From PTJ: New Recommendations for PT Treatment of Childhood Obesity

Primary care providers, rather than simply prescribing physical activity to young patients with obesity, should involve physical therapists (PTs) who can assess the child’s risk factors and evaluate and monitor the child’s increasing level of physical activity, say authors of a clinical recommendation in Physical Therapy(PTJ), APTA’s science journal.

While children with obesity need to increase their level of physical activity, they also are more likely to have comorbid conditions such as diabetes, asthma, or hypertension, and they also are at increased risk of injury from exercise. The authors, who represent the Belgian Physical Therapy Association (AXXON), present clinical recommendations for “first-line” PTs treating children and adolescents with obesity in a private practice or home care setting.

Full story on PT treatment for childhood obesity at APTA

Survey: Most Older Americans Have 2 or More Chronic Health Conditions

If you’re an American adult 65 or older, it’s more likely than not that you’re being treated for at least 1 chronic health condition, and there’s a good chance you have 4 or more, according to the Medical Expenditure Panel Survey (MEPS).

The new data, presented in a MEPS statistical brief, targets the prevalence and costs of treated chronic conditions among US adults in 2012. It shows that in the 65 and older demographic, it’s less a matter of if an individual in this group has a chronic condition as it is a matter of how many he or she has: nearly 66% of adults 65 and up reported being treated for at least 2 chronic conditions. Just under 1 in 4—23.2%—report receiving treatment for 4 or more.

Overall, 25.9% of all Americans have reported being treated for 2 or more chronic conditions, accounting for 57% of all health care expenditures. When you add in the 18.6% of Americans who have 1 treated chronic condition, the combined group accounts for 77.7% of US health care expenditures. In the report, “expenditures” is defined as “payments from all sources for hospital inpatient care, ambulatory care provided in offices and hospital outpatient departments, care provided in emergency departments, home health care, dental care, prescribed medicine purchases reported by respondents,” and other services such as prescription glasses and medical supplies.

Full story of older Americans and chronic health conditions at APTA

Is Physical Therapy Cost-Effective? It’s Complicated

A new systematic review takes on the question “is physical therapy cost-effective?” and responds with a definitive “it depends.” But the equivocation isn’t about whether physical therapy treatment actually makes a difference in patients as it is about the definition of “cost-effective”—and particularly, whether that definition includes societal costs.

According to authors of the review, e-published ahead of print in the December issue of Physical Therapy (PTJ), APTA’s research journal, there is little doubt that physical therapy improved health in nearly all 18 studies reviewed. But the question of whether the therapy was cost-effective is a little harder to pin down, with authors of this study applying a fairly rigorous definition of “cost-effectiveness” and finding that about half the studies cleared the bar.

Researchers analyzed studies between 1998 and 2014 that compared physical therapy with usual care only, as well as studies that compared physical therapy added to usual care with usual care only. Of the 18 studies, 13 were classified as focusing on musculoskeletal issues, 2 were linked to “internal conditions” (urinary incontinence and intermittent claudication), 2 were related to neurological conditions, and 2 to what authors called “internal medicine” (falls prevention and the intermittent claudication study, which was also included in the internal conditions category). Studies reviewed were limited to only those that included data that would allow for an analysis of cost-effectiveness.

Full story of cost effective Physical Therapy at APTA

Lymphedema Coverage Legislation Now in House and Senate

Expanding Medicare coverage for lymphedema treatment, a change long-supported by APTA, may be closer to reality now that companion bills to that effect have been introduced in the US Senate and House of Representatives.

In early December, Sen Maria Cantwell (WA), along with Sens Chuck Grassley (IA), Charles Schumer (NY) and Mark Kirk (IL), introduced the Senate version of the Lymphedema Treatment Act (S. 2373), a proposal that would expand the range of compression supplies covered by Medicare “that are the cornerstone of lymphedema treatment,” according to a consumer group created to support the legislation. The version introduced in the Senate is companion legislation to a House bill (H.R. 1608) introduced in March by Rep. David Reichert (WA-8). The House bill now has 175 cosponsors.

APTA’s support for the legislation dates to 2014, when association representatives participated in a congressional hearing to educate lawmakers and staff on the bill after its introduction.

Full story of lymphedema legislation at APTA

Keeping PTs in the Workforce May Be Key to Reducing Anticipated Shortage

No matter how you slice the data, there will likely be a growing shortage of physical therapists (PTs) in the coming years. And while there are several moving parts that could affect just how big the shortage will be, authors of a new study believe that keeping PTs from leaving the workforce could have a major impact on reducing those supply gaps.

For the study, e-published ahead of print in APTA’s journal Physical Therapy (PTJ), researchers compared methodologies they used in calculating workforce projections in 2010/2011, 2012, and 2013. Authors describe how changes to elements such as a rise in PT graduates, a decline in the number of PTs failing the National Physical Therapist Exam (NPTE) for licensure, and the increase in the number of insured Americans under the Affordable Care Act (ACA) have an effect on just how significant the shortage of PTs will be through 2020.

But it turns out that the biggest variable may be 1 of the hardest to pin down—exactly how many PTs will be lost to attrition over the next 5 years.

Full story of keeping PTs in the workforce at APTA

Rise in Obesity More About Inactivity Than Caloric Intake

It’s no news that Americans have become more obese during the past 15 years, but a new study adds an interesting perspective—the dramatic gains may be almost entirely due to lack of physical activity, and not an increase in caloric intake.

In an article e-published ahead of print in the American Journal of Medicine, researchers examined data from National Health and Nutrition Examination Surveys (NHANES) administered between 1988 and 2010. Much of what they discovered about rates of obesity, overweight, and abdominal obesity have been well-substantiated, but some twists to the story were uncovered when researchers looked at these data in terms of caloric intake and levels of physical activity.

Full story of inactivity and obesity rise at APTA

Obesity Goes Global

A new study published in the May 29 Lancet reports the results of a worldwide study of obesity and overweight, and found that rates have increased between 1980 and 2013 by 27.5% for adults and 47.1% for children. Although rates vary by region, increases can be found almost everywhere in the world, authors write, and when it comes to the battle against obesity, “no national success stories have been reported in the past 33 years.”

During the 33-year timeframe reviewed, worldwide obesity rates rose from 28.8% to 36.9% in men, and from 29.8% to 38% in women. Children and adolescents also experienced “substantial” increases in obesity and overweight, with developing countries rising from 8.1% to 12.9% in boys, and from 8.4% to 13.4% in girls. Among developed countries, the child and adolescent rates rose from 16.9% to 23.8% of boys, and from 16.2% to 22.6% of girls. Authors defined overweight as BMI between 25 and 30 kg/m2 and obesity as BMI of 30 kg/m2 for adults, and used the International Obesity Task Force definition for children.

Full story of global obesity at APTA

US Diabetes Rates Double in 20 Years, Diagnosis Rates Improve

The “staggering” increase in obesity rates among Americans is the most likely reason behind a near-doubling in the prevalence of diabetes over the past 20 years, according to a new study, which also found “striking differences” in diabetes rates among minorities. On average, about 10% of the adult US population now suffers from the disease—up from 5.5% in 1994.

The findings, which appear in the April 15 issue of Annals of Internal Medicine, point to general improvements in diagnosis rates, with the rate of undiagnosed diabetes estimated at about 11% of total confirmed cases. The study also reports that prevalence of treatment is also more widespread.

Full story of diabetes diagnosis rates improving at APTA

Omron Healthcare Named a Strategic Business Partner

Omron Healthcare Inc, a manufacturer of personal wellness products, has been named a Strategic Business Partner of the American Physical Therapy Association (APTA).

“We are pleased to welcome Omron Healthcare to APTA’s Strategic Business Partners family,” said APTA President Paul A. Rockar Jr, PT, DPT, MS. “It is important to APTA to enhance our business relationships and develop meaningful partnerships with for-profit companies. We are pleased to offer services and marketing opportunities that provide mutual benefits to our partners and APTA.”

In our connected and digital world, consumers want to accurately monitor and track certain aspects of their day-to-day health on and offline. Omron products provide accurate health information that support positive lifestyle changes. The company’s personal wellness products can be used safely and accurately at home.

Full story on the new partner at APTA

Sitting Connected With Heart Failure in Men

The flurry of news and magazine articles last year proclaiming that “sitting is the new smoking” may have been a bit hyperbolic, but apparently there’s at least 1 thing a sedentary lifestyle has in common with tobacco use: increased risk of heart failure in men, even with low to moderate exercise.

The conclusion is drawn from an article (abstract only available for free) recently published in Circulation, the journal of the American Heart Association, and has received wide attention in newspapers and other media. The study focused on lifestyles of 84,170 men aged 45 to 69 and the incidence of heart failure (HF) over time. Researchers found that while high rates of physical activity did reduce risk of HF, low to moderate exercise had less of an impact on HF rates among men who also spent relatively long periods of time sitting.

Full story on connected heart failure at APTA