Patients with TKA Who Receive Outpatient Physical Therapy Soon After Surgery Recover More Quickly Than Patients Who Receive Home Physical Therapy First

In brief:

  • Retrospective cohort study focused on 109 TKA patients
  • One group (87) received outpatient physical therapy beginning within a week of discharge; a second group (22) received 2-3 weeks of home physical therapy before entering an outpatient physical therapy program
  • While 6MWT and KOOS outcomes were the same for both groups at completion of outpatient physical therapy, the home health group took average of 20 days longer to reach benchmarks
  • Authors believe results point to need for patient education and choice; potential cost savings of immediate outpatient physical therapy

A new study finds that when it comes to results, patients who undergo total knee arthroplasty (TKA) and engage in home physical therapy before participating in outpatient physical therapy ultimately wind up doing just about as well as patients who proceed directly to physical therapy sessions. The time it takes them to reach those outcomes, however, is another story.

Full story of outpatient PT after surgery wit TKA vs home PT at APTA

A Better Way Back

According to the Bureau of Labor Statistics, there were 2.9 million non-fatal, recordable injuries in 2015. More than 320,000 involved some type of sprain, strain, or tear; 155,740 involved injuries to the back; and the more than 900,000 of the total cases involved days away from work.

In many cases, these work-related injuries impact not only the worker, but also the worker’s family. A recent study noted in a 2015 OSHA report found that workers in New Mexico, for example, earn 15% less over 10 years than they would have earned, following an injury. The economic costs of these injuries to the United States economy are trending in the same stratosphere as dementia and diabetes. The National Safety Council estimates these type of injuries cost the US economy $198 billion in 2012. This compares to $159 billion and $245 billion for dementia and diabetes, respectively.

Physical therapy rehabilitation is generally effective for injured workers who are not performing manual labor (eg, office work, sales, education, etc), about 80% of the injured population. For the remaining 20%, such as manual laborers, carpenters, ironworkers, roofers, etc, physical therapy rehabilitation often falls short and leaves them unable to return to their occupations.

Full story of work related injuries and PT at PTProducts

From PTJ: Study of 1 Hospital Finds Nearly 16% of Scheduled Physical Therapy Sessions Don’t Happen

In brief:

  • Study focused on a single hospital and reviewed 6,246 scheduled physical therapy sessions
  • Overall, 15.9% of scheduled sessions never occurred
  • Nontreatment was highest on Sundays (33.8%)
  • Authors caution against “quick fixes” such as prohibiting Sunday sessions; assert that PTs need to exercise clinical judgment to schedule when needed

Researchers who tracked a hospital found that, on average, more than 15%–and as many as 1in 3–hospital physical therapy sessions never actually took place, depending on the reason for hospitalization and the day of the week treatment was scheduled. Authors of the study say that’s too many, and if other facilities are facing the same issue, fixing the problem will require hospitals to address their “internal culture and weekend staffing policies” and not just look for quick fixes.

Full story of scheduled PT sessions not happening at APTA

How Technology Is Changing Physical Therapy

Over the last decade, virtually every aspect of health care has been affected by technology in some way. From electronic health records to telehealth, from wearable devices to apps that let you make appointments and refill prescriptions with a few taps, technology has made the delivery of health care more efficient and more effective.

One area that is changing drastically due to technology is physical therapy. While it might seem like some of the innovations in PT are something out of a science fiction movie, they are very real — and making a very real difference in patients’ lives, especially when it comes to reduced healing times and more comfortable care. Technology is allowing physical therapists to deliver better care than ever before, and leading to new advancements beyond what anyone imagined.

Full story on technology changing physical therapy at PTProducts

CMS Considers Upgraded Requirements for Orthotics and Prosthetics Providers

A proposed new rule from the Centers for Medicare and Medicaid Services (CMS) would include qualified physical therapists (PTs) among the providers who could furnish and bill for custom orthotics and prosthetics; however, the CMS definition of “qualified” may have administrative and financial implications for PTs.

The proposed rule, issued on January 11, aims to tighten up requirements around who CMS will work with when it comes to making and furnishing devices ranging from glass eyes to exoskeletal systems and finger orthotics. In addition to an estimated 900 PTs who could be affected by the proposed rule, the provisions would also have an impact on facilities including skilled nursing facilities (SNFs) and rehabilitation agencies.

Full story of CMS and orthotics and prosthetics providers at APTA

Move Forward Radio: Country Music’s Clay Walker Discusses Living With MS

It was just over 20 years ago, and multiplatinum country music star Clay Walker was riding high, on tour with his band, when he experienced a set of symptoms—poor balance, double vision, and what he calls “lazy legs”—that seemed almost funny at first; just some weird, passing thing. On the morning of the last show of his tour, Walker woke up expecting the joke to be over, the symptoms gone. They weren’t.

“That was a scary moment,” Walker said. “But that was when I knew that I should probably get to a doctor.”

It didn’t take long for Walker to learn that he had multiple sclerosis (MS). His first 2 doctors told him that would be in a wheelchair in 4 years, and likely dead in 8. But here it is, 2 decades later, and Walker is still on his feet, still touring, and still living life to the fullest—thanks, he says, to his faith, an excellent physician, appropriate medications, and a mobility “protocol” he learned from his physical therapist (PT).

Full story of Clay Walker’s life with MS at APTA

Home Health Agencies Face New CMS Rules for Participation Starting July 13

The Centers for Medicare and Medicaid Services (CMS) brought its home health participation rule out of the 1990s by issuing its first revision to the rule in more than 20 years. The new rule, set to go into effect July 13, 2017, establishes minimum standards for home health agencies (HHAs) that want to serve Medicare and Medicaid beneficiaries, and includes requirements that CMS hopes will strengthen patient rights, encourage more effective communication between patients and caregivers, and result in better outcomes reporting.

APTA regulatory affairs staff are reviewing the 374-page rule now, and will publish a fact sheet in the coming weeks. In the meantime, here are a few basics on the new rule.

Full story of home health agencies facing new participation rule at APTA

Reintroduced Bill Protecting PTs Traveling With Sports Teams Passes in House – Again

A new year, a new Congress, and, now, new movement on a bill that helps to protect physical therapists (PTs) and other health care providers who travel across state lines with sports teams.

On January 9, the US House of Representatives passed the Sports Medicine Licensure Clarity Act (HR 302) in a noncontentious vote. The legislation aims to provide added legal protections for sports medicine professionals when they’re traveling with professional, high school, college, or national sports teams by extending the provider’s “home state” malpractice and professional liability insurance to any other state the team may visit.

Full story of bill protecting PTs traveling with sports teams at APTA

Computer models could help design physical therapy regimens

After a stroke, patients typically have trouble walking and few are able to regain the gait they had before suffering a stroke. Researchers funded by the National Institute of Biomedical Imaging and Bioengineering (NIBIB) have developed a computational walking model that could help guide patients to their best possible recovery after a stroke. Computational modeling uses computers to simulate and study the behavior of complex systems using mathematics, physics, and computer science. In this case, researchers are developing a computational modeling program that can construct a model of the patient from the patient’s walking data collected on a treadmill and then predict how the patient will walk after different planned rehabilitation treatments. They hope that one day the model will be able to predict the best gait a patient can achieve after completing rehabilitation, as well as recommend the best rehabilitation approach to help the patient achieve an optimal recovery.

Currently, there is no way for a clinician to determine the most effective rehabilitation treatment prescription for a patient. Clinicians cannot always know which treatment approach to use, or how the approach should be implemented to maximize walking recovery. B.J. Fregly, Ph.D. and his team (Andrew Meyer, Ph.D., Carolynn Patten, PT., Ph.D., and Anil Rao, Ph.D.) at the University of Florida developed a computational modeling approach to help answer these questions. They tested the approach on a patient who had suffered a stroke.

Full story of computer models help design PT regiments at Science Daily

Pilot Study Indicates Yoga Improves Quality-of-Life for Pediatric Cancer Patients and Their Parents

With childhood cancer mortality rates falling over the past 4 decades, some researchers say it’s time to take a closer look at better ways of supporting the psychosocial and quality-of-life needs of patients and their families during treatment—including making yoga a part of the mix.

That’s the premise of a preliminary feasibility study that looked at parent and patient receptivity to the idea of including yoga as an adjunct to cancer treatment, and tracked changes to quality of life after an 8-week yoga program. Results were published in Rehabilitation Oncology, the science journal of the APTA Oncology Section.

The research was conducted in 2 parts: first, researchers administered surveys to patients and their parents that aimed to assess willingness and barriers to participate in a yoga program that would take place during treatment visits; in the second phase of the project, patients and their parents participated in an 8-week yoga program, and were asked about quality-of-life issues at baseline and after the program’s completion. To qualify for the studies, patients had to be 8-18 years old, possess a cognitive ability of at least an 8-year-old, and be undergoing cancer treatment during the study period. In addition, parents were required to be able to physically participate in yoga with their children. The first phase of the study involved 20 patients and 20 parents or guardians; the second part of the study included 12 patient-parent pairs.

Full story of yoga for pediatric cancer patients at APTA