Category: stroke

Move Forward Radio: Country Music’s Clay Walker Discusses Living With MS

It was just over 20 years ago, and multiplatinum country music star Clay Walker was riding high, on tour with his band, when he experienced a set of symptoms—poor balance, double vision, and what he calls “lazy legs”—that seemed almost funny at first; just some weird, passing thing. On the morning of the last show of his tour, Walker woke up expecting the joke to be over, the symptoms gone. They weren’t.

“That was a scary moment,” Walker said. “But that was when I knew that I should probably get to a doctor.”

It didn’t take long for Walker to learn that he had multiple sclerosis (MS). His first 2 doctors told him that would be in a wheelchair in 4 years, and likely dead in 8. But here it is, 2 decades later, and Walker is still on his feet, still touring, and still living life to the fullest—thanks, he says, to his faith, an excellent physician, appropriate medications, and a mobility “protocol” he learned from his physical therapist (PT).

Full story of Clay Walker’s life with MS at APTA

Don’t Slip on Appeal: Tips and Resources to Help You Navigate Payers and Insurance Commissioners

Everyone knows the old saying about death and taxes being the only certainties in life. Physical therapists (PTs) and physical therapist assistants (PTAs) can probably add 1 more to that list: appeals to insurance company payment decisions.

Here are a few tips and resources from APTA, to help you get it right.

The tips

Appeals are important …
Yes, the appeals process adds yet another administrative burden to your plate, but don’t forgo the process when you feel that medically necessary services have been denied or partially approved. You have a responsibility to protect the patient if payment for appropriate care is denied. And, remember, you won’t be able to pursue an appeal at a higher level—the insurance commissioner’s office—unless you have done your due diligence and exhausted all other means of reconsideration.

Full story of navigating payers and insurance commissioners at APTA

From PTJ: For the Very Elderly, Poststroke IRF Stays May Not Be Long Enough

For patients who are very elderly, receiving postacute stroke care in inpatient rehabilitation facilities (IRFs) often results in increased functional ability, with 54% of patients achieving discharge to the community. But, say researchers who studied IRF data from 2002 to 2007, there are “worrisome trends” that point to the notion that the average length of stay (LOS) wasn’t enough to produce a clinically significant increase in function.

The study, e-published ahead of print in Physical Therapy (PTJ), APTA’s scientific journal, examined functional outcomes and length of stay in inpatient rehabilitation facilities for patients with stroke at age 85 or older. Most studies haven’t broken out the data for this age group, which is “most at risk for disability,” authors note.

Authors focused on IRFs because stroke outcomes have been “consistently associated with more functional improvements and more discharges to home” for patients in IRFs than for those in skilled nursing facilities. IRFs are required to provide at least 3 hours of therapy per day.

Full story of elderly poststroke IRFs at APTA

Study: 10 Modifiable Risk Factors Associated With 90% of Strokes Worldwide

Ten modifiable risk factors are associated with 90% of strokes, according to a recently published international study. Risk factors include physical inactivity, hypertension, poor diet, obesity, smoking, cardiac causes, diabetes, alcohol use, stress, and increased lipid levels.

The case-control study was “phase 2” of the larger INTERSTROKE study. According to lead author Martin McDonnell in a related Lancet podcast, the goals of this study were to describe and quantify stroke risk factors and identify any “regional variations by population characteristics or stroke subtype.”

Researchers examined patient data from 142 participating facilities in 32 countries representing all continents (26,919 participants and 13,472 controls). Participants were assessed with a variety of measures, as well as MRI or CT imaging and blood and urine samples, within 5 days of acute first stroke.

Full story of risk factors associated with strokes at APTA

PTs, PTAs, Students Bring the #PTTransforms Message to Capitol Hill During Federal Advocacy Forum

When it comes to issues such as repeal of the therapy cap, opportunities for student loan relief, and the ability of a physical therapist (PT) to bring in another qualified PT during absences, the halls of Congress may be just a little more physical therapy-informed than they were this time last week. But then, what do you expect when more than 250 PTs, physical therapist assistants (PTAs), and students from 46 states meet face-to-face with hundreds of legislators and staff?

The meetings were part of the APTA Federal Advocacy Forum, held April 3-5 in Washington DC, a yearly event designed to educate participants on hot legislative issues and creative outreach ideas, as well as provide an opportunity for in-person advocacy on Capitol Hill.

For their advocacy with legislative offices, participants came ready to discuss a wide range of topics related to physical therapy but placed particular emphasis on 3 bills:

Full story of #PTTransforms to Capitol Hill at APTA

No Turning Back: 4 Ways Bundled Payments Will Change Rehab Care

Maybe the biggest ICYMI issue in physical therapy so far this year is the impending implementation of Medicare’s Comprehensive Care for Joint Replacement model (CJR), a program that will require hospitals in 67 metropolitan areas to use bundled payment systems for total knee arthroplasty (TKA) and total hip arthroplasty (THA). The system launches on April 1.

You may have some familiarity with the immediate impacts of the CJR on physical therapists (PTs) and physical therapist assistants (PTAs), but the model, and others like it, also set the stage for even bigger shifts in how rehabilitation professionals interact with the health care system.

In the February issue of Physical Therapy (PTJ), APTA’s research journal, APTA Executive Vice President of Public Affairs Justin Moore, PT, DPT, laid out the top 4 long-term practice implications of payment bundles. The article, appearing in PTJ‘s new “Point of View” feature, provides much more detail (as well as an explanation of how we’ve arrived at this moment in health care), but here’s a quick take on that list.

Full story of ways bundled payments will change rehab care at APTA

Could ‘Bioresorbable’ Sensors Help Individuals Recover From Brain Injury, Surgery?

They melt in your brain, not in your hand.

Scientists at the University of Illinois at Urbana-Champagne have created a sensor they hope can one day be implanted in the brains of patients to monitor and wirelessly transmit data on pressure and temperature within the skull for a time, and then simply resorb into the body. Researchers believe the new approach could help make physical therapy less complicated for individuals recovering from brain injury or surgery (no more external wires in the way) and reduce the incidence of infection, allergic reaction, or other complications associated with implanted sensors that require external wiring and eventual surgical removal.

Described in a report in Science Daily as “smaller than a grain of rice,” the sensors are made of thin sheets of naturally biodegradable silicon that send data to a transmitter “roughly the size of a postage stamp” implanted under the skin of the skull. This transmitter in turn feeds temperature and pressure data to monitoring equipment, all without the use of external wires.

Full story of bioresorbable sensors and brain injuries at APTA

Lives Transformed by Physical Therapy Recognized at MoveForwardPT.com

There was a point in Scott Aldridge’s life when he wondered if he was about to lose the ability to walk. He was 50 years old, 520 pounds, and dealing with chronic venous wounds on his legs.

He wasn’t particularly hopeful that he could get better. But his physical therapist,Stephanie Fournier, PT, DPT, WCS, CLT-LANA, had other ideas.

Three years, more than 300 pounds, lots of physical activity later, Aldridge has an uplifting story worth sharing—and APTA is helping that story find a wider audience.

Aldridge’s transformational story is now part of the Patient Stories section of APTA’s official consumer information website, MoveForwardPT.com. Publication of the story will be followed by a podcast in which Aldridge describes his incredible improvement and Fournier’s role in inspiring that change.

Full story of transformation by physical therapy at APTA

Student Loan Repayment to Be Focus of Flash Action Nov 4-5

People in rural and underserved areas deserve access to physical therapy—and including physical therapists (PTs) in the National Health Services Corps (NHSC) could make that access possible. Plus, participating in the NHSC could qualify PTs for a student loan repayment program.

In other words, it’s advocacy time.

On November 4-5, students in PT and physical therapist assistant (PTA) programs will lead association members and supporters in a “Flash Action” to advocate for allowing PTs to participate in the NHSC and its Student Loan Repayment Program. That program 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.

Full story of PTs and student loan repayment in Flash Action at APTA

50 Years In, Medicare Experiences ‘Jaw Dropping’ Drop in Mortality, Hospitalizations, and Expenditures

Nothing eases the sting of turning 50 like knowing you’re in better shape now than you were at 34.

Just in time for the 50th anniversary of Medicare, a new study published in JAMA(abstract only available for free) is making headlines for its findings that Medicare beneficiaries’ mortality and hospitalization rates declined between 1999 and 2013, as did overall expenditures per beneficiary. The rate of decline was described as “jaw-dropping” by lead researcher Harlan Krumholz, MD, SM, in an article in USA Today.

Researchers analyzed data from 68,374,904 Medicare beneficiaries, both in fee-for-service and Medicare Advantage systems, and found that all-cause mortality dropped from 5.30% in 1999 to 4.45% in 2013. Among slightly more than 60,000 fee-for-service beneficiaries, the total number of hospitalizations per 100,000 person-years decreased from 35,274 to 26,930, while average inflation-adjusted per-beneficiary inpatient expenditure shrank from $3290 in 1999 to $2801 in 2013.

Full story of Medicare and drop in mortality at APTA