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  • New Webinar: Reporting Functional Limitations on Claim Forms

    Beginning January 1, 2013, outpatient therapy providers will need to report information about their Medicare patient’s functional limitations on the claim form. This reporting requirement will apply to outpatient physical therapy, occupational therapy, and speech language pathology services provided in hospitals, critical access hospitals, skilled nursing facilities, comprehensive outpatient rehabilitation facilities (CORFs), rehabilitation agencies, home health agencies (when the beneficiary is not under a home health plan of care), and in private offices of therapists, physicians and nonphysician practitioners. A new APTA webinar recording provides information regarding the new functional limitation reporting as you implement the requirement in your practice. Specific information is provided on which new codes to report, documentation, and claims submission. The video can be found on the Functional Limitation Reporting Under Medicare webpage under General Information.  

    BJD Issues Call for Action in Wake of Global Burden of Disease Study

    Following the December 13 publication of the Global Burden of Disease Study 2010 (GBD 2010) in The Lancet, The Bone and Joint Decade (BJD) issued a call for urgent action by the World Health Organization, the United Nations, and by national governments and for explicit plans to respond to the study's results and the new ranking that shows that musculoskeletal conditions have an enormous and growing impact in all regions of the world.

    According to BJD's call to action, GBD 2010 shows that musculoskeletal conditions are the second greatest cause of disability globally. Back pain causes the most disability across the globe, with osteoarthritis showing the greatest increase in the last 20 years.

    GBD 2010 is the largest ever systematic effort to describe the global distribution and causes of a wide array of major diseases, injuries, and health risk factors. The results show that infectious diseases, maternal and child illness, and malnutrition now cause fewer deaths and less illness than they did 20 years ago. As a result, fewer children are dying every year, but more young and middle-aged adults are dying and suffering from disease and injury, as noncommunicable diseases become the dominant causes of death and disability worldwide. Since 1970, men and women worldwide have gained slightly more than 10 years of life expectancy overall, but they spend more years living with injury and illness.

    GBD 2010 includes 7 articles, each containing data on different aspects of the study (including data for different countries and world regions, men and women, and different age groups). Accompanying comments include reactions to the study's publication from World Health Organization Director-General Margaret Chan and World Bank President Jim Yong Kim. The study is described by Lancet Editor-in-Chief Richard Horton, BSc MB FRCP FMedSci, as "a critical contribution to our understanding of present and future health priorities for countries and the global community."

    APTA is a founding member of the United States Bone and Joint Initiative, which is part of the international BJD. 

    New in the Literature: Locomotor Rehabilitation of Individuals With Chronic Stroke (Arch Phys Med Rehabil. 2012, Dec 4. [Epub ahead of print])

    Authors of an article published in Archives of Physical Medicine and Rehabilitation say their study is the first step toward discerning the underlying factors contributing to improved walking performance in individuals with chronic stroke.

    For this study, 27 patients with hemiparetic stroke (17 left hemiparesis, 19 men, age: 58.7 + 13.0 years, 22.7 + 16.4 months poststroke) were stratified based on a walking speed change of greater than (responders) or less than (nonresponders) 0.16 m/s. Paired sample t-tests were run to assess changes in each group, and correlations were run between the change in each variable and change in walking speed.

    The patients participated in a 12-week locomotor intervention incorporating training on a treadmill with body weight support and manual trainers accompanied by training overground walking. Motor control, balance, functional walking ability, and endurance were collected at pre- and postintervention assessments.

    Eighteen responders and 9 nonresponders differed by age (responders=63.6 years, nonresponders=49.0 years) and the lower extremity Fugl-Meyer (responders=24.7, nonresponders=19.9). Responders demonstrated an average improvement in walking speed of 0.27 m/s as well as significant gains in all variables except daily step activity and paretic step ratio. Conversely, the nonresponders demonstrated statistically significant improvements only in walking speed and endurance. However, the walking speed increase of 0.10 m/s was not clinically meaningful. Change in walking speed was negatively correlated with changes in motor control in the nonresponder group, implying that walking speed gains may have been accomplished via compensatory mechanisms.

    APTA member Mark G. Bowden, PT, PhD, is the article's lead author. APTA members Andrea L. Behrman, PT, PhD, FAPTA, and Chris M. Gregory, PT, PhD, are coauthors.

    New Workers' Compensation Resources Now Available

    APTA has developed new workers’ compensation resources for members. The resources include a market basket comparison of maximum fee schedule rates in all 50 states and the District of Columbia, as well as state summaries of workers' compensation regulations pertinent to physical therapy services. The link to the map can be found on APTA's Workers' Compensation webpage.

    If you have any questions, comments, or corrections regarding your state's workers' compensation page, contact advovcacy@apta.org.

    Education Added to Categories Available for PTA Recognition of Advanced Proficiency

    The PTA Recognition of Advanced Proficiency Program now recognizes physical therapist assistants (PTAs) who have achieved advanced proficiency as educators. Eligibility requirements include APTA membership, 5 years of teaching experience with 900 total contact hours of teaching, including 180 hours in the past year; 60 contact hours of continuing education, 45 in topics related to education; excellent references; and evidence of a minimum of 3 volunteer experiences.   

    For complete details and to download application forms, visit APTA's website. The next application deadline is February 1, 2013. 

    CER Projects to Study Rehab for Stroke, Nonsurgical Spinal Stenosis Treatment

    The Patient-Centered Outcomes Research Institute (PCORI) yesterday approved 25 awards, totaling$40.7 million over 3 years, to fund patient-centered comparative clinical effectiveness research (CER) projects under the first 4 areas of its National Priorities for Research and Research Agenda.

    The projects approved for funding include those that will study rehabilitation services for survivors of acute ischemic stroke, nonsurgical treatment methods for patients with lumbar spinal stenosis, and a patient-centered risk stratification method for improving primary care for back pain. Other projects seek ways to improve patient-clinician communication, reduce selected health disparities, and improve the way health care systems operate.

    The projects were approved by PCORI's Board of Governors through a competitive, multi-stage review process that incorporated patients, caregivers, and other stakeholders in the evaluation of proposals. Applications were evaluated on scientific merit, engagement of patients and other stakeholders, methodological rigor, and fit within PCORI's research priorities and research agenda.

    The awards are part of PCORI's first cycle of primary research funding and selected from among nearly 500 completed applications submitted earlier this year.

    Insufficient Exercise a Barrier to Decreasing CVD Deaths

    Poor exercise and eating habits could be the game-changer in the fight against heart disease and stroke deaths, according to the American Heart Association's (AHA) "Heart Disease and Stroke Statistical Update 2013."

    Between 1999 and 2009, the rate of deaths from cardiovascular disease (CVD) fell 32.7%, but still accounted for nearly 1 in 3 deaths in the nation. However, according to projections in the 2013 report, heart health may only improve by 6% if current trends continue. The biggest barriers to success are projected increases in obesity and diabetes, and only modest improvements in diet and physical activity. On a positive note, smoking, high cholesterol, and high blood pressure rates are projected to decline.

    Among heart disease and stroke risk factors, the most recent data show:

    • 68.2% of adults are overweight or obese; 34.6% are obese; 31.8% are normal or underweight.
    • 31.8% of children ages 2-19 are overweight or obese.
    • 32% of adults report no aerobic activity.
    • 17.7% of girls and 10% of boys, grades 9-12, report fewer than 1 hour of aerobic activity in the past week.
    • 13.8% of adults have total cholesterol of 240 mg/dL or higher.
    • 33% of adults have high blood pressure; African-Americans have among the highest prevalence of high blood pressure (44%) worldwide.
    • 8.3% of adults have diagnosed diabetes; 8.2% have undiagnosed diabetes; 38.2% have prediabetes.

    AHA says it plans to focus on population-based ways to improve health factors for all Americans. Some of these include:

    • Working with health care systems to support and reward providers who help patients improve their health behaviors and manage their health risk factors.
    • Working with insurers to cover preventive health services and reward positive health behaviors and medication adherence.
    • Working with the education community to make changes in schools that support healthy diets and physical activity for children.
    • Building comprehensive worksite wellness programs.
    • Building healthier communities with improved access to healthier foods and green space for physical activity.

    "Americans need to move a lot more, eat healthier and less, and manage risk factors as soon as they develop," said Alan S. Go, MD, chair of the report's writing committee. "If not, we’ll quickly lose the momentum we've gained in reducing heart attack and stroke rates and improving survival over the last few decades."

    Free full text of the article is available in Circulation