Thirty percent increase in risk of fracture after gastric bypass

A study published in the Journal of Bone and Mineral Research shows that the risk of fractures increases by about 30 percent after a gastric bypass operation. It was also discovered that falls increase after these operations.

“Gastric bypass is a well-established method that has proven effective in reducing obesity, diabetes and mortality, so naturally our findings do not mean that you should stop providing these types of operations,” says Mattias Lorentzon, professor of geriatrics at Sahlgrenska Academy, University of Gothenburg, Sweden, and Chief Physician at the University Hospital.

The study is based on the records of 38,971 patients who underwent gastric bypass operations, of which 7,758 had diabetes and 31,213 did not. Those who had had the operation were compared with an equally large group of individuals who had not been operated on and who had the equivalent morbidity and background data.

Full story at Science Daily

Animations prove effective in accurately measuring pain

To improve communication about pain between patients and physicians, a team led by researchers from the University of Pittsburgh and UPMC has developed a mobile application called “Painimation” that has the potential to assess and monitor pain better than any previously used measurement tools. Results of the clinical trial were published today in the Journal of Medical Internet Research.

“Currently, our only available tools for patients to communicate their pain is to either give them 0 to 10 scales or a selection of words and phrases to describe their pain, methods that have been used for more than 50 years,” said lead author Charles Jonassaint, Ph.D., M.H.Sc., assistant professor of medicine, social work and clinical and translational science. “Many pain patients will say their pain can’t be measured on the 0-to-10 scale and that it is too challenging to describe their pain using words. As a result, their pain is misunderstood and patients in pain may be prescribed more opioids without always knowing whether they are needed or if they are working.”

Painimation is an electronic assessment tool that uses animations to assess pain quality, type and location. With this app, patients are first provided with a selection of animations that they can use to describe the severity of their pain. These animations can then be increased or decreased in speed, color saturation, focus and size to accurately match their pain experience. The app also provides users with the opportunity to label their pain on a human body, allowing them to identify where and how much of their body is affected by pain.

Full story at Science Daily

Goal Setting in Rehabilitation: What do Patients Think?

We recently finished another round of our increasingly popular Volunteer Orientation Course. As part of the final assignment members were tasked to write an original piece of work to share with the profession, the contributions were of the highest quality. Below is the great piece of work written by  Lauren Lopez.

Goal setting. SMART goals. Client-centred goals. Goal setting and the best way to do it are hot topics in rehabilitation. A quick search through rehabilitation literature reveals a growing body of literature dedicated to the methods and evidence for goal setting with clients during rehabilitation. There is no consensus on a gold standard for a method of goal setting but it is widely held that it is a priority for guiding rehabilitation interventions toward achievable and meaningful outcomes. In the absence of a gold standard there are many research reports documenting health professionals’ opinions on and approaches to goal setting we can refer to. But what about our clients’ perspectives?

Full story at Physiospot

From PT in Motion Magazine: How to Defend Yourself Against Scams and Cyberattacks

As technology and information sharing evolves at a rapid pace, it becomes harder to keep up with criminals and scammers—even if you are an experienced professional. Last year, a staggering 83% of physicians said they had experienced some form of cyberattack, according to an American Medical Association report. What kind of scams are out there? What should you be wary of? What new threats are emerging?

A feature in this month’s PT in Motion magazine describes common cybercrimes and scams, including data breaches, phishing, and ransomware. Author Katherine Malmo reports that cyberattacks happen to more organizations than we might think, since people don’t want to share their experiences. Robert Latz, PT, DPT, told PT in Motion, “The question is less if there will be a breach and more what to do when the breach happens.”

Full story at APTA

SNF, IRF Final Rules Follow Through on Proposed Shifts in SNF Payment Systems, IRF Reporting Requirements

The final 2019 rules for skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs) are substantially similar to what the Centers for Medicare and Medicaid (CMS) proposed in the spring, but that’s not to say physical therapists (PTs) should assume it’s a “same rule, different year” situation.

In fact, the situation is far from a “same as usual” scenario—at least for PTs in SNF settings, who will be facing a dramatic change in how payment is determined.

The new rules, set to go into effect in October of this year, include increases in payment of 2.4% for SNFS and 0.9% for IRFs, but the heart of the changes have less to do with payment increases and more to do with how payment will be determined and what needs to be reported. For PTs in IRFs, the reporting process could become a bit less burdensome, while PTs in SNFS will need to get up to speed with an entirely new payment system that does away with the Resource Utilization Groups Version IV (RUG-IV) process.

Full story at APTA

How long will my hip or knee replacement last?

For people considering hip or knee replacement surgery, it’s something they want — and need — to know.

In the US alone, surgeons perform more than 600,000 knee replacements and about 330,000 hip replacements each year. These operations can provide a major improvement in quality of life and function for those with severe arthritis. On the other hand, there are risks associated with the operation (as is true for any major surgery), there is a long road to recovery even when all goes well, and these operations aren’t cheap. For knee replacement surgery alone, an estimated $9 billion or more is spent each year in the US (although economic analyses suggest the surgery may actually be cost-saving over the long run).

So, if the first joint replacement is unsuccessful for some reason (such as infection or loosening), a second (or even third) operation may be necessary. And that’s a big deal, especially since “revision surgery” is technically more difficult, recovery can take longer, and success rates may be lower than first operations.

Full story at Harvard Health Edu

Aggressively lowering blood pressure could reduce risk of developing dementia, study finds

The medical mantra that “what’s good for the heart is good for the brain” got more support Wednesday.

Aggressively lowering blood pressure in people at high risk for heart attacks and stroke also reduced their likelihood of developing mild cognitive impairment, a condition that often leads to dementia, a new study found.

“This is the first intervention ever to be shown to reduce the risk of MCI,” said Jeff Williamson, who helped lead the study and who co-directs the Alzheimer’s Research Center at Wake Forest University in Winston-Salem, North Carolina.

Patients treated to reduce their systolic blood pressure – the top number in a blood pressure reading – to 120 mm Hg were 19 percent less likely to develop mild cognitive impairment than those whose blood pressure was targeted to 140 mm Hg.

Full story at USA Today

APTA Helps Create New Grant Opportunities for PTs

A new “mini grant” project aimed supporting implementation of a self-directed and group intervention program for adults living with arthritis is now accepting applications. The grants of at least $2,000 each are available to individual physical therapists (PTs) as well as APTA state chapters. APTA is a cosponsor of the program.

The grants will be awarded to successful applicants who propose ways to implement the “Walk With Ease” (WWE) program either directly or in partnership with an external agency. Developed by the Arthritis Foundation, WWE is a community-based walking program based on group walking sessions and pre-walk discussions held multiple times per week. The initiative is a US Centers of Disease Control and Prevention (CDC)-recommended physical activity program.

Grantees are expected to recruit at least 200 participants and work to ensure all participants complete 100% of the intervention by September 29, 2018, the end of the 3-month project period. Selected applicants can anticipate an average award of $2,000, although the number of awards is contingent on the availability of federal funds.

Full story at APTA

What You Need to Know About Pelvic Floor Dysfunction

THE WOMAN, A LAWYER IN her 30s, was desperate when she went to New York City-based physical therapist Isa Herrera. The patient, Nancy (U.S. News is not identifying the woman by her real or full name to protect her privacy) was suffering from terrible pelvic pain while sitting and when she had sexual intercourse – and her wedding was a few months away.

Nancy’s doctor had given her injections of the numbing agent lidocaine in her pelvis. Nancy had also applied lidocaine on the labia of her vagina. On the advice of her doctor, the woman was on eight medications, including OxyContin, the powerful opioid painkiller. But the prescription drugmade her constipated and didn’t relieve her pain, Herrera says.

Nancy is suffering from pelvic floor dysfunction, a group of conditions, also known as pelvic floor disorders, that affect the pelvic floor, says Dr. R. Mark Ellerkmann, director of urogynecology, Weinberg Center for Women’s Health and Medicine at Mercy Medical Center in Baltimore. (A urogynecologist is an obstetrician-gynecologist who’s completed specialized training in treating women with pelvic floor disorders.) About 25 percent of women age 20 or older suffer with a pelvic floor disorder or disorders, he says. The ratio of women who suffer from a pelvic floor disorder goes up with age. For example, about 40 percent of women between ages 40 and 50 have pelvic floor dysfunction, and the figure rises to more than 50 percent for women age 60 and above, says Dr. Felicia L. Lane, division director of the female pelvic medicine and reconstructive surgery fellowship program and vice chair, department of obstetrics and gynecology at UC Irvine Medical Center in Orange, California. Men suffer from pelvic floor dysfunction at a lower rate, experts say.

Full story at US Health News

BuzzFeed Features Physical Therapy ‘Success Stories’

How about a little good news? Specifically, how about a little good news from patients who credit physical therapy and their physical therapists (PTs) for transforming their lives?

Recently, BuzzFeed published “9 Physical Therapy Success Stories That’ll Make You Choke Up A Bit,” a collection of first-person accounts from patients who faced a range of issues including spine facture, labrum tears, recovery from a coma, and interstitial cystitis. The reason for the project, according to BuzzFeed, was to “inspire others who are currently recovering from pain, injuries, surgery, or other problems.

Full story at APTA