APTA joined representatives from several major health care organizations Tuesday on Capitol Hill to participate in a panel briefing on what the expiration of Medicare extenders will mean to health care for patients and providers in rural areas. The briefing was sponsored by the American Hospital Association and hosted by Reps Cathy McMorris Rodgers (R-WA) and Mike Thompson (D-CA).
"The therapy cap has a disproportionate impact on older, more chronically ill beneficiaries and those from underserved areas, including rural areas," said APTA Senior Government Affairs Director Mandy Frohlich in remarks delivered Tuesday on behalf of the association. She went on to say "data indicates that there is a higher prevalence of chronic disease in rural areas, and beneficiaries with chronic conditions are most likely to hit the therapy cap."
APTA believes that extension of the therapy cap exceptions process into 2013 is imperative if patients are to continue to have access to the vital care they need. However, the real fix is in reform of the payment system. APTA has begun crafting a reformed payment system for outpatient physical therapy services that it believes will strike a balance between ensuring access to services while improving accuracy of payment.
"The impact of this briefing was significant as more than 100 Hill staff were in attendance," said APTA Vice President of Public Policy, Practice, and Professional Affairs Justin Moore. "APTA represented the more than 40 organizations involved in the therapy cap coalition and continues to serve as the leader on this issue and in the rehabilitation community."
Two systematic reviews by Frank et al published in the May issue of Journal of Rehabilitation Medicine provide an overview of the effectiveness of conceptual approaches, additional therapies, and basic techniques used in lower limb physical therapy in children with cerebral palsy (CP).
For both systematic reviews, the authors searched 5 electronic databases, extracting literature published between 1995 and 2009. Studies were evaluated using the framework recommended by the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM), which classifies outcomes according to the International Classification of Functioning, Disability and Health (ICF). Three independent evaluators rated the strength of evidence of the effects according to the AACPDM levels of evidence classification, and the quality of the studies according to the AACPDM conduct score system.
One systematic review included 37 studies that used conceptual approaches (neurodevelopmental treatment [NDT], conductive education, Vojta therapy, sensory integration, functional training and goal-oriented therapy) and 21 studies that focused on additional therapies (aquatic therapy and therapeutic horseback riding). Level II evidence was found for the effectiveness of therapeutic horseback riding on posture and for NDT and functional training on gross motor function. Goal-oriented therapy and functional training were effective on the attainment of functional goals and participation. With level IV evidence, NDT was effective on all levels of ICF. (J Rehabil Med. 2012;44:396-405.)
The other systematic review examined basic techniques and included 83 studies divided into the following categories: stretching; massage; strengthening; electrical stimulation; weight-bearing; and balance, treadmill, and endurance training. Interventions targeting problems at body function and structure level generally influenced this level without significant overflow to activity level and vice versa. The more recent studies evaluating strength training mainly demonstrated level II evidence for improved gait and gross motor function. There was limited evidence for specific information on intensity, duration, and frequency of training. (J Rehabil Med. 2012;44:385-395.)
(Bonita) Lynn Beattie, PT, MPT, MHA, vice president of Injury Prevention at the National Council on Aging (NCOA), and lead for the National Falls Free© Initiative, represented APTA at the 2012 Transforming Fall Management Practices Conference, May 22-24. Beattie welcomed 191 attendees on behalf of APTA and its more than 80,000 members. She noted the growing activities of the 70-member NCOA-led Falls Free© Coalition, of which APTA is an active member, and of the 41 state coalitions on falls prevention. Beattie pointed out APTA's strong focus in the area in falls prevention and that it would devote 3 days of programming to falls prevention during PT 2012 in Tampa. She also acknowledged that many state chapters are similarly engaged with their state coalitions in promoting awareness, education and training of providers, and investment in evidence-based interventions that link health care providers to community resources and falls prevention programs. Beattie invited attendees to join their state and local coalitions.
The annual conference, held in Clearwater, Florida, is provided by the VISN 8 Patient Safety Center of Inquiry and the Tampa Veterans Administration Research and Education Foundation. Sponsoring organizations included APTA, Gainesville Geriatric Research Education and Clinical Center, and the National Center for Patient Safety.
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