More doctor visits can lower risk of suicide attempts in fibromyalgia patients

Fibromyalgia patients who regularly visit their physicians are much less likely to attempt suicide than those who do not, according to a new Vanderbilt University Medical Center study published in Arthritis Care & Research.

Patients who did not attempt suicide were at the doctor an average of 50 hours per year versus less than one hour per year for the group who committed self-harm, according to lead author Lindsey McKernan, PhD, assistant professor of Psychiatry & Behavioral Sciences, Physical Medicine & Rehabilitation.

“Fifty hours versus one hour – that’s a staggering difference,” McKernan said. “They might have been at one appointment in a year and this disorder, fibromyalgia, takes a lot to manage. It takes a lot of engagement.”

Full story at news-medical.net

Women in Physical Therapy Summit: Fueling Change in the Profession

Next professional conference you go to, take a look around. Chances are you’ll see a disproportionate number of men at podiums, on panels, and walking around with all those extra ribbons on their ID badges—even when the profession itself is supposedly “female dominated.” It’s a symptom of a bigger problem that many people, including Karen Litzy, PT, DPT, would like to change.

Litzy will be the first to admit that there’s much work to be done. But as the organizer of the Women in Physical Therapy Summit, now in its third year, Litzy can take some pride in knowing that when it comes to at least 1 conference, the problem has been turned on its head.

The 2-day summit, coming up on September 21 at John Jay College in New York City, focuses on the contributions women have made and the ways they can have an even greater impact. Men are of course welcome (and do attend), but the emphasis is on women—not just as speakers, but as sources of inspiration, insight, and experience. The event is sponsored in part by APTA.

Full story at APTA

APTA, Other Health Care Leaders Call for CMS to Rethink Evaluation and Management Payment Plan

APTA has joined with more than 150 other health care organizations to let the US Centers for Medicare and Medicaid Services (CMS) know that while its “Patients Over Paperwork” efforts are appreciated, one CMS attempt to reduce administrative burdens is likely to result in reduced access to care for some of the sickest Medicare beneficiaries.

The concerns center around a provision related to evaluation and management (E/M) visits included in the 2019 physician fee schedule rule proposed by CMS over the summer. The change, ostensibly intended to reduce paperwork, would collapse E/M payment rates currently based on a 5-level complexity system for new and established patients into what would amount to a 2-level system—combining levels 1-3 and levels 2-5. CMS acknowledges that the change would result in higher payments for E/M visits at the 1-3 levels while levels 4 and 5 will see reductions based on the 2019 proposed relative value units. However, CMS argues, the reduced paperwork burden would offset the payment drop.

In a letter sent to CMS last month, APTA and other cosigners praise CMS for its initiative to reduce provider paperwork, but question the wisdom of the E/M plan, arguing that the change would unfairly impact providers who see sicker patients, “ultimately jeopardizing patients’ access to care.”

Full story at APTA

How does rheumatoid arthritis affect the ankles?

Rheumatoid arthritis can affect the ankle joints in a similar way to other joints, causing stiffness, swelling, and pain.

Most often, rheumatoid arthritis or RA affects the hands and feet, but, less commonly, it can also affect the ankles.

The condition typically impacts on smaller joints first, such as the toe joints in the foot. It may then move to larger joints, such as the ankles. RA in the ankles can impede walking and cause considerable discomfort.

In this article, we take a close look at how RA affects the ankles, including the symptoms, and how people can relieve pain and swelling.

Full story at Medical News Today

From PTJ: Getting at the Risk Factors for Falls Post-TKA

Up to a third of patients with total knee arthroplasty (TKA) experience a fall within 6 months to a year after surgery, but a new study suggests that physical therapists (PTs) can reduce this risk by targeting specific deficits for intervention.

Researchers followed 134 individuals at a Hong Kong hospital for 6 months after TKA to determine falls frequency, circumstances, and risk factors. All patients had been referred for outpatient rehabilitation. The individuals were all between the ages of 50 and 85 with a primary diagnosis of knee osteoarthritis (OA). Results were published in the September issue of PTJ(Physical Therapy).

Participants attended physical therapy 1-2 times per week for 8-10 weeks, beginning 2 weeks after surgery. Sessions included electrotherapy, mobilizing and strengthening exercises, and gait and balance training. At 4 weeks postsurgery, PTs evaluated knee proprioception, balance, knee pain, knee extension and flexion muscle strength, range of motion, and balance confidence. Patients also were given a log book to record any falls. After the evaluation, authors followed up monthly to ask participants about any falls they may have experienced.

Full story at APTA

Help Aging Communities ‘Go4Life’ in September

Physical therapists (PTs), physical therapist assistants (PTAs), students, and supporters of the profession shouldn’t wait until National Physical Therapy Month in October to spread the word about the importance of mobility and physical activity—September is Go4Life month, a National Institutes of Health (NIH)-sponsored campaign that provides plenty of opportunities to educate the public on the ways older Americans can stay healthy through maintaining or increasing endurance, strength, balance, and flexibility.

Strongly supported by APTA, Go4Life is an ongoing effort to connect the public and health care providers with information and resources related to healthy aging. In addition to information on how exercise improves health, the Go4Life website includes suggested exercises, workout videos, fitness tracking resources, and access to printed materials including infographics, posters, bookmarks, and postcards, all available for free. The program also offers a free “Speaker’s Toolkit” to help providers develop presentations to target audiences—available by emailing Go4Life@mail.nih.gov.

Full story at APTA

How does rheumatoid arthritis affect the ankles?

Rheumatoid arthritis can affect the ankle joints in a similar way to other joints, causing stiffness, swelling, and pain.

Most often, rheumatoid arthritis or RA affects the hands and feet, but, less commonly, it can also affect the ankles.

The condition typically impacts on smaller joints first, such as the toe joints in the foot. It may then move to larger joints, such as the ankles. RA in the ankles can impede walking and cause considerable discomfort.

In this article, we take a close look at how RA affects the ankles, including the symptoms, and how people can relieve pain and swelling.

Full story at Medical News Today

Study shows how exercise generates new neurons, improves cognition in Alzheimer’s mouse

A study by a Massachusetts General Hospital (MGH) research team finds that neurogenesis -inducing the production of new neurons—in the brain structure in which memories are encoded can improve cognitive function in a mouse model of Alzheimer’s disease. Their investigation shows that those beneficial effects on cognition can be blocked by the hostile inflammatory environment present in the brain of patients with Alzheimer’s disease and that physical exercise can “clean up” the environment, allowing new nerve cells to survive and thrive and improving cognition in the Alzheimer’s mice.

“In our study we showed that exercise is one of the best ways to turn on neurogenesis and then, by figuring out the molecular and genetic events involved, we determined how to mimic the beneficial effects of exercise through gene therapy and pharmacological agents,” says Rudolph Tanzi, Ph.D., director of the Genetics and Aging Research Unit, vice-chair of the Department of Neurology and co-director of the Henry and Alison McCance Center for Brain Health at MGH and senior author of the paper published in Science.

Lead author, Se Hoon Choi, Ph.D., of the Genetics and Aging Research Unit adds, “While we do not yet have the means for safely achieving the same effects in patients, we determined the precise protein and gene targets for developing ways to do so in the future.”

Full story at Medical Xpress

Mechanically ventilated patients treated with vasopressor may develop ICU-related weakness

At least 25 percent of critically ill patients who receive mechanical ventilation in intensive care units (ICUs) develop muscular weakness severe enough to impair their quality of life. In a new study published in the journal CHEST® designed to investigate possible causes, researchers found that mechanically ventilated patients treated with vasopressor medications had a more than three-fold increase in the odds of developing ICU-associated weakness. These findings highlight the unintended adverse effects of treatment and suggest possible interventions or avoidance strategies.

Patients with shock, a life-threatening condition causing a decrease in blood flow to the body, often require treatment with vasopressor medications that raise the blood pressure and restore blood flow to vital organs.

“Survivorship from critical illness is improving; however, patients often inherit many burdens including severe persistent weakness. In order to work towards improving long-term outcomes of critical illness, it is imperative to first improve our understanding of why patients develop weakness, specifically whether it is solely due to the underlying illness or if the treatments provided during the course of critical illness also play a role,” explained lead investigator Krysta S. Wolfe, MD, of the University of Chicago, Department of Medicine, Section of Pulmonary and Critical Care, Chicago, IL, USA.

Full story at news-medical.net

New legislation to provide licensure clarity for sports medicine professionals passes the U.S. Senate

The Sports Medicine Licensure Clarity Act (S. 808) has successfully passed the U.S. Senate, taking another critical step forward. Introduced by Senators John Thune (R-SD) and Amy Klobuchar (D-MN) in 2017, this legislation clarifies medical liability rules for sports medicine physicians, athletic trainers and other medical professionals to ensure they’re properly covered by their liability insurance while traveling with athletic teams to another state.

The bill previously passed out of the U.S. Senate HELP Committee in June and will now go back to the U.S. House of Representatives to approve language changes made by the Senate. The House approved a slightly different version of the bill in 2017. Once the House approves the changes, it will advance to the President for signature.

“The passage of S. 808 will ensure patients are able to receive quality care from their respective medical teams, no matter where they are competing,” said AMSSM President Chad Asplund, MD, MPH. “This is another decisive step benefiting everyone involved in taking care of athletic teams.”

Full story at news-medical.net