‘Top 15′ Clinical Trials in Physical Therapy Released by PEDro

The “top 15″ physical therapy clinical trials include 5 trials related to low back pain, and 1 trial on Bell palsy that dates back to 1958, according to a list based on nominations from physical therapists (PTs) around the world.

The list was developed by the Physiotherapy Evidence Database (PEDro), an Australia-based project and collaborative partner with PTNow, in celebration of its 15th anniversary. PEDro solicited nominations from PTs for the clinical trials that had the most impact on the field of physical therapy, then turned over those nominations to an expert panel for final selection.

Full story of top 15 clinical trials at APTA

US Ranks Near Bottom in Level of Trust in Medical Profession; Near Top in Personal Satisfaction With Treatment

It’s accepted wisdom that 21st century Americans generally mistrust Congress but feel good about their own representatives. Apparently, the same seemingly paradoxical views are true for the medical profession, and in a big way—the US ranks near the bottom among 29 countries in level of trust in the overall medical system, and near the top in satisfaction with individual care.

A study published in the October 23 issue of the New England Journal of Medicine reports on polling data that show a dramatic drop in Americans’ confidence in the medical profession between 1966 and 2014. The decline is significant: in 1966, nearly 3 quarters (73%) of Americans expressed “great confidence in the leaders of the medical profession,” but that rate is now 34%.

Full story of trust in medical professions at APTA

New DOT Initiative Aimed at Reducing Pedestrian, Bicycle Fatalities

Americans’ steadily increasing rate of walking and biking is definitely good news—but that healthy shift needs to be accompanied by more attention to safety, according to a new initiative from the US Department of Transportation (DOT).

This fall, the DOT launched “Safer people, safer streets,” an effort to curb a recent uptick in the rate of fatalities among bicyclists and pedestrians, which accounted for 16% of all traffic-related fatalities in 2012.

The initiative will begin with a survey of pedestrian and bicyclists “gaps” across the country—places where safety is compromised by lack of sidewalks or other safety infrastructure. With gaps identified, DOT and its agencies will work with state, local, and private industry partners to help create so-called “road diets” that are more attentive to safe space allocation for pedestrians and bicyclists.

Full story of new DOT initiative at APTA

Cell Transplant Procedure Repairs Severed Spinal Cord

A Bulgarian man whose spinal cord was completely severed has regained limited mobility and feeling in his lower extremities after a surgical procedure that used nerve-supporting cells taken from his nose. Once completely paralyzed in both legs, he can now walk with a walker and drive a car.

According to an article in the Guardian, Darek Fidyka is believed to be the first person to recover from a complete severing of the spinal cord, an injury he sustained in a knife attack in 2010.

Polish surgeons accomplished the recovery by transplanting olfactory ensheathing cells (OECs) from Fidyka’s nose into the severed ends of his spinal cord. The cells connected and allowed nerve impulses to once again travel through the entire spinal cord. The technique was developed by the University College of London’s Institute of Neurology.

Full story of cell transplant to repair spinal cord at APTA

AMA Issues Top 10 Least, Most Competitive States for Insurance

The American Medical Association’s (AMA) latest ratings of health insurance competitiveness across the United States finds that in 17 states, a single health insurer commands 50% or more of the market in each state, and that in 45 states 2 insurers have captured over half or more of each state’s share.

The AMA’s Competition in Health Insurance: A Comprehensive Study of US Markets uses commercial enrollment data from 2012 to create lists of the country’s most and least competitive states for insurance companies, and to assess competitiveness in 388 metropolitan areas.

The 10 least-competitive states are, in order, Alabama, Hawaii, Michigan, Delaware, Louisiana, South Carolina, Alaska, Illinois, Nebraska, and North Dakota. States that have the most competitive markets are, in order, Oregon, Wisconsin, Pennsylvania, New York, Colorado, Missouri, Washington, Ohio, California, and Florida.

Full story of competitive states for insurance at APTA

‘Severe’ Restriction on Compression Devices on Indefinite Hold

A planned change to Medicare coverage of pneumatic compression devices (PCDs) that would have severely restricted patient access to the devices at home has been put on indefinite hold, thanks in part to the efforts of an alliance that includes APTA.

Had it been implemented, the final local coverage determination (LCD) would have imposed restrictions for PCDs that would only allow their use after a 6-month period of “chronic and severe” lymphedema, and would have attached other requirements including the presence of lymphedema into the trunk or chest, the use of manual lymphatic drainage prior to PCDs, and the use of medications. Additionally, the new policy would have denied PCDs to patients who experience any kind of improvement through conservative therapy. The requirements were set to become effective on November 1.

Full story of restrictions on compression devices at APTA

Midterms and Beyond: Find Out What Could Happen on Capitol Hill

A recent APTA Google+ Roundtable now available on YouTube makes one point very clear: while there’s plenty of media attention on which party will control the US Senate after the coming midterm elections, that’s just 1 of several moving parts in Congress that could impact how the physical therapy profession’s legislative priorities are addressed on Capitol Hill.

In a 35-minute video session that covered everything from Senate races to the politics of lame duck sessions, APTA Director of Grassroots and Political Affairs Michael Matlack answered questions about the current political landscape in Washington, and how APTA and its members can continue to influence legislation on issues such as the therapy cap, locum tenens, and direct access.

Full story on physical therapy profession’s legislative priorities at APTA

New Urinary Prosthesis Could be Alternative to Catheterization for Some Women

The US Food and Drug Administration (FDA) has approved a replaceable urinary prosthesis that could free women with impaired detrusor contractility (IDC) from the mobility problems associated with catheters.

The in Flow Intraulrethal Valve Pump is a replaceable device consisting of a sterilized single-use urethral insert, an introducer, an activator, and a sizing shaft. According to a news release from the FDA, the device “draws urine out to empty the bladder and blocks urine flow when continence is desired.”

Patients with IDC are unable to spontaneously urinate, a condition that can result from stroke, spinal cord injury, diabetic neuropathy, or other neurologic disease or injury. Typically patients with IDC must use some type of catheter, and are unable to experience continence.

Full story of new urinary prosthesis at APTA

Exercise Regimen Significantly Decreases Disability in Individuals With RA of the Hand

Tailored hand exercise used as an adjunct to drug regimens can make a significant, cost-effective difference in function and quality of life for individuals with rheumatoid arthritis (RA) of the hand, according to a new randomized controlled trial from the United Kingdom (UK).

In the Strengthening and Stretching for Rheumatoid Arthritis of the Hand study (SARAH), 438 participants representing “the population of people with rheumatoid arthritis in the UK in terms of age and sex” were divided into 2 groups, 1 receiving usual care and the other receiving usual care plus special strengthening and stretching exercises overseen by a physiotherapist or occupational therapist. More than 90% of participants in both groups had been placed on a stable regimen of disease modifying drugs (DMARDs) for at least 3 months before the study, and all continued to take the drugs.

Full story of exercise regimen decreasing disability of RA at APTA

New System Delivers Sense of Touch From Prosthetic Hand

A new development in prosthetic hands is not only restoring a sense of touch to individuals with amputations, but seems to be making a significant impact in reducing phantom limb pain.

Researchers from Case Western Reserve University and the Louis Stokes Cleveland Veterans Affairs Medical Center have found a way to attach sensors to mechanized prosthetic hands that feed touch sensations to nerve bundles in the patient’s arm. The connection allows users to actually feel sensations of pressure and texture—video of the system shows a user picking up and holding a cherry delicately enough between finger and thumb to pluck off its stem without crushing the fruit. Another photo shows a user squeezing toothpaste out of a tube.

Full story of sense of touch with a prosthetic hand at APTA