Category: stroke

Yoga and physical therapy effective in treating co-occurring sleep disturbance, back pain

Yoga and physical therapy (PT) are effective approaches to treating co-occurring sleep disturbance and back pain while reducing the need for medication, according to a new study from Boston Medical Center (BMC). Published in the Journal of General Internal Medicine, the research showed significant improvements in sleep quality lasting 52 weeks after 12 weeks of yoga classes or 1-on-1 PT, which suggests a long-term benefit of these non-pharmacologic approaches. In addition, participants with early improvements in pain after 6 weeks of treatment were three and a half times more likely to have improvements in sleep after the full, 12-week treatment, highlighting that pain and sleep are closely related.

Sleep disturbance and insomnia are common among people with chronic low back pain (cLBP). Previous research showed that 59% of people with cLBP experience poor sleep quality and 53% are diagnosed with insomnia disorder. Medication for both sleep and back pain can have serious side effects, and risk of opioid-related overdose and death increases with use of sleep medications.

Full story at News-Medical.net

Patient-Driven Groupings Model: An Opportunity for Physical Therapists

When it comes to Centers for Medicare and Medicaid Services (CMS) changes, I have come to believe that there are 3 sides of the story: the CMS version, the providers’ version, and the truth, which is usually somewhere in the middle. The Patient-Driven Groupings Model (PDGM) that will govern home health payment beginning January 2020 is a good example of what I’m talking about.

PDGM shook the therapy world when it was announced that the number of therapy visits will not be considered or weighed into each 30-day period pricing for home care within a 60-day episode. As usual, providers, fearful of losing money, started to lay off therapy staff without really understanding what CMS intended.

Most of us understand that therapy visit thresholds were used to determine the additional pricing to the base rate for a home care 60-day episode. Home health providers have paid particular attention to this fact, realizing that the number of therapy visits at certain thresholds adds value to the base amount of the home care episodic rate. Back when the therapy threshold was 10 visits, home care agencies tried to have a minimum of 10 visits to capture that dollar amount. When the threshold increased to 13 visits, that number soon became the norm of therapy visits for every patient. Later, the therapy threshold moved to 19 visits. Home care agencies started to add multiple therapy services to attain that number and discharged every patient after 19 visits.

Full story at APTA

Final Home Health Rule Cements PDGM, Allows PTAs to Perform Maintenance Therapy

When it comes to its most talked-about provisions, the US Centers for Medicare and Medicaid Services’ (CMS) final rule for home health payment under Medicare isn’t much of a change from the proposed version released earlier this year, meaning that an entirely new payment system will indeed be rolled out beginning January 1. But other parts of the rule have been tweaked—and in several areas, those tweaks represent wins for the physical therapy profession and the patients it serves in home health settings.

It’s official: PDGM is on for 2020.
There wasn’t much debate about whether this would happen, but the final rule eliminates any doubt: the Patient-Driven Groupings Model (PDGM) will be the system under which CMS pays home health agencies (HHAs). It’s a big change, and APTA offers extensive information on the details of the model, but the bottom line is that the PDGM moves care from 60-day to 30-day episodes and eliminates therapy service-use thresholds from case-mix parameters. The system classifies episodes according to a set of 5 major buckets and subsets within those buckets. Patients are assigned a status within the 5 major areas, and within some of those areas they can be assigned to more detailed clinical categories—the combination of categories assigned to a patient generates a particular case-mix grouping. CMS says it will monitor how HHAs are operating under the PDGM, including the provision of therapy services.

Full story at APTA

Stroke rates continue decline in the U.S.

Rates of stroke among U.S. adults over age 65 have steadily decreased over the past 30 years, according to a study that tracked participants from the 1980s through December 2017.

Rates of decline were consistent across decades, sex and race, the study authors report in JAMA Neurology.

“Stroke is the main cause of disability in adult populations and one of the main causes of death in developed countries,” said lead study author Silvia Koton of Tel Aviv University in Israel and Johns Hopkins University in Baltimore, Maryland.

“The importance of stroke, a disease more common in older than younger ages, is likely to increase with the aging of the global population, therefore, it is important to evaluate trends,” she told Reuters Health by email.

Full story at Reuters

National Athletic Trainers’ Association Releases Official Statement of Recommendations to Reduce the Risk of Injury Related to Sport Specialization for Adolescent and Young Athletes

DALLAS, TX – In anticipation of National Youth Sports Specialization Awareness Week (third full week in October) the National Athletic Trainers’ Association (NATA) released an official statement with health-focused recommendations to reduce the risk of injury due to youth sports specialization, which is often defined as year-round participation in a single sport, usually at the exclusion of other sports.

The statement was endorsed by Professional Football Athletic Trainers Society (PFATS), Professional Hockey Athletic Trainers Society (PHATS), Professional Soccer Athletic Trainers Society (PSATS), National Basketball Athletic Trainers’ Association (NBATA), Professional Baseball Athletic Trainers Society (PBATS), and the NATA Intercollegiate Council for Sports Medicine (ICSM).

Full story at Newswise

BU researcher receives NIH grant for clinical research in rheumatology

David Felson, MD, MPH, professor of medicine and epidemiology at Boston University Schools of Medicine (BUSM) and Public Health (BUSPH), was awarded a National Institute of Health (NIH) P30 Center Grant.

The five-year, $3.6 million award will allow for further clinical research in rheumatology at the Boston University Core Center for Clinical Research, and will provide broad clinical research expertise to a large multidisciplinary group of investigators whose research focuses on osteoarthritis and gout with a secondary emphasis on scleroderma, spondyloarthritis, osteoporosis and musculoskeletal pain.

The Center includes researchers from BU, Boston Children’s Hospital, the Beth Israel Deaconess Hospital, Massachusetts Institute of Technology, Northeastern University and different groups at Harvard University. This group is comprised of individuals with backgrounds in rheumatology, physical therapy, engineering, epidemiology, biostatistics, genetics, evolutionary biology and behavioral science, who critically review projects, provide methodologic guidance to research and creates new multidisciplinary collaborations.

Full story at News Medical

Exercise especially important for older people with heart disease

It is well-known that exercise is good for cardiac health, but older adults tend to fall through the cracks when it comes to rehabilitation programs. Now, a study has shown that these individuals have the most to gain.

Heart disease is the leading cause of death for both men and women in the United States, being responsible for 1 in 4 deaths. Every year, approximately 610,000 people in the U.S. die of heart disease, while about 735,000 people have a heart attack.

Adults over the age of 65 years are more likely than younger people to have heart disease because the heart changes with age. Heart disease is a significant cause of disability, according to the National Institute on Aging, who note that it affects the ability of millions of older people to be active and have a good quality of life.

Full story at Medical News Today

Dog ownership associated with longer life, especially among heart attack and stroke survivors

Dog ownership may be associated with longer life and better cardiovascular outcomes, especially for heart attack and stroke survivors who live alone, according to a new study and a separate meta-analysis published in Circulation: Cardiovascular Quality and Outcomes, a journal of the American Heart Association.

“The findings in these two well-done studies and analyses build upon prior studies and the conclusions of the 2013 AHA Scientific Statement ‘Pet Ownership and Cardiovascular Risk’ that dog ownership is associated with reductions in factors that contribute to cardiac risk and to cardiovascular events,” said Glenn N. Levine, M.D., chair of the writing group of the American Heart Association’s scientific statement on pet ownership. “Further, these two studies provide good, quality data indicating dog ownership is associated with reduced cardiac and all-cause mortality. While these non-randomized studies cannot ‘prove’ that adopting or owning a dog directly leads to reduced mortality, these robust findings are certainly at least suggestive of this.”

Full story at Medical Xpress

Target introduces adaptive Halloween costumes for kids with disabilities

Halloween costumes are more inclusive than ever before, thanks in part to Target’s latest innovative options. Target’s Hyde and Eek! Boutique range has introduced four new Halloween costumes adapted for kids with disabilities. 

One of the designs allows kids to transform their wheelchair into a pirate ship, complete with a Jolly Roger flag and with waves for wheels. The other turns it into a luxurious purple princess carriage. Both wheelchair covers use “hook-and-loop closures for a secure fit,” and can fit on a variety of chair sizes, according to the Target website. 

The actual pirate and princess costumes are sold separately. They are specifically designed for ease of dressing for wheelchair users, with openings in the back and wide pant legs. 

Full story at CBS News

5 Ways to Get Ready for Falls Prevention Awareness Day

An estimated 1 in 4 adults 65 and older experiences a fall each year, and according to a recent study, falls-related deaths among adults 75 and older are on the rise, all of which makes falls prevention more relevant than ever.

With Falls Prevention Awareness Day coming September 23, now is a great time to check out a few falls-related resources from APTA and its components. Here are a few ways to make the next few days a little more fall-focused.

1. Check out the tests and measures at PTNow.
In addition to being your source for clinical summaries, clinical practice guidelines, and research, APTA’s evidence-based practice resource also includes a host of tests and measures—including many related to balance. Members can download information on the 360-degree turn stand, the balance error scoring system, the elderly mobility scale, and the falls risk assessment tool, to name a few. Some of the resources even come with accompanying videos. And don’t forget other falls-related resources at PTNow, such as this clinical summary on fall risk in community-dwelling elders.

Full story at APTA