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  • Budget on the Table Provides Support for Reform of Caps and SGR

    Reform of the caps on outpatient therapy and repeal of the Medicare sustainable growth rate (SGR) payment formula will be part of the 2014 federal budget discussions in a conference committee seeking compromise after disagreements led to a 16-day government shutdown. Amendments to a congressional budget resolution support the authority to "reform or replace" both provisions.

    The conference committee has until December 13 to send a compromise budget to both chambers of Congress—failure to do so will leave unresolved many of the issues that sparked the October 1 shutdown. The shutdown was rooted in largely partisan disagreements over federal spending, disagreements that budget conferees hope to resolve before the December deadline.

    Conference committee members will discuss a budget proposal that allows for substantive changes to be made to limitations on Medicare Part B payments. The legislative language in the budget resolution lends support to SGR and therapy cap reform efforts being reviewed by both the House and Senate. These discussions include finding a permanent path to repeal the Medicare therapy caps and the SGR.

    APTA has been a strong advocate for changes that would end hard caps and put a permanent end to the SGR—an outdated formula that has been temporarily altered by Congress every year in so-called "Doc Fix" legislation. Grassroots efforts to make these changes are now under way and will become a central focus of APTA's advocacy agenda through the end of the year.

    Personal Physical Therapy Success Stories Featured On Move Forward Radio

    Physical therapists (PTs), physical therapist assistants (PTAs), and their patients can tell plenty of stories about the power of physical therapy. Throughout October, in honor of National Physical Therapy Month, APTA is using Move Forward Radio to bring those inspiring stories to a wider audience.

    In today's episode, Linda Conklin, a personal trainer and recreational marathoner from Illinois, and her physical therapist, Patrick Chapman, PT, MS, discuss her incredible recovery from a water skiing accident that broke 2 bones in her left leg and nearly led to the amputation of her foot.

    Last week's episode featured Pam Pelton, a school worker from Kentucky, who after a single dry needling treatment by her physical therapist, Chad Garvey, PT, DPT, OCS, FAAOMPT, CSCS, noticed immediate changes to the range of motion of her surgically repaired shoulder and to her ability to sleep through the night.

    Additional success stories are slated for the coming weeks.

    These Move Forward Radio episodes, which can be streamed online or downloaded as a podcast via iTunes, provide great resources for PTs and PTAs to share with friends and family to create awareness about the benefits of physical therapy.

    Ideas for future episodes can be e-mailed to consumer@apta.org.

    iPods—The Next Tool in Parkinson Disease Treatment?

    A new approach that uses music may improve freezing of gait among patients with Parkinson disease (PD) and can be used as part of an assessment tool to give physical therapists (PTs) and other health care professionals a better understating of symptom severity. Discussion of the new system took place at the 3rd World Parkinson Congress and was reported in Medscape Medical News.

    The system is called Ambulosono, and it uses an app called Gait Reminder in conjunction with motion sensing technology in an iPod Touch. The iPod is strapped to an arm or leg, and the app controls music, which plays or stops based on the quality and synchronization of the patient's stride length, arm swing, and other factors. The system was featured in a YouTube video posted by the University of Calgary in May.

    The app-assisted exercise focuses on areas of the brain that respond to reward-based learning, and patients tend to find that walking exercises become more pleasurable, according to Amulosono developer Bin Hu, MD, PhD. A University of Calgary pilot study of the system cites marked improvement in average daily walking time (from 6.3. minutes to 20.4 minutes) and 10% -30% improvements in stride length and walking speed. The study involved 46 patients who used the system for 320 days.

    PTs also can use the system to assess PD patients, which may be particularly useful in incorporating coordination evaluations with evaluations of gait and freezing. The system is under study at 4 trial sites in Canada.

    PTs and physical therapist assistants (PTAs) are on the front lines of care of patients with PD. APTA has highlighted the PT's role in PD and created a guide at its Move Forward website. An APTA video released in spring of 2013 highlights the ways in which PTs can help patients with PD improve their symptoms.