How To Teach Future Doctors About Pain In The Midst Of The Opioid Crisis

The next generation of doctors will start their careers at a time when physicians are feeling pressure to limit prescriptions for opioid painkillers.

Yet every day, they’ll face patients who are hurting from injuries, surgical procedures or disease. Around 20% of adults in the U.S. live with chronic pain.

That’s why some medical students felt a little apprehensive as they gathered recently for a mandatory, four-day course at Johns Hopkins University in Baltimore — home to one of the top medical schools in the country.

The subject of the course? Pain.

Full story at NPR

APTA’s September Flash Action Strategy: Student-Led, Member-Powered

What Is FAS?

Flash Action Strategy is an annual student-led campaign in which students, educators, and clinicians use social media and email to educate members of Congress about legislative priorities that impact the physical therapy profession. First held in 2013, FAS has resulted in more than 32,000 emails to legislators.

Social media has become a powerful advocacy tool. Many congressional offices have a dedicated staff member who works on social media, and just a few constituents tweeting about an issue can catch the attention of legislative staff.

This year’s goal: to increase the number of cosponsors of the Physical Therapist Workforce and Patient Access Act.

What Is the Physical Therapist Workforce and Patient Access Act?

The legislation, known as H.R. 2802 in the House of Representatives and S. 970 in the Senate, would allow PTs to participate in the National Health Service Corps (NHSC) Loan Repayment Program, which repays up to $50,000 in outstanding student loans to certain health care professionals who agree to work for at least 2 years in a designated Health Professional Shortage Area (HPSA).

Full story at APTA

Feeling legs again improves amputees’ health

While walking, people with intact legs can feel when they move their knee or when their feet touch the ground. The nervous system constantly draws on sensory feedback of this sort to control muscles precisely. People using a leg prosthesis, however, do not know precisely where the prosthesis is located, how it is moving, or what type of terrain it is standing on. They often cannot trust their prosthesis completely when walking, leading them to rely too often on their intact leg, which in turn reduces their mobility and causes them to tire quickly.

A simple walk on pebbles or sand, for example, can prove very exhausting for people using a prosthesis. Furthermore, people with amputations can experience phantom limb pain, a condition that existing medications often cannot treat. Savo Panic, who experiences this phenomenon, says he wakes up at night due to the phantom pain: “The toe that I don’t have hurts. My big toe, foot, heel, ankle, calf—they all hurt, and I don’t even have them.”

An international team of researchers led by ETH Zurich and Lausanne-based start-up company Sen-sArs has now developed an interface to connect a leg prosthesis with the residual nerves present in the user’s thigh, thus providing sensory feedback. In a study conducted in collaboration with the University of Belgrade, the scientists tested this neurofeedback system with two volunteers who have an above-knee leg amputation and use a leg prosthesis, Panic among them.

Full story at Medical Xpress

How Your Well Intentioned Exercises Can Go Wrong If You’re Not Careful

Exercise prescription is at the heart of every rehab professional’s arsenal.  Whether you are prescribing a simple one such as a straight leg raise or something much more complex involving coordination of proprioception and plyometrics, you are intending to help your patients.  There’s a key component that is often missed during rehab however, and when it is, it can limit your effectiveness.  It may even drive your patients to report increased pain with treatment and in the worst cases, it prevents your patient from achieving their goals.

I don’t believe this is intentionally missed in rehab, but it’s something you will rarely see in research and a component rarely focused on in school.  Is your intervention aimed at the wrong impairment?

Let’s start with this example that’s easier to see and then we’ll move onto one that may be a bit less obvious.

Full story at Physiospot

How to stop or reduce a stutter

Stuttering is a speech disorder. People who stutter may repeat sounds, syllables, or words, or they may prolong sounds. There may also be interruptions to the normal flow of speech, known as blocks, along with unusual expressions or movements.

Stuttering affects more than 70 million people worldwide, including more than 3 million people in the United States. It is more common among men than women. Some people refer to stuttering as stammering or childhood onset fluency disorder.

Approximately 5–10% of all children will stutter at some point in their lives, but most will typically outgrow this within a few months or years. Early intervention can help children overcome stuttering.

Full story at Medical News Today

Posture and Movement Coordination, Sensorimotor Integration May Affect Motor Skills in Children With Autism

The message

In children with autism spectrum disorder (ASD), problems with sensorimotor integration and difficulty in coordinating posture and arm motions may result in impaired motor planning and control. These children also exhibited fewer anticipatory postural adjustments and demonstrated more corrective control during arm movements. Compared with typically developing peers, children with ASD were less likely to use visual cues to plan for motions required to catch an item, such as a ball.

The study

To examine the interplay of sensory cues, postural demands, and arm movement during ball-catching, researchers in Taiwan asked children with and without ASD to catch a ball rolling down a ramp toward them. Of the children, 15 had ASD and 15 were typically developing age- and sex-matched peers.

Full story at APTA

A young woman, a wheelchair and the fight to take her place at Stanford

Sylvia Colt-Lacayo is 18, fresh-faced and hopeful, as she beams confidence from her power wheelchair. Her long dark hair is soft and carefully tended, and her wide brown eyes are bright. A degenerative neuromuscular disease, similar to muscular dystrophy, has left her with weak, underdeveloped muscles throughout her body, and her legs are unable to support any weight. Each time she needs to get in or out of her wheelchair — to leave bed in the morning, use the bathroom, take a shower, change clothes — she needs assistance.

Throughout her young life, Sylvia has been told her disability didn’t need to hold her back. And she took those words to heart. She graduated near the top of her high school class in Oakland with a 4.25 GPA. She was co-captain of the mock trial team at school, served on the youth advisory board of the local children’s hospital, interned in the Alameda County District Attorney’s Office and is a budding filmmaker. In April, Sylvia learned she had been admitted to Stanford University with a full scholarship for tuition, room and board.

Full story at News Medical

Lifestyle, not genetics, explains most premature heart disease

Physical inactivity, smoking, high blood pressure, diabetes, and high cholesterol play a greater role than genetics in many young patients with heart disease, according to research presented today at ESC Congress 2019 together with the World Congress of Cardiology. The findings show that healthy behaviours should be a top priority for reducing heart disease even in those with a family history of early onset.

“Genetics are an important contributor to premature heart disease but should not be used as an excuse to say it is inevitable,” said study author Dr Joao A. Sousa of Funchal Hospital, Portugal.

“In our clinical practice, we often hear young patients with premature heart disease ‘seek shelter’ and explanations in their genetics/family history,” he added. “However, when we look at the data in our study, these young patients were frequently smokers, physically inactive, with high cholesterol levels and high blood pressure — all of which can be changed.”

Full story at Science Daily

Adults with cerebral palsy about twice as likely to develop non-communicable diseases

Adults with cerebral palsy are about twice as likely to develop cardiovascular disease and chronic respiratory disease compared to adults without cerebral palsy, according to a new study led by RCSI (Royal College of Surgeons in Ireland) and Brunel University London.

The study compared 1,700 adults with cerebral palsy and 5,000 adults without cerebral palsy to identify how many developed non-infectious diseases, such as asthma or stroke. The research is published in the current edition of Neurology.

Patients with cerebral palsy were overall 75% more likely to have a non-communicable disease. After adjusting for other variables, the study found that adults with cerebral palsy were around twice as likely to develop cardiovascular disease and chronic respiratory disease, such as asthma, but not more likely to develop diabetes or cancer.

Full story at Medical Xpress

TWEETS SHOW HOW DIFFERENT U.S. REGIONS LIKE TO EXERCISE

Researchers used machine learning to find and comb through exercise-related tweets from across the United States, unpacking regional and gender differences in exercise types and intensity levels. By analyzing the language of the tweets, this method was also able to show how different populations feel about different kinds of exercise.

“In most cases, lower-income communities tend to lack access to resources that encourage a healthy lifestyle,” says Elaine Nsoesie, an assistant professor of global health at the School of Public Health at Boston University and a data science faculty fellow at the Rafik B. Hariri Institute for Computing & Computational Science.

“By understanding differences in how people are exercising across different communities, we can design interventions that target the specific needs of those communities,” she says.

Full story at Futurity