Category: Health

Majority of hospitalized patients with advanced cancer have functional impairment

New research from Mass General Cancer Center, published in the June 2020 issue of JNCCN–Journal of the National Comprehensive Cancer Network, found 40.2% of hospitalized patients with advanced, incurable cancer were functionally impaired at the time of admission, meaning they needed assistance with activities of daily living (ADLs) like walking, bathing, getting dressed, or other routine tasks. Patients with functional impairment also had higher rates of pain, depression, and anxiety, and were more likely to have longer hospital stays and worse survival.

“We are also actively exploring interventions to help patients transition from the inpatient to the outpatient setting, which we have identified as a key challenge for patients with functional impairment,” added senior researcher Ryan D. Nipp, MD, MPH, Mass General Cancer Center.

“Future work is needed to develop novel models of care to enhance access to palliative care services and address barriers that limit appropriate access to palliative care among patients with advanced cancer.”

Full article at News Medical

CEUs for Physical Therapists, Physical Therapist Assistants, and Occupational Therapists

After Heart Attack, Home Care Can Prevent a Return to Hospital

Receiving home health care reduces heart attack survivors’ risk of hospital readmission after discharge, a new study finds.

In the United States, only a small percentage of heart attack survivors receive home care such as nursing and physical therapy, according to study authors.

The findings were presented recently at a virtual American Heart Association meeting. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

“Little is known regarding the impact of home health care on heart attack patients,” lead author Muhammad Adil Sheikh said. “Since patients who receive home health care tend to be older and sicker than others, and these characteristics themselves can lead to hospital readmission, we wanted to investigate the impact of home health care alone on readmission.”

Full article at US News

CEUs for Physical Therapists, Physical Therapist Assistants, and Occupational Therapists

New framework for assessing and managing people with serious spinal pathologies

Rehabilitation clinicians and other health care professionals now have a framework for assessing and managing people who may have serious spinal pathologies. Detailed in a position statement about red flags for serious spinal injuries and disease, this new guidance for clinical practice was developed for the International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) and published online this month in the Journal of Orthopaedic & Sports Physical Therapy® (JOSPT®).

IFOMPT drew on the expertise of 100 experts from 19 countries to synthesize current research and reach consensus on the framework. Seventy clinicians from 13 countries, supported by patient partners, reviewed the information and approved the final version of the framework and its decision tools.

The framework covers four serious spine pathologies: cauda equina syndrome, compression of the nerve roots at the base of the spinal cord; spinal fracture, which accounts for the largest number of serious pathologies of the spine; spinal malignancy, which includes cancers that have spread from a primary cancer site to bone; and spinal infection, which includes infectious disease affecting spinal structures. For each pathology, decision tools summarize the red flags; outline the risk factors, symptoms, signs, and initial investigations; and offer a series of scenarios illustrating how red flags may raise suspicion of that condition.

Full article at News Medical

CEUs for Physical Therapists, Physical Therapist Assistants, and Occupational Therapists

PTs, PTAs Could Be ‘Exempted’ From Receiving Additional COVID-19 Leave

Emergency paid sick leave and expanded family and medical leave provisions will be implemented broadly in response to the COVID-19 pandemic, but PTs, PTAs, and other health care providers employed in certain settings can be prevented from receiving the additional relief if their employers say so: That’s how the U.S. Department of Labor has laid out its plans for implementing the Families First Coronavirus Response Act signed into law on March 18. The exemption provisions could also be applied to first responders.

At issue is a requirement in the Families First Act that employers with fewer than 500 employees provide up to 80 hours of paid sick leave and additional FMLA leave related to COVID-19—and in particular, instances in which an employer would have the option to exempt employees from the extra leave provisions. In health care, DOL is allowing that option to be exercised by employers from a list of health care settings, to be applied on a case-by-case basis to any of their health care providers.

For the physical therapy profession, the term “health care provider” is key, because PTs and PTAs fall into that category for purposes of the rule.

Full article at APTA

Physical Therapists, Physical Therapist Assistants, and Occupational Therapists

Virtual PT after knee replacement provides good outcomes with lower costs

A virtual system for in-home physical therapy (PT) provides good outcomes for patients undergoing rehabilitation following total knee arthroplasty (TKA) – with lower costs than traditional in-person PT, reports a study in the January 15, 2020 issue of The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer.

“Relative to traditional home or clinic PT, virtual PT with telerehabilitation for skilled clinical oversight significantly lowered three-month health-care costs after TKA while providing similar effectiveness,” according to the clinical trial report by Janet Prvu Bettger, ScD, of Duke University, Durham, N.C., and colleagues.

Ready full article at News-Medical.net

Study finds dopamine, biological clock link to snacking, overeating and obesity

Coinciding with this increase in weight are ever-rising rates of heart disease, diabetes, cancer and health complications caused by obesity, such as hypertension. Even Alzheimer’s disease may be partly attributable to obesity and physical inactivity.

“The diet in the U.S. and other nations has changed dramatically in the last 50 years or so, with highly processed foods readily and cheaply available at any time of the day or night,” Ali Güler, a professor of biology at the University of Virginia, said. “Many of these foods are high in sugars, carbohydrates and calories, which makes for an unhealthy diet when consumed regularly over many years.”

In a study published Thursday in the journal Current Biology, Güler and his colleagues demonstrate that the pleasure center of the brain that produces the chemical dopamine, and the brain’s separate biological clock that regulates daily physiological rhythms, are linked, and that high-calorie foods — which bring pleasure — disrupt normal feeding schedules, resulting in overconsumption. Using mice as study models, the researchers mimicked the 24/7 availability of a high-fat diet, and showed that anytime snacking eventually results in obesity and related health problems.

Read full article at Science Daily

Earlier falls predict subsequent fractures in postmenopausal women

The risk of fracture in postmenopausal women can be predicted by history of falls, according to new findings from the Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) at the University of Eastern Finland. Published in Osteoporosis International, the study is the first to follow up on the association between history of falls and subsequent fractures.

Falls in the elderly are common, resulting in fractures and other serious health consequences. In people aged 65 years or over, falls are the leading cause of injury-related death and hospitalisation. Fall-induced injuries cause a substantial economic burden worldwide.

Conducted at the University of Eastern Finland and Kuopio University Hospital, the study comprised 8,744 women whose mean age at the beginning of the study was approximately 62 years. The study started in 1999 with an enquiry asking the study participants about their history of falls in the preceding 12 months. The researchers wanted to know how many times the study participants had fallen, what had caused the falls and how severe the falls had been; i.e., did they lead to injuries that required treatment. A follow-up enquiry was conducted in 2004, asking the study participants about any fractures they had suffered during the five-year follow-up. The self-reported fractures were confirmed from medical records.

Read full article at Eureka Alert

A key-hole procedure to treat foot and ankle disorder decreases pain, improves patient outcomes

A minimally invasive procedure to treat a common foot and ankle disorder can reduce pain, recovery time, and postsurgery complications while improving functional outcomes, according to a report published in the journal Foot and Ankle Surgery.

The procedure treats insertional Achilles tendinopathy, a common and chronic orthopedic disorder in which patients experience pain at the Achilles tendon. The chronic degenerative condition can be particularly painful for athletes who perform push-off activities, such as basketball and soccer players.

The key-hole procedure, known as percutaneous Zadek osteotomy (ZO), can significantly decrease pain and provide a patient with relief in as little as six weeks after this technique compared to 23 weeks for recovery after the traditional open surgery.

Full article at News-Medical.net

5 Reasons Why I Love Working in a Military Health System

I’m a physical therapist (PT) at Walter Reed National Military Medical Center (WRNMMC), and I love my job.

I didn’t start my career in the military health system (MHS). I worked in a civilian outpatient physical therapy clinic like a lot of physical therapists do, and then began working at WRNMMC 2 years ago. I have to say that it has been an eye-opening experience for me. What I want to do in this post is to break down the 5 reasons why I love working in the MHS. They revolve around 2 things: our patients, and the autonomy PTs have in taking care of them.

  1. The patient population: As a PT working at WRNMMC, I see a diverse group of patients. We see active duty service members, beneficiaries of service members, and retirees. The variety of patients, in turn, allows me to see a wide variety of diagnoses from poly traumas to neck and low back pain. This keeps me excited to come to work every day, because I know I’m likely to see something different. Most important, it’s incredibly rewarding to know that I can help return active duty service members to full health and duty.
  2. Working with my military counterparts: WRNMMC is my first clinical experience in the MHS, and the facility is considered the “flagship of military medicine.” I work alongside my active duty PT counterparts and military and civilian physical therapist assistants and physical therapy technicians, many with deployment and overseas experience. The level of care and compassion that the WRNMMC PT staff show daily is what makes this service run as well as it does, and it is one of my favorite things about working at WRNMMC.

Full article at APTA

Using gene therapy to treat CTE

A new study shows the feasibility of using gene therapy to treat the progressive neurodegenerative disorder chronic traumatic encephalopathy (CTE). The study, which demonstrated the effectiveness of direct delivery of gene therapy into the brain of a mouse model of CTE, is published in Human Gene Therapy.

Ronald Crystal and colleagues from Weill Cornell Medical College, New York, NY, coauthored the article entitled “Anti-Phospho-Tau Gene Therapy for Chronic Traumatic Encephalopathy.”

There is currently no treatment for CTE, which is caused by repeated trauma to the central nervous system (CNS), such as that suffered by soldiers, athletes in contact sports, and in accident-related trauma. Inflammation results in the accumulation of hyperphosphorylated forms of Tau protein (pTau). Crystal et al. developed an adeno-associated virus (AAV) vector to deliver an anti-pTau antibody to the (CNS). They showed that direct delivery of the AAVrh.10anti-pTau directly into the hippocampus of brain-injured mice was associated with a significant reduction in pTau levels across the CNS. They propose that doses could be scaled up and this strategy could be effective in humans as well.

Full article at Nuero Science News