A groundbreaking plan to jumpstart physical therapist research in health services and health policy is about to take a big step toward becoming a reality. The Foundation for Physical Therapy has announced that is has released its request for applications for a $2.5 million grant to create a “Center of Excellence” (COE) that would serve as a one-of-a-kind center focused on providing physical therapists with the training they need to expand the profession’s research portfolio into underrepresented areas.
The 5-year grant will be awarded to an institution or health systems network to create and oversee the Center of Excellence in Physical Therapy Health Services and Health Policy Research and Training, whose goal is to “develop sustainable research infrastructure and centralized resources to enhance interdisciplinary health services/health policy research by physical therapist scientists,” according to the request document.
According to a recent federal report on the health of Americans, the US is making steady gains in the number of adults who meet guidelines for physical activity, but obesity rates haven’t changed much for any population age group—including children.
The latest findings are included in a progress report on 26 leading health indicators (LHIs) tracked by Healthy People 2020, a federal program that monitors a long list of health objectives. The report compares current LHIs against a baseline as well as goals for the campaign. In the case of adults meeting aerobic physical activity and muscle-strengthening guidelines, the report shows a 2012 rate of 20.6%–up from the 2008 baseline of 18.2% and slightly above the goal of 20.1%.
In a study they describe as the first to incorporate analyses of International Classification of Functioning, Disability, and Heath (ICF) data, researchers make a cautious assertion that for individuals poststroke, the use of virtual reality—including commercially available video game systems—produces “a significant moderate advantage” in ICF outcomes compared with conventional therapies.
The findings were the result of an analysis of 26 randomized controlled trials that focused on the use of virtual reality (VR) to augment or replace conventional therapy in populations largely or solely comprising individuals poststroke. Of the studies analyzed, 4 focused on the use of commercially available gaming platforms such as the Nintendo Wii, while the rest used more specialized virtual environment (VE) equipment designed for rehabilitation. The study was published in the March 28, 2014, edition of PLoS ONE.
In results that even study authors describe as “surprising,” electrical stimulation of the spinal cord accompanied by a home exercise program has helped 4 people with paraplegia regain movement in muscles that had been paralyzed for more than 2 years. The technique, which uses a 16-electrode array implanted on the spinal cord, allowed all 4 patients to regain some voluntary control of previously paralyzed muscles within days of the start of stimulation. The study quickly received coverage from media outlets such as CNN and the Los Angeles Times.
The report, published in the journal Brain, follows up a pilot trial of 1 patient that began in 2009. In that pilot, patient Rob Summers was implanted with the electrodes and engaged in intensive physical therapy using a harness suspended over a treadmill. According to a press release from the National Institutes of Health, which helped fund the study, “with his stimulator active Summers was able to gradually bear his own weight and could eventually stand without assistance from physical therapists for up to 4 minutes.” In addition, other related impairments improved over time absent the stimulation, including bladder control and sexual function.
A recently released report from the federal Food and Drug Administration (FDA) proposes regulating health management health information technology (IT) based on where and how the IT product is used, and not on platforms or product names and descriptions. APTA provided comments on a draft version of the report, which sets the stage for a more nuanced approach to how the government may regulate health IT applications ranging from billing software to robotic surgical control.
The proposed strategy identifies 3 types of health IT functions—administrative, health management, and medical device—and evaluates levels of risk associated with each. Administrative IT functions such as billing and claims processing, inventory management, and scheduling “pose limited or no risk to patient safety and, thus, do not require additional oversight,” the report states. The FDA describes health management IT—applications such as provider order entry, patient identification, and access to clinical results—as slightly higher-risk but still not a particular target for FDA oversight. In fact, the report states, even if a particular product meets the definition of a “medical device,” if its functionality is within the health management area, “FDA does not intend to focus its oversight on it.”
Dry needling is now included in the scope of practice for licensed physical therapists (PTs) in Utah thanks to legislation signed into law by Utah Governor Gary R. Herbert on April 1.
“We are pleased that the Utah Chapter took this legislative action to ensure that physical therapists in the state are able to legally provide the full range interventions within the physical therapist scope of practice,” said APTA President Paul A. Rockar Jr, PT, DPT, MS, in an APTA press release. ”This is a step in the right direction to ensure that all patients have access to the care they need from their physical therapists.”
Making an ethical decision or evaluating the ethics of a colleague’s action requires careful consideration of facts and circumstances that can vary dramatically from one situation to the next. It can be a complicated process for any practitioner, particularly when opinions on ethics can differ, but familiarity with ethical decision-making can help—that’s the thinking behind a reorganized APTA members-only offering that collects all of PT in Motion’s ”Ethics in Practice” articles into one easy-to-access webpage.
The articles, a regular column of the monthly APTA member magazine and written by Nancy R. Kirsch, PT, DPT, PhD, tackle current and complex ethical issues as they appear in real-world practice. APTA’s webpage organizes the articles by topic as well as by their relationship to provisions in the Code of Ethics for the Physical Therapist and Standards of Ethical Conduct for the Physical Therapist Assistant. The page also includes links to articles that guide readers through an ethical decision-making process.
APTA sections have until May 2 to nominate individuals for an association program that will help them develop clinical practice guidelines (CPGs). Successful nominees will be invited to participate in a free July workshop that will address both the big picture and nuts-and-bolts of CPG creation.
The July 23-25 workshop will be held at APTA headquarters in Alexandria, Virginia, and will include a pre-workshop assignment, presentation of a CPG development methodology, and interactive discussion on how to apply the methodology to successfully develop CPGs for the physical therapist profession. This is the third year the association has offered the program.
A new leg brace that is reducing amputations and allowing wounded soldiers to run again was the focus of a recent National Public Radio feature story that included an interview with the physical therapist (PT) involved in the project.
The story, which aired during the March 31 broadcast of “All Things Considered,” describes the success of the IDEO brace, a “deceptively simple” device that is being used on wounded veterans at the Center for the Intrepid facility in the Brooke Army Medical Center near San Antonio, Texas. According to reporter Melissa Block, when used correctly the device allows some wearers to run again, “virtually pain free.”
Whether you call it a “change” or a “clarification,” the fact is this: the Centers for Medicare and Medicaid Services (CMS) is providing more details on skilled maintenance care in the wake of the landmark Jimmo v Sebelius settlement. An article in the April Edition of PT in Motion, APTA’s monthly member magazine, helps to explain the explanations.
In this month’s “Compliance Matters” column, APTA Director of Regulatory Affairs Roshunda Drummond-Dye, JD, writes that the CMS manual updates “shatter the longstanding myth that skilled therapy services can be provided to Medicare beneficiaries only if material improvement in the patient’s condition can be proven.” The column outlines the history of the settlement and the ways in which CMS has revised Medicare manuals to shed light on exactly how maintenance care will be evaluated.