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  • New in the Literature: Postacute Care Site on Stroke Outcomes (Arch Phys Med Rehabil. 2013;94(4):622-629.)

    Patients with stroke may make more functional gains if their postacute care includes treatment received at an inpatient rehabilitation facility (IRF), say authors of an article published this month in Archives of Physical Medicine and Rehabilitation. This finding may have important implications as postacute care delivery is reshaped through health care reform, they add.

    Researchers conducted this prospective cohort study at 4 northern California hospitals that are part of a single health maintenance organization. They enrolled patients with stroke (N=222) between February 2008 and July 2010.

    Baseline and 6-month assessments were performed using the Activity Measure for Post Acute Care (AM-PAC), a test of self-reported function in 3 domains: basic mobility, daily activities, and applied cognition.

    Of the 222 patients analyzed, 36% went home with no treatment, 22% received home health/outpatient care, 30% included an IRF in their care trajectory, and 13% included a skilled nursing facility (but not IRF) in their care trajectory. At 6 months, after controlling for variables such as age, functional status at acute care discharge, and total hours of rehabilitation, patients who went to an IRF had functional scores that were at least 8 points higher (twice the minimally detectable change for the AM-PAC) than those who went to a skilled nursing facility in all 3 domains and in 2 of 3 functional domains compared with those who received home health/outpatient care.

    APTA members Alan Jette, PT, PhD, FAPTA, Diane E. Brandt, PT, PhD, and Elizabeth K. Rasch, PT, PhD, coauthored the article.   

    Kansas Improves Patient Access to Physical Therapists

    This week APTA announced in a press release that Kansas became the latest state to improve patient access to physical therapists. Gov Sam Brownback signed HB 2066 into law on March 28, easing burdensome referral requirements that impede timely care from skilled physical therapists. Achievement of direct access in all 50 states has been a longtime and fundamental goal of APTA.  

    Alliance Develops Plan to Prevent and Control Noncommunicable Diseases

    The NCD Alliance has published a detailed response to the World Health Organization's (WHO) draft on a 2013-2020 global action plan on noncommunicable diseases (NCDs). The alliance's 4-point plan includes recommendations on leadership, aim, and scope; principles, objectives, and action points; resourcing and implementation; and measuring progress, reporting, and accountability.  

    The plan says that the absence of a formal mechanism at the global level to catalyze multisectoral action and collaboration on NCDs has been a major weakness in the global NCD response to date. In 2011, the United Nations mandated governments to work with "all relevant stakeholders" to strengthen action on NCDs through effective partnerships, the alliance says.  

    According to a 2010 report from WHO, physical inactivity is 1 of 4 risk factors that contributes to 80% of all NCDs. The other 3 risk factors are tobacco use, the harmful use of alcohol, and poor diet.

    Last year, APTA's House of Delegates adopted Physical Therapists as Expert Providers for Exercise and Physical Activity—recognizing physical therapists as health service delivery providers of choice to prevent or treat NCDs and their related risk factors. The position holds that APTA seeks participation in the development and/or update of physical activity or exercise guidelines for NCDs.