Resistance Training Effective in Countering Bone Density Loss, but Only When Combined With High-Impact, Weight-Bearing Exercise

Nondrug approaches to preserving bone mineral density (BMD) in women postmenopause can be effective—but only if the training includes high-impact or weight-bearing exercise in addition to progressive resistance training, according to a new meta-analysis of 24 studies.

Researchers analyzed results from the studies—5 controlled trials and 19 randomized controlled trials involving 1,769 women who were postmenopausal—to determine the effects of physical training on bone density, particularly in the spine and hip. Participants were limited to women who did not engage in regular exercise prior to study enrollment, and who were not receiving hormone replacement therapy or antiresorptive treatment. BMD outcomes were measured by way of X-ray or photon absorptiometry.

Full story of resistance training at APTA

New APTA Policy Priorities Leverage the Power of Physical Therapy

The vision is plugged in. Now it’s time to turn on the power.

APTA’s public public priorities for the next 2 years will bring new energy to some longstanding advocacy efforts, new focus on issues that are crucial to the profession, and new approaches to influencing decision-makers, all designed to advance the association’s vision of “transforming society by optimizing movement to improve the human experience.”

The association will focus on 4 major objectives: the positioning of physical therapists (PTs) as integral to collaborative care; the ongoing support of integrity in practice through reduction of fraud, abuse, and waste, and creation of strong state regulatory frameworks; the promotion of the value of physical therapy through support for research, outcome measures, and effective payment models; and the continued effort to increase patient access to care from a PT.

Full story of policy priorities in PT at APTA

Health Care Hiring Will Increase Overall – For Hospitals, Not So Much

After anemic growth over the past 5 years, hiring in health care is predicted to return to boom times in 2015 and beyond—but the future landscape could be very different, with hiring in outpatient facilities, skilled nursing facilities, and home health growing while hospital hiring rates slow.

According to a recent article in Modern Healthcare, predicted increases in health care hiring will be “uneven,” with the growth in hospital-based hiring anticipated to be “modest at best.”

Full story of health care hiring at APTA

Rise in Fall Prevalence ‘Exceeds What Would be Expected’

The prevalence of self-reported falls among adults 65 and older is on the rise, and it’s not just because of an aging American population, according to researchers who analyzed data collected from 1998 to 2010.

Researchers anticipated that if increases in falls prevalence were found, they would be largely due to “changes in age structure of the population”—that is, more and more people getting older and older. What they found surprised them: while prevalence did increase across the board for adults 65 and older from 1998 to 2010, from 28.2% to 36.3%, the largest jumps in prevalence occurred in the lower age brackets.

Full story of rise in falls at APTA

APTA: To Transform Health Care, Insurance Must Empower Consumers, Increase Access to Physical Therapy, Other Needed Services

With the health care landscape evolving into a system built around patient-centered, coordinated care, APTA believes it’s time that insurance laws catch up to ensure that networks provide the kind of coverage that will make this transformation possible.

The association delivered this message by way of comments to a draft managed plan care network adequacy model act developed by the National Association of Insurance Commissioners (NAIC). The model will be a template to help federal and state lawmakers and regulators develop changes to actual laws and regulations.

Full story of the model act at APTA

Direct Access Tops List of Physical Therapy-Related Stories From 2014

Readers of PT in Motion News couldn’t have made it any clearer: the achievement of some form of direct access to physical therapists (PTs) in all 50 states and DC in 2014 was something to remember.

Last week, News asked readers to choose the top 3 physical therapy-related stories from 2014 from a list of 8 contenders. Among the options, “all states achieve some form of direct access to PTs” was selected by nearly 85% of respondents.

Full story of direct access to PTs at APTA

Study: Physical Inactivity Responsible for Twice as Many Deaths as Obesity

A study of 334,000 European men and women over 12 years concludes that physical inactivity is responsible for more than twice as many deaths as obesity, and that even small changes in activity levels can make a significant difference in life expectancy regardless of BMI.

In an article e-published ahead of print in the American Journal of Clinical Nutrition researchers compared individual BMI, waist circumference (WC), and self-reported physical activity (PA) levels with all-cause mortality data for 116,980 men and 217,181 women in Sweden, Denmark, The Netherlands, United Kingdom, France, Germany, Spain, Italy, and Greece. Individuals with baseline heart disease, cancer, or stroke history were excluded from the analysis, as were individuals who were in the top or bottom .5th percentile of the energy intake-to-estimated basal metabolic ratio rate. Researchers then created a 4-level activity designation based on daily kilojoule-per-kilogram rates: inactive (36 kJ/kg), moderately inactive (41 kJ/kg), moderately active (46 kJ/kg), and active (51 kJ/kg).

Full story of physical activity and deaths at APTA

IOM on Board With Sharing Clinical Trial Data, But Sees ‘Significant Barriers’

According to the Institute of Medicine (IOM), there is little doubt that data from clinical trials should be shared easily and widely—but getting to that point is going to take some doing, and no small amount of money.

This week IOM released a report that supports efforts to increase access to data sets from clinical trials as a way to “enhance public well-being by accelerating the drug discovery and development process, reducing redundant research, and facilitating scientific innovation.” The report, which was developed after a call for comment early last year, asserts that the rate of medical advances could increase dramatically, and new ideas for research could germinate at a much faster rate through more easily accessed data.

However, the IOM report—characterized by its authors as “a practical and ethical framework to help stakeholders navigate this complex terrain”—makes 1 thing clear: the devil is in the details.

Full story of sharing clinical trial data at APTA

FDA Approves Electronic Stimulation Device as Obesity Treatment

The US Food and Drug Administration (FDA) has approved a first-of-its-kind weight loss device the uses surgically implanted electrodes to block nerve activity between the stomach and brain.

Called the Maestro Rechargeable System , the new device uses a rechargeable electronic pulse generator that sends intermittent pulses to the trunks of the nerves responsible for signaling whether the stomach feels empty or full. According to an FDA news release, although it’s clear that the impulses block nerve activity, “the specific mechanisms for weight loss due to use of the device are unknown.”

The system was evaluated in a clinical trial of 233 patients with a BMI of 35 or more that recorded weight loss of 8.5% more than a control group after 12 months. According to the FDA, just over half of the participants in the experimental group lost at least 20% of their excess weight.

Full story of electronic stimulation for obesity treatment at APTA

PTNow Blog, Google Hangout Feature EBP in Home Health

Applying evidence to patient care in home health physical therapy is crucial—but overcoming organizational, logistical, and even attitudinal barriers can be challenging. A new Google Hangout featured in the most recent PTNow blog could help physical therapists (PTs) respond to those challenges.

In addition to a discussion of barriers to changing practice to reflect current evidence, the hangout also provides some tips on how to get the message across that go beyond the “here’s a handout” approach.

Full story of EBP in home health at APTA