A freak accident left Katherine (Kathy) Wenning unable to move her upper body. She knew she needed medical attention, but she was at her country getaway in Washington, Connecticut -; two hours by car from her home in Manhattan and the New York medical system she trusted. Kathy put her faith in a neurosurgeon and care team at Danbury Hospital to treat her severe spinal cord injury.
Fateful fall leads to unexpected injury
Kathy, 75, was getting ready for bed when she tripped on her clothes and struck her neck on a shelf inside her closet. She lost consciousness and woke up to pain radiating from her neck down to her arms. Kathy’s husband, Michael, found her lying on the floor of the closet unable to move. She just wanted to go to sleep, hoping she would feel better in the morning.
A large study analyzing 107,000 knee replacement surgeries found that African Americans were significantly more likely than white patients to be discharged to an inpatient rehabilitation or skilled nursing facility rather than home care after the procedure. Researchers also found that African American patients under 65 were more likely to be readmitted to the hospital within 90 days of a knee replacement.
The regional database analysis study was published in JAMA Network Open, an open access journal of the American Medical Association, on October 30. It was a collaborative effort among researchers from Hospital for Special Surgery (HSS) in New York City (Michael L. Parks, MD), the University of Alabama at Birmingham (Jasvinder Singh, MBBS, MPH), the University of Pennsylvania (Yong Chen, PhD) and Weill Cornell Medicine/New York Presbyterian Hospital (Said A. Ibrahim, MD, MPH). The study included patients who had elective knee replacement surgery in the state of Pennsylvania between 2012 and 2015.
Unrestricted Direct Access to Physical Therapist Services Is Associated With Lower Health Care Utilization and Costs in Patients With New-Onset Low Back Pain
The message Does unrestricted direct access to a physical therapist (PT) make a difference compared with “provisional” direct access systems that include restrictions such as visit limits and referral requirements for specific interventions? A new analysis of insurance claims records from nearly 60,000 adults across the US says yes.
The study, cosponsored by APTA, reveals that for patients with new-onset low back pain (LBP), seeing a PT first in states with unrestricted direct access resulted in lower health care costs and use compared with patients seeking care in provisional access states. And the differences don’t end there: researchers found that patients in provisional access states who saw a PT first tended to incur higher costs than those who saw a primary care provider (PCP) first, while data from unrestricted direct access states showed relatively equal, if not slightly lower, costs for seeing a PT first compared with PCPs.
One of the top-ranked archers in the country is 36-year-old Matt Stutzman of Fairfield, Iowa. “The last time we looked into it, 1% of archers in the world make a living shooting a bow,” he said.
He’s not bragging – he is really just that good, and has the accolades to prove it. “January of 2010 is when I decided to be the best archer in the world. And by 2011, I had already made the U.S. Team, and by 2012, I went to my first Games, and won a Silver!”
And he did it all with his feet.
Yes – one of the most celebrated archers in the world was born without arms.
“When it first started, it was, ‘Look at this guy without arms!’ And now it’s like, ‘Uggh, Matt’s here,'” he laughed.
A common myth about urinary incontinence (the loss of bladder control or urinary leakage) in women is that surgery is your only option.
Urinary incontinence can happen to women at any age, but is most common in older women. The course of treatment, be it surgical or nonsurgical, is based on the type of incontinence you have and the severity of your symptoms.
The most common types of urinary incontinence are stress incontinence (a condition in which you lose urine during general physical movement or activities like coughing, laughing, sneezing or exercising) and urgency urinary incontinence (an urge to urinate so intense you lose urine before you’re able to get to the toilet, also referred to as overactive bladder incontinence). Many women have a combination of stress incontinence and urgency urinary incontinence, a condition called mixed urinary incontinence.
That latest piece of technology you’re thinking about weaving into your practice? Maybe it should come with a warning label.
This month, PT in Motion magazine takes a look at the ethical issues that new technologies can introduce in physical therapist practice. From seemingly offhand social media posts to the use of voice assistant devices (VADs) such as Alexa to mounting cameras in clinics, experts interviewed for the story explain the ethical considerations that need to be weighed before powering up.
“New Technology: Keeping It Ethical, Keeping It Legal” focuses on 7 general areas of technology: providing online advice, posting photos, VADs, wearable technology, use of cameras, electronic health records, and telehealth. PTs interviewed for the article include APTA Ethics and Judicial Committee Chair Bruce Greenfield, PT PhD, FAPTA; APTA Section of Health Policy and Administration member Robert Latz, PT, DPT, who’s also the section’s representative on the association’s Frontiers in Rehabilitation, Science, and Technology Council; and Nancy Kirsch, PT, DPT, PhD, FAPTA, president of the Federation of State Boards of Physical Therapy and author of PT in Motion‘s “Ethics in Practice” column.
Josh Van Wyngaarden grew up in a military family, traveling all over the world during his father’s 22 years in the Air Force.
“It’s really all I ever knew,” he said. “And I knew I wanted to serve in that way, too.”
The University of Kentucky College of Health Sciences doctoral student was in high school when 9/11 occurred. It moved him to follow in his father’s footsteps by applying for the Air Force Academy, where he studied for four years. Knowing he wanted to pursue a medical career, he ultimately chose the path of physical therapy, earning his doctorate of physical therapy at San Antonio’s Army-Baylor DPT Program.
John Kaczmarczyk’s wife, Noelle, and their son, Dylan, were at home when they heard a thud. They went to investigate the sound and found the alarming cause. John, 58, was unconscious on the floor at the bottom of a flight of stairs with shattered glass around him.
Noelle and Dylan quickly assessed the situation. They suspected John fell backwards while walking up the stairs to take out the recycling. He was breathing and they didn’t see blood at first. Noelle stayed with John and Dylan went to call 911.
Everything that happened next felt like rapid fire to Noelle. Emergency medical services quickly arrived at their home and transported John to the Norwalk Hospital Bauer Emergency Care Center, where the trauma team examined him immediately.
Momentum around better insurer coverage of physical therapy continues to build at UnitedHealthcare (UHC), which announced that it’s moving ahead to expand a pilot project that waives copays and deductibles for 3 physical therapy sessions for patients with new-onset low back pain (LBP). The pilot follows a multiyear collaboration between APTA, OptumLabs®, and UHC.
The program is targeted at UHC enrollees in employer-sponsored plans who experience new-onset LBP and seek care from an outpatient in-network provider. The program fully covers up to 3 visits to a physical therapist (PT) or chiropractor in addition to visits normally covered. When the program was rolled out in June, it was limited to plans sponsored by employers of more than 50 employees in Florida, George, Connecticut, North Carolina, and New York. The expanded pilot, which begins January 1, 2020, will extend to self-funded plans with 2 to 50 employees in Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia.
When it comes to its most talked-about provisions, the US Centers for Medicare and Medicaid Services’ (CMS)final rule for home health payment under Medicare isn’t much of a change from the proposed version released earlier this year, meaning that an entirely new payment system will indeed be rolled out beginning January 1. But other parts of the rule have been tweaked—and in several areas, those tweaks represent wins for the physical therapy profession and the patients it serves in home health settings.
It’s official: PDGM is on for 2020. There wasn’t much debate about whether this would happen, but the final rule eliminates any doubt: the Patient-Driven Groupings Model (PDGM) will be the system under which CMS pays home health agencies (HHAs). It’s a big change, and APTA offers extensive information on the details of the model, but the bottom line is that the PDGM moves care from 60-day to 30-day episodes and eliminates therapy service-use thresholds from case-mix parameters. The system classifies episodes according to a set of 5 major buckets and subsets within those buckets. Patients are assigned a status within the 5 major areas, and within some of those areas they can be assigned to more detailed clinical categories—the combination of categories assigned to a patient generates a particular case-mix grouping. CMS says it will monitor how HHAs are operating under the PDGM, including the provision of therapy services.