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

Preventing ACL injuries in high school athletes

It’s not an uncommon scenario. An athlete is sailing through the air or making a quick turn when all of a sudden he or she hears a “pop” in the knee. An athlete who experiences this followed by sudden pain and swelling often receives the much-feared diagnosis of an anterior cruciate ligament (ACL) tear.

“Young, growing athletes are at high risk for ACL injuries, so it is important to work with coaches, trainers and medical professionals to minimize the risk of injury today, as well as the likelihood of reinjury or arthritis many years from now,” said Dr. Paul Sherbondy, an orthopedic surgeon at Penn State Health Medical Group – Park Avenue in State College.

According to Sherbondy, the ACL is one of the four major ligaments in the knee and the most commonly injured. It connects the thigh bone to the shin bone and helps stabilize the knee joint. ACL injuries range from a mild overextension to a full tear. “Anyone who has injured this ligament is at higher risk for reinjury, as well as early-onset osteoarthritis of the knee,” he said.

Full story at news-medical.net

Short-Term Insurance Rule Adds More Uncertainty to Care

As APTA continues to advocate for the maintenance of essential health benefits (EHBs) in insurance offered through Affordable Care Act (ACA) marketplaces, the association and other stakeholders are facing another potential challenge to patient access to care: private insurer short-term, temporary health plans that can skirt many ACA requirements around EHBs, preexisting conditions, and continued coverage.

Earlier this month, the Department of Health and Human Services (HHS) adopted a final rule on the short-term plans, allowing the policies to provide 1 year of coverage, renewable for up to 3 years. Previously, the plans could only be used for a maximum of 3 months.

The plans are intended to offer a cheaper insurance alternative than plans available through the ACA (although most individuals who purchase insurance through the ACA marketplaces receive subsidies that lower the out-of-pocket costs). But they are not required to comply with many of the consumer protections included in ACA plans. Instead, the plans are able to deny coverage of a preexisting condition, drop coverage should a customer’s health status change, and refuse coverage for services such as mental health, prescription drugs—and, possibly, physical therapy.

Full story at APTA

Eight exercises for tennis elbow

Tennis elbow is also known as lateral epicondylitis. It occurs when a person strains the tendons in their forearm. People can usually treat tennis elbow at home with rest and over-the-counter medication. Doing specific exercises can also help ease the pain and prevent reoccurrence.

We describe eight exercises to help strengthen muscles in the forearm and prevent tennis elbow from coming back. We also cover causes and symptoms, home treatment, prevention, and when to see a doctor.

Before trying these exercises, wait for any swelling to go down. It is also a good idea to check with a doctor or a physical or occupational therapist first.

Full story at Medical News Today

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

Predicting 1 Repetition Maximum Using Handheld Dynamometry

Isometric assessment of muscular function using a handheld dynamometer (HHD) is frequently used in clinic environments. However, there is controversy in terms of the validity of isometric assessment to monitor changes in dynamic performance. One repetition maximum (1RM) is considered the gold standard for evaluating dynamic strength, though clinicians do not often use 1RM testing, preferring to be cautious with clients who have preexisting impairments. If strength testing using an HHD could be used to predict 1RM, this may have significant implications for the use of isometric testing to prescribe exercise in clinical environments.

The aim of this study was to establish the relationship and agreement between 1RM and isometric strength scores measured using HHD for the biceps and quadriceps muscle groups and to determine if HHD measurements can be used to predict 1RM. This involved a convenience sample of 50 healthy adults (26 women) aged 19-33 years (mean 23.38 ± 3.11 years) who had their bicep and quads muscle strength tested muscle groups measured by 1RM and isometric maximal voluntary contraction measured using an HHD.

Full story at Physiospot

Rocker bottom shoes help reduce chronic low back pain

A new study confirms that rocker bottom shoes helps strengthen back muscles, improving the spine’s curvature and thus reducing low back pain.

Researchers of the Sports Physiotherapy master’s degree at Valencia’s CEU Cardenal Herrera university have confirmed, in a new study of their research work into back pain, that unstable shoes improve the strength of back muscles in order to maintain balance and stability when walking. This muscular strengthening contributes to reducing low-intensity chronic low back pain, which can be disabling for those who suffer it. The results of this new study, headed by CEU UCH teachers Juan Francisco Lisón and Pablo Salvador, co-authors of the first international study on this matter, have been published in the Q1 edition of scientific magazine Clinical Rehabilitation.

As the coordinator of the CEU UCH master’s degree, Pablo Salvador, explains, “patients with chronic low back pain are usually advised to perform exercises to strengthen the muscles in their back, which improve stability of the spine in the lower back area, although it is always hard to make sure they comply with this type of exercises. What this new study shows is that the use of unstable shoes for several hours during a patient’s day-to-day life, without any other specific exercises, effectively contributes to the muscular strengthening of their back and improves the degree of curvature of the spine in the lumbar area, thus helping to reduce chronic pain.”

Full story at Science Daily

Patients who live alone can safely be sent home after joint replacement

Most patients who live alone can be safely discharged home from the hospital to recover after hip or knee replacement surgery, suggests a study in the January 17, 2018 issue of The Journal of Bone & Joint Surgery.

The results question the belief that patients who live alone should routinely be sent to an inpatient rehabilitation facility after total joint replacement surgery, before going home. “Patients living alone had a safe and manageable recovery when discharged directly home after total joint arthroplasty,” write Andrew N. Fleischman, MD, and colleagues from The Rothman Institute, Thomas Jefferson University, Philadelphia.

Similar Outcomes after Joint Replacement for Patients Living Alone

The study included 769 patients who were discharged home after one-sided total hip or knee replacement. Of these, 138 patients were living alone for the first two weeks after surgery. The researchers compared complication rates and other important outcomes for patients who lived alone versus those who lived with others.

Full story at Medical Xpress