did not include the types of unsecured protected health information involved, contact procedures for individuals who want to learn more, or steps individuals can take to protect themselves from harm.

    "CMS has made progress in responding to medical identity theft by developing a compromised number database for contractors," says the report. "However, the database's usefulness could be improved."  

    Based on its findings, OIG recommends that CMS ensure that breach notifications meet Recovery Act requirements, improve the compromised number database, provide guidance to contractors about using database information and implementing edits, develop a method for ensuring that beneficiaries who are victims of medical identity theft retain access to needed services, and develop a method for reissuing identification numbers to beneficiaries affected by medical identity theft.

    Commission Calls for Greater Protections of Patient Data in Genome Sequencing

    To realize the promise of whole genome sequencing, scientists and clinicians must have access to data from large numbers of people who are willing to share their private information, say authors of a report issued yesterday by the Presidential Commission for the Study of Bioethical Issues. "This in turn requires public trust that any whole genome sequence data shared by individuals with clinicians and researchers will be adequately protected," they write.

    The commission's investigation found that current governance and oversight of genetic and genomic data varies in its protection of individuals from the risks associated with sharing their whole genome sequence data and information. In particular, a great degree of variation exists in what protections states afford to their citizens regarding the collection and use of genetic data.

    To improve current practices and help ensure privacy and security as the field of genomics advances, the commission offers 12 recommendations, including proposals that clinicians and researchers use robust and understandable informed consent procedures and engage in productive exchanges of those collections of genomic information that are based on such consent procedures. The commission recommends that the federal government facilitate broad public access to the important clinical advances that result from whole genome sequencing. The commission also urges federal and state governments to ensure a consistent floor of individual privacy protections covering whole genome sequence data across state lines, regardless of how the data were obtained.