• News New Blog Banner

  • Lynda Woodruff, Leader in Physical Therapy Education, Dies at 70

    Lynda D. Woodruff (1947-2018)

    Lynda Woodruff, PT, PhD, an educator and trailblazer in the physical therapy profession, died at her home on March 20. The APTA lifetime member was 70.

    Woodruff was a visiting professor at Alabama State University (ASU) and began the transitional doctor of physical therapy program there in 2008. She continued as a consultant until her death. In 2012 ASU established the Baines-Woodruff Endowed Lectureship on Health Disparities to honor Woodruff and Ruth E. Baines, PT, PhD, former assistant chancellor of health sciences for the State University of New York Central Administration.

    Earlier, Woodruff was the founding director and professor in the department of physical therapy at North Georgia College, having retired in 2005. The department was the state university system’s first postbaccalaureate physical therapist education program. In 1971 she received her master’s degree in physical therapy at Case Western Reserve University, and in 1974 she was the first African American to join the faculty in the Division of Physical Therapy at the School of Medicine at the University of North Carolina at Chapel Hill. In 1978 she joined the faculty in Georgia State University’s Department of Physical Therapy, and in 1984 Georgia State awarded her a PhD.

    At the age of 13, Woodruff was 1 of 2 African American students to desegregate EC Glass High School in Lynchburg, Virginia, resulting in the first court-ordered desegregation since the landmark Brown v Board of Education decision in 1954.

    Woodruff would go on in her academic career to direct an award-winning program for minority student recruitment and retention at Georgia State. In 2014 she received the Education Achievement Award from the Physical Therapy Association of Georgia for her exceptional commitment to student learning and growth of the profession, as well as for her work to advance research and evidence-based practice. A member of the APTA Academy of Clinical Electrophysiology and Wound Management, Woodruff made particular strides in that field of practice. She also was a member of the Academy of Physical Therapy Education, a trustee for the Foundation for Physical Therapy, and a Georgia delegate to the APTA House of Delegates, and she served on the House Elections Committee.

    Woodruff was instrumental in establishing APTA’s original Advisory Council on Minority Affairs and the Office of Minority Affairs, and in establishing the Minority Scholarship Fund and the Minority Scholarship Award for Academic Excellence.

    Among Woodruff’s other numerous recognitions were APTA’s Lucy Blair Service Award, the Kellogg Fellowship for International Leadership, the Distinguished Service Award for the (then) Section on Clinical Electrophysiology, designation as a fellow of the American Academy of Physical Therapy, and a gubernatorial appointment to the Georgia State Board of Physical Therapy on which she served for more than 10 years. In 2006, the Georgia Senate declared February 24 as Dr Lynda D. Woodruff Appreciation Day.

    "The profession of physical therapy grieves the loss of Lynda Woodruff, a truly legendary champion for positive change," said APTA President Sharon L. Dunn, PT, PhD. "Dr. Woodruff’s spirit was big and her presence was powerful—a fact evidenced not just in her curriculum vita, but through the stories and successes of those she mentored and inspired, her 'Woody Babies.' Our profession has lost a an important voice, a stalwart advocate for our professional conscience for diversity and inclusion, a driver of clinical excellence in electrophysiological diagnostics, and a matriarch for others’ pursuit of opportunities within the profession and beyond. We will honor Dr. Woodruff’s legacy and her relentless pursuit of 'better' by doing better and being better at all the things for which she dedicated her life and career. Her loss will leave a void in many hearts."

    APTA has issued a statement on Woodruff from Dunn. Additionally an oral history of Woodruff, recorded in 2002, is part of APTA’s archives that association members can check out. Visit the Oral Histories webpage for instructions on borrowing and returning materials.

    Those wishing to make a donation to the APTA Minority Scholarship Fund in honor of Woodruff may make checks payable to "PT Fund," with "Minority Scholarship Fund" noted in the memo line. Checks should be mailed to APTA, 1111 North Fairfax Street, Alexandria, VA, 22314; ATTN: Minority Scholarship Fund.

    Labels: None

    Researchers Say Tai Chi Shows Promise Over Aerobic Exercise for Fibromyalgia

    In brief:

    • Researchers measured outcomes of 226 adults with fibromyalgia divided into 2 groups: 1 group received twice-weekly 60-minute aerobic exercise classes for 24 weeks; the second group received tai chi classes and was further divided into 12- and 24-week program groups, with some participants receiving tai chi once a week and others receiving the class twice a week.
    • At 24 weeks, the twice-weekly, 24-week tai chi group reported the most significant improvement compared with the aerobic exercise group—an average 16.1 point difference on the Fibromyalgia Impact Questionnaire (FIQR).
    • All tai chi groups reported better scores than the aerobic group on secondary outcome measures including global assessment, efficacy, depression, coping, and anxiety.
    • All groups—tai chi and aerobic exercise—reported decreased use of drugs including analgesics, antidepressants, and muscle relaxers.
    • Researchers believe the mind-body approach of tai chi may contribute to its effectiveness and suggest it may be useful in reducing opioid use

    Tai chi may not just be another option in the management of pain for individuals with fibromyalgia— according to authors of a new study, it may actually be a more effective physical activity than aerobic exercise, arguably the most common nondrug treatment approach for the condition.

    In a randomized controlled trial, researchers analyzed the progress of 226 adults with fibromyalgia over a 52-week period. Participants were placed into 1 of 5 groups: an aerobic exercise group that met twice weekly for 24 weeks; a tai chi group that met once a week for 12 weeks; a tai chi group that met twice a week for 12 weeks, and once weekly and twice weekly tai chi groups that met for 24 weeks. The outcomes, measured at 12, 24, and 52 weeks, covered a wide range of areas, but researchers focused on improvements to the fibromyalgia impact questionnaire (FIQR) as the primary outcome. Results were published in BMJ.

    The aerobic exercise group participated in a "closely supervised" group program "consistent with current recommended guidelines of moderate intensity exercises for fibromyalgia," according to authors. That program included an active warm-up with stretching, "choreographed aerobic training" that progressed from low to moderate intensity, and a cool-down involving low intensity movements and stretching. The hour-long sessions were customized to each participant and were adjusted over time to reach training heart rate goals ranging from 67.9% to 79.5% of maximum heart rate. Individuals in the aerobic group also were encouraged to walk 30 minutes daily.

    All tai chi groups received the same Yang-style tai chi instruction, provided by experienced instructors who participated in a training session on protocol and concepts related to fibromyalgia. The only differences were in the frequency and timeline for the 60-minute sessions: once weekly versus twice weekly, and 12 weeks versus 24 weeks. As with the aerobic exercise group and encouragement to walk, tai chi participants were encouraged to engage in tai chi outside of the scheduled classes for at least 30 minutes a day. Both groups were instructed to continue exercise after they completed their programs.

    While researchers mainly were focused on FIQR scores, they also recorded outcomes for secondary measures including depression, global assessment, self-efficacy, sleep, overall health, social support, and physical activity. Physical assessments also were included by way of the chair stand, 6-minute walk test, and balance tests.

    Authors of the study describe participant characteristics—mean age of 52, 92% women, 61% white, with an average reported duration of body pain of 9 years—as balanced among all 5 groups. Likewise, participant baseline treatment expectations were similar.

    Here's what researchers found:

    • At 24 weeks, the combined tai chi groups (once and twice weekly) improved FIQR scores over the aerobic group by an average of 5.5 points on the 100-point scale—a "significantly" different improvement rate, yet one that authors describe as not clinically important. However, when researchers compared groups with similar intensity—the twice-weekly 24-week aerobic group matched against the twice-weekly 24-week tai chi group—the improvement difference rose to an average of 16.2 points on the FIQR scale, doubling the minimum clinically significant difference mark identified by researchers.
    • The 24-week tai chi group recorded greater improvement than the 12-week group in FIQR and depression scores, but those differences tended to fade at the 52-week mark.
    • All groups—tai chi and aerobic—reported lower use of analgesics, antidepressants, muscle relaxants and antiepileptic drugs.
    • All tai chi groups reported significantly better improvements than the aerobic group in several secondary outcomes including global assessment, anxiety, self-efficacy, and coping strategies.
    • Tai chi participants attended 62% of possible classes, compared with a 40% attendance rate among the aerobic group.

    "By improving psychological wellbeing, coping, and self-efficacy, tai chi mind-body exercise may help to bolster confidence of patients with fibromyalgia to engage in behaviors that help them manage their symptoms and to persist in those behaviors," authors write. "Tai chi might also help buffer the negative impact of fibromyalgia on the patients' physical and psychosocial wellbeing."

    Authors note several limitations that may have affected the results. First, they write, patients were aware of their treatment group, and expectations could have produced placebo or nocebo responses. Second, the class attendance rates for both groups were not great, and they differed substantially between the tai chi and aerobic groups. Third, they write, there was a substantial loss of patient reporting due to dropoff as the study progressed, "a common problem in clinical trials of participants with chronic pain." The researchers also acknowledge that tai chi may not be a viable option in many places (their study was conducted in the metro Boston area).

    Authors believe that among the listed limitations, the attendance rate differences also may be interpreted as an indicator of the potential for tai chi as an intervention. "Attendance can be considered part of the intervention, and so part of the benefit of tai chi is that patients are more likely to continue to practice it," authors write. And while both the aerobic and tai chi groups reported decreased use of drugs, authors write that the fact that the tai chi group tended to stick with the program longer suggests that "tai chi, which can address both the physical and the psychological symptoms in chronic pain, could be particularly effective in targeting opioid use and misuse."

    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.

    The Crisis Continues: Opioids in the News, March 2018

    Last week President Trump signed a 2018 budget bill that includes more than $3 billion for opioid efforts. The plan allocates $500 million in grant funding for research on opioid addiction, development of opioid alternatives, pain management, and addiction treatment; $20 million for telemedicine and distance learning in rural areas to help address opioids; and $1 billion among states and American Indian tribes. The spending plan includes wins for other areas of health care, even as some providers and public health experts say it falls short of what's needed.

    But that's just 1 recent development related to the nation's opioid crisis. Here's a brief roundup of other recent opioid-related news reports and stories.

    Opioid Painkiller Is Top Prescription in 10 States
    Hydrocodone/acetaminophen (brand name Norco or Vicodin) is 1 of the most commonly filled prescriptions in the United States, according to an analysis by GoodRx, an online prescription cost service.

    Measuring the Toll of the Opioid Epidemic Is Tougher Than It Seems
    Comprehensive national data on opioid prescribing, treatment, overdoses, and deaths is often incomplete, contradictory, or simply unavailable.

    Americans Take More Pain Pills—but not Because They're in More Pain
    Despite levels of chronic pain similar to Italy and France, researchers say Americans consume 6 to 8 times as many opioid painkillers per capita.

    The Opioid Crisis Is Surging In Black, Urban Communities
    Because African Americans have "historically been less likely" to be prescribed pain medication, it probably protected them from the initial wave of opioid addiction that hit white suburban and rural areas, says a DC physician who treats patients with opioid use disorder. But with the introduction of fentanyl, opioid overdose deaths among black individuals in urban counties are increasing at a faster rate than in suburban and rural areas

    ER Visits for Opioid Overdose Up 30%, CDC Study Finds
    Increases were highest in the Midwest and lowest in the Southeast. The largest state-level increases were in Wisconsin, Delaware, and Pennsylvania, while Kentucky saw a slight decrease.