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COVID-19 has rightfully become the focus of much of the discussion around health care, but interesting findings in other areas have continued to emerge during the pandemic. Here's the second in our roundup series of notable research released over the past few months.

1. Study of Rats Finds Promise in Eccentric Exercise for Injury Recovery
When it comes to muscle recovery after injury, eccentric exercises  did a better job at promoting muscle growth in rats than did concentric exercises, judging by protein markers associated with that growth. (Eccentric movements contract the muscle during lengthening, while concentric movement contracts the muscle during shortening.) Researchers also found "very limited" evidence of fiber damage — one of the arguments against including eccentric exercise. They're calling for more research on human subjects. (Journal of Athletic Training, April 1, 2020)

2, High-Intensity Aerobic/Resistance Exercise Helps Reduce Musculoskeletal Pain, but Not Neuropathic Symptoms, for Individuals With Type 2 Diabetes
Researchers studying the effects of exercise on pain and neuropathic symptoms associated with Type 2 diabetes have concluded that eight weeks of high-intensity combined aerobic and resistance exercise can result in a higher reduction of musculoskeletal pain compared with eight weeks of high-intensity interval training or no exercise. The aerobic/resistance group recorded "significantly greater" improvements on the Nordic Musculoskeletal Questionnaire than did the other two groups (true, or just the HIIT group?), but recorded no significant differences from the HIIT group (and the no exercise group?) on the Neuropathy Total Symptom Score. (Diabetes Research and Clinical Practice, June 2020)

3. Physical Therapy Prescription and Use Still a Relatively Rare Occurrence in Year Before Spine Surgery
A study of 411 beneficiaries of the military health system receiving elective lumbar spine surgery has revealed that during the 12 months before the procedure, only 34.8% had a physical therapy plan of care, and fewer than half that number attended six or more physical therapy visits. The use of opioids, however, was a different matter: More than eight in 10 received at least one opioid prescription in the year leading up to surgery. The study focused on beneficiaries treated at Brook Army Medical Center. (Archives of Physical Medicine and Rehabilitation, May 13, 2020)

4. "Real Life" Cardiac Rehabilitation Programs Reduce Risk Factors After One Year
It's widely accepted that cardiac rehabilitation for patients with myocardial infarction reduces risk factors in clinical trials, but researchers from Sweden wanted to find out if those benefits held true in "real-life" CR exercise programs, and if the more widespread use of statins, ACE inhibitors, and percutaneous coronary interventions have made those differences in risk reduction less dramatic. They found that attendance in an exercise program (SWEDEHEART) did in fact have an impact: After one year, compared with non-attenders, participants recorded a higher rate of smoking cessation, greater rates of physical activity outside the program, and lower triglyceride levels. In addition, male attenders reported gaining less weight, and women attenders achieved better lipid control. (PLOS ONE, May 11, 2020)

5. Clinical Practice Guideline on Physical Therapy After Concussion/Mild TBI Released
The APTA academies representing the specialty areas of orthopaedic, sports, physical therapy, and pediatric physical therapy collaborated to create a clinical CPG that provides specific guidance for PT management of concussion and associated impairments. Recommendations are graded for the strength of evidence, and they address diagnosis, screening for emergency conditions, examination for motor function impairments, and implementation of progressive aerobic training, among other areas. (Journal of Orthopaedic and Sports Physical Therapy, April 2, 2020)

6. New Guidelines Support Physical Therapy's Role in Management of Huntington Disease
A mixed-method systematic review yielded evidence to support physical therapy's ability to improve motor impairments and limitations in individuals with HD, and researchers have used those findings to establish "specific recommendations to guide clinical practice." Among the recommendations most strongly supported were gait training and exercise (with or without resistance training) to improve motor function. Exercise function was found to improve balance but not found to reduce fall frequency. (Neurology, February 4, 2020)

7. Medicare Benficiaries Receive Few Home Health Rehab Visits
This study looked at the trend toward discharging Medicare beneficiaries to home instead of a postacute care facility after recovery from a critical illness and found low rates of rehab visits. The analysis of 3,176 beneficiaries who were discharged home after recovering from an ICU stay of longer than 24 hours revealed that one-third received no rehab visits during home health care. Individuals with the highest disability at baseline received 30% more visits than did those with the least disability. Those with more comorbidities tended to receive 11% fewer visits, as did those who lived alone. Individuals in rural areas received 6% fewer visits. (Journal of the American Geriatrics Society, March 18, 2020)


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