About Flex Therapist

FlexTherapist CEUs provides professional online training to Physical Therapists and Physical Therapist Assistants. Our courses are approved by boards throughout the United States for CE renewal. We blog about news and research related to the field of physical therapy that will keep licensed professionals informed.

Exercise Benefits Brains and Blood Flow Changes in Older Adults

Exercise training alters brain blood flow and improves cognitive performance in older adults, though not in the way you might think. A new study published by University of Maryland School of Public Health researchers in the Journal of Alzheimer’s Disease showed that exercise was associated with improved brain function in a group of adults diagnosed with mild cognitive impairment (MCI) and a decrease in the blood flow in key brain regions.

“A reduction in blood flow may seem a little contrary to what you would assume happens after going on an exercise program,” explained Dr. J. Carson Smith, associate professor in the Department of Kinesiology. “But after 12-weeks of exercise, adults with MCI experienced decreases in cerebral blood flow. They simultaneously improved significantly in their scores on cognitive tests.”

Dr. Smith explains that for those beginning to experience subtle memory loss, the brain is in “crisis mode” and may try to compensate for the inability to function optimally by increasing cerebral blood flow. While elevated cerebral blood flow is usually considered beneficial to brain function, there is evidence to suggest it may actually be a harbinger of further memory loss in those diagnosed with MCI. The results of the study by Dr. Smith and his team suggest exercise may have the potential to reduce this compensatory blood flow and improve cognitive efficiency in those in the very early stages of Alzheimer’s Disease.

Full story at NeuroScience News

Magic-themed Therapy May Help Hand and Arm Function in Children with Unilateral Cerebral Palsy, Study Says

A type of intensive therapy that asks children with unilateral cerebral palsy (CP) to learn and practice magic tricks may help improve their hand and arm function and enhance their ability to do everyday tasks, a study reports.

The study, “Upper Limb Function of Children with Unilateral Cerebral Palsy After a Magic-Themed HABIT: A Pre-Post-Study with 3- and 6-Month Follow-Up,” was published in the Journal of Physical & Occupational Therapy in Pediatrics.

Children with unilateral CP have movement limitations mainly on one side of the body, affecting their ability to perform daily activities that require the use and coordination of both hands.

Hand-arm bimanual intensive therapy, or HABIT, is based on the principles of motor learning theory and neuroplasticity through structured, playful, and activity-based tasks involving two hands. HABIT includes motor learning principles of task selection, a structured practice of grading tasks, feedback, and home practice. In this way, children are engaged in fun activities and supportive environments that are different from typical therapy.

Full story at Cerebral Palsy News Today

Systematic Review: LBP Studies Make the Case for Early Physical Therapy

Authors of a new systematic review of 11 studies on low back pain (LBP) have found that despite sometimes-wide variation in research design, a picture of the value of early physical therapy for the condition is emerging—and the results are encouraging.

According to the review, e-published ahead of print in the Archives of Physical Medicine and Rehabilitation, evidence supports the cost-effectiveness and better patient outcomes of early physical therapy over later physical therapy for LBP, and even points to a correlation between early physical therapy and lower rates of opioid prescription overall. As for utilization and costs associated with early physical therapy versus so-called “usual care” (UC)? Early treatment by a physical therapist (PT) adhering to APTA guidelines could make a positive difference there as well, authors say, but that’s a harder question to answer definitively until studies become more uniform in terminology and design.

Full story at APTA

Automated Text Messages Improve Outcomes after Joint Replacement Surgery

An automated text messaging system increases patient engagement with home-based exercise and promotes faster recovery after total knee or hip replacement surgery, reports a study in the January 16, 2019 issue of The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer.

Patients receiving timely texts showed improvement in several key outcomes, including fewer days on opioid pain medications, more time spent on home exercises, faster return of knee motion, and higher satisfaction scores, according to the research by Kevin J. Campbell, MD, of Rush University Medical Center, Chicago, and colleagues. “A chatbot that texts timely, informative and encouraging messages to patients can improve clinical outcomes and increase patient engagement in the early postoperative period after total joint replacement,” Dr. Campbell comments.

Automated Texts Lead to Improved Outcomes of Surgery

The randomized trial included 159 patients undergoing primary total knee or hip replacement. All received standard education, including instructions on home exercises after surgery.

Full story at News Wise

‘Enhanced recovery’ protocol reduces opioid use in spinal surgery patients

A novel “Enhanced Recovery After Surgery” (ERAS) protocol developed by Penn Medicine for patients undergoing spinal and peripheral nerve surgery significantly reduced opioid use. A new study published in the Journal of Neurosurgery: Spine showed that when an ERAS protocol was employed—which optimizes patients’ surgical care before, during, and after surgery, including patient education, post-operative medications, and recovery plans—fewer patients needed pain medications one month after surgery.

Nearly 75 percent of patients at Penn Medicine who undergo spinal surgeries are opioid naïve—patients who are not chronically taking opioids on a daily basis—putting them at an increased risk for dependency following surgery. Previous studies have also shown that up to 7 percent of all patients who undergo spinal surgeries continue to take opioids one year after surgery. Part of the ERAS protocol at Penn includes a personalized, safe, and effective pain management plan to help prevent opioid dependency, which has rapidly become a public health crisis in the United States.

Full story at Medical Xpress

UTHealth enrolls first U.S. patient in novel stem cell trial to treat stroke disability

The first U.S. patient to participate in a global study of a stem cell therapy injected directly into the brain to treat stroke disability was enrolled in the clinical trial this week at The University of Texas Health Science Center at Houston (UTHealth).

“At McGovern Medical School at UTHealth, we have been studying cellular therapies as a novel treatment for stroke over the past 10 years. We are very excited to partner with ReNeuron and enroll the first patient into the PISCES III study,” said Sean I. Savitz, MD, the study’s global principal investigator and professor and director of the Institute for Stroke and Cerebrovascular Disease at UTHealth. “This study represents an important next step in the development of novel cellular therapies for chronic stroke and, to date, is the most advanced clinical trial to determine whether neural stem cells improve recovery in patients chronically disabled by stroke.”

Full story at news-medical.net

Shedding light on spinal cord injuries

Thousands of people worldwide suffer severe spinal cord injuries each year, but little is known about why these injuries often continue to deteriorate long after the initial damage occurs.

Yi Ren, a professor of biomedical sciences at the Florida State University College of Medicine, is making progress in understanding why such significant harm is inflicted in the weeks and months after a spinal injury. In a study published today in the journal Nature Neuroscience, Ren explained how a natural immune system response may contribute to additional injury.

When spinal cord damage occurs, the endothelial cells that line blood vessels are activated to remove potentially harmful material, like myelin debris, from the site of the injury. However, Ren and her team discovered that this process may be responsible for causing further harm.

“The consequences of the effort of endothelial cells to clear myelin debris is often severe, contributing to post-traumatic degeneration of the spinal cord and to the functional disabilities often associated with spinal cord injuries,” said Ren, whose team conducted the study over a period of five years.

Full story at Science Daily

UTHealth enrolls first U.S. patient in novel stem cell trial to treat stroke disability

The first U.S. patient to participate in a global study of a stem cell therapy injected directly into the brain to treat stroke disability was enrolled in the clinical trial this week at The University of Texas Health Science Center at Houston (UTHealth).

“At McGovern Medical School at UTHealth, we have been studying cellular therapies as a novel treatment for stroke over the past 10 years. We are very excited to partner with ReNeuron and enroll the first patient into the PISCES III study,” said Sean I. Savitz, MD, the study’s global principal investigator and professor and director of the Institute for Stroke and Cerebrovascular Disease at UTHealth. “This study represents an important next step in the development of novel cellular therapies for chronic stroke and, to date, is the most advanced clinical trial to determine whether neural stem cells improve recovery in patients chronically disabled by stroke.”

Full story at news-medical.net

New recovery pathway could speed up time to next treatment for pancreatic cancer patients

Pancreaticoduodenectomy, or the Whipple operation, is one of the most complex abdominal surgeries, and is commonly prescribed as a first line of therapy for cancer located within the pancreatic head. It remains the most effective treatment method associated with prolonged survival. The surgery involves removal of parts of the pancreas, bile duct, and small intestine, requiring careful reconstruction of the organs involved. Clinicians at Jefferson have now shown that providing patients intensive care after surgery can help reduce hospital stay and reduce time to eligibility for adjuvant chemotherapy. The prospective, randomized, controlled study was published in the Journal of the American College of Surgeons.

“The trial was so successful that we were able to halt the study early and change our standard practice to providing this accelerated post-operative care to all eligible patients,” said Harish Lavu, MD, Associate Professor of Surgery at Jefferson (Philadelphia University + Thomas Jefferson University) and researcher with the NCI-Designated Sidney Kimmel Cancer Center – Jefferson Health.

Full story at news-medical.net

Study: Physical Activity and Higher Motor Skills Create a ‘Cognitive Reserve’ Even When Brain Pathologies Are Present

New research combining postmortem examination of brain tissue with testing during life has revealed what researchers believe to be an as-yet unexplained connection: higher levels of physical activity (PA) and motor skills seem to create a “cognitive reserve” that buoys cognitive performance during life, even in the presence of Alzheimer’s disease (AD), Lewy body disease, and other brain pathologies associated with dementia.

For the study, published ahead of print in Neurology, researchers examined brain tissue from 454 participants involved in the Rush Memory and Aging Project (MAP). The subjects participated in a battery of annual clinical assessments and agreed to brain donation at the time of death. The clinical tests included 21 cognitive assessments, an analysis of 10 motor abilities, and an estimation of total daily PA drawn from accelerometers worn constantly for 10 days (researchers in this study used only the first 7 days’ data).

Full story at APTA