New Pediatric mTBI Guidelines from CDC Take Comprehensive Approach

In light of what it describes as a “significant public health concern,” the US Centers for Disease Control and Prevention (CDC) has issued what it says are the first-ever comprehensive clinical guidelines for the diagnosis and management of mild traumatic brain injury (mTBI) in children. The 19 sets of recommendations address the condition from diagnosis through management and treatment, and cover settings including primary care, outpatient settings, inpatient care, schools, and emergency departments.

The resource, published in JAMA Pediatrics and available for free, is organized into 3 main areas—diagnostic recommendations, prognostic recommendations, and recommendations related to management and treatment—with each area containing several recommendations based on extensive literature reviews. The 46 discrete recommendations are organized into 19 topic areas, and include do’s and don’ts that cover the gamut from the use of serum testing to diagnose mTBI to the best approaches for talking with families about the injury.

Full story at APTA

Doctor with Guillain Barré syndrome recovers back to normal life

Doctors do the darndest things. Take the one who walked right up to Dan Thomas, MD, at a lecture, got into the ready position, and proceeded to perform several squats as Thomas watched, puzzled.

“Dr. Thomas,” his squatting colleague said upon returning to upright, “I had Guillain Barré three years ago, and I just wanted to show you that if you work hard enough, you can get better.”

Ohhh, so it was about that, Thomas thought. It was a nice gesture, and from his wheelchair the Children’s Hospital Los Angeles gastroenterologist offered thanks. Thomas could hardly touch his finger to his chin, so he couldn’t see far enough out to imagine ever doing squats. He was merely on a nice excursion out from his hospital room, a break from the tedium of rehab and a chance to join with his peers.

Full story at news-medical.net

Aetna’s Policy Clarifications Increase Access to PT Care

Major commercial insurer Aetna recently provided some clarification on policies related to payment for physical therapy, and it’s good news for physical theapists (PTs) and their patients.

The clarifications help to answer questions related to the company’s physical therapy policy, specifically around payment for evaluations and the ways direct access provisions can affect payment. Here’s what Aetna said:

Evaluations could be eligible for payments sooner than the 180-day wait period.
Although Aetna’s policy reads that “physical therapy evaluations will be eligible for payment once every 180 days,” Aetna representatives have informed APTA that evaluations performed within 180 days of the original evaluation may be allowed upon reconsideration or appeal, providing the evaluation is for a new or unrelated condition.

Full story at APTA

A recipe for regenerating nerve fibers across complete spinal cord injury

Neuroscientists at UCLA, Harvard University and the Swiss Federal Institute of Technology have identified a three-pronged treatment that triggers axons—the tiny fibers that link our nerve cells and enable them to communicate—to regrow after complete spinal cord injury in rodents. Not only did the axons grow through scars, they could also transmit signals across the damaged tissue.

If researchers can produce similar results in human studies, the findings could lead to a therapy to restore axon connections in people living with spinal cord injury. Nature publishes the research in its Aug. 29 online edition.

“The idea was to deliver a sequence of three very different treatments and test whether the combination could stimulate disconnected axons to regrow across the scar in the injured spinal cord,” said lead author Michael Sofroniew, a professor of neurobiology at the David Geffen School of Medicine at UCLA. “Previous studies had tested each of the three treatments separately, but never together. The combination proved to be the key.”

Full story at Medical Xpress

Sharp increase in falls in women during midlife

Falls are not just a problem of advanced age, according to researchers in Trinity College Dublin, who have identified a sharp increase in falls after the age of 40, particularly in women.

The research, which drew on data from TILDA (the Irish Longitudinal Study on Ageing) as well as data from similar studies in Australia, Great Britain and the Netherlands, found that for women the prevalence of falls increases from the age of 40 on — 9% in 40-44 year olds, 19% in 45-49 year olds, 21% in 50-54 year olds, 27% in 55-59 year olds and 30% in 60-64 year olds.

The findings indicate that middle-age may be a critical life stage for interventions designed to prevent falls, according to the authors. The study incorporated the data from 19,207 men and women aged between 40 and 64 years. It has been recently published in the international journal PLOS ONE.

Full story at Science Daily

MedPAC Recommendations for PT Payment Decreases Met With Strong Responses From APTA, Private Practice Section, Alliance

The Medicare Payment Advisory Commission (MedPAC) may be right in its claim that Medicare Part B payment should be increased for ambulatory evaluation and management (E&M) services, but it’s dead wrong when it says that those increases should be paid for by cuts to physical therapy-related payment: that’s the message APTA, its Private Practice Section (PPS), and the Alliance for Physical Therapy Quality and Innovation (Alliance) delivered to MedPAC recently.

The comments were provided in response to MedPAC’s 2018 report to Congress on Medicare. In the chapter titled “Rebalancing Medicare’s physician fee schedule toward ambulatory evaluation and management services,” MedPAC argues that ambulatory E&M services—defined by MedPAC as office visits, hospital outpatient department visits, visits to patients in other settings such as nursing facilities, and home visits—are “underpriced.” That’s a problem in need of fixing, MedPAC says, because E&M services “are critical for both primary and specialty care.”

MedPAC’s suggestion for how to pay for repriced E&M services, however, isn’t exactly a study in nuance. The commission recommends that the increase can be accomplished in a way that won’t hurt Medicare’s bottom line simply by reducing payment for a wide range of “procedures, images, and tests” that it believes are over-valued—including physical therapy-related services. Depending on the procedure, imaging, or test in question, the recommended cuts are as high as 3.8%.

Full story at APTA

PT, PTA, Student Involvement in Special Olympics is Improving Health…and Changing Attitudes

Vicki Tilley, PT, and Donna Bainbridge, PT, ATC, EdD, wanted to make a difference in the lives of others by working with Special Olympics. Along the way, Special Olympics returned the favor.

“I have a different lens now,” Tilley said. “Being able to engage, explore, and interact with the ID [intellectual disabilities] population in a way that’s positive has changed the way I think about people in general, and about inclusion and access.”

“My experiences with Special Olympics have shaped my entire career path in practice, research, and programming,” Bainbridge added. “I have a better understanding of the health needs of individuals with ID, and what we as physical therapists can do to improve the lives and function of people with ID at all ages.”

As Special Olympics celebrates its 50th year, Tilley and Bainbridge are marking their 19th year with the program, and their 18th with “Healthy Athletes,” an initiative that brings health professionals and students from multiple disciplines to provide education, screenings, and other services to athletes. Both were instrumental in the creation of FUNfitness, the branch of Healthy Athletes responsible for screenings and education around balance, strength, flexibility, and aerobics fitness. FUNfitness is primarily performed by physical therapists (PTs), physical therapist assistants (PTAs), and students.

Full story at APTA

HSS takes young patients with physical challenges on a surfing trip

Hospital for Special Surgery (HSS) made a splash this week with a surfing trip for young patients. Giving new meaning to the term “patient care,” the Adaptive Sports Academy at Lerner Children’s Pavilion at HSS treated 12 patients, along with some of their siblings, to sand and surf in Long Beach, Long Island.

The Academy enables young people with cerebral palsy or another physical challenge to experience the benefits of exercise. The program’s trips and recreational experiences aim to build their self-confidence, encourage independence, and increase physical activity and mobility. The excursions are offered without cost, thanks to the generosity of donors.

Adaptive surfing and other activities are competitive or recreational sports for people with disabilities. Sometimes rules or equipment is modified to meet the needs of participants. Some are understandably nervous at first, but they almost always exceed their own expectations and have a blast.

Full story at news-medical.net

Physical therapy for older adults may lead to fewer fall-related ED revisits

Falls are the leading cause of illness and death among Americans aged 65 and older. In 2014, some 2.8 million older adults visited the emergency department (ED) for a fall-related injury. And over time, the ED visit rate for falls among older adults has grown to 68.8 per 1,000 older adults (as of 2010).

Older adults who visit the ED for a fall are at high risk for both revisiting the ED and dying. In fact, some estimates show that 25 percent of older adults visiting the ED for a fall returned for at least one additional fall-related visit. Fifteen percent of those older adults died within the following year.

Because so many older adults visit an ED due to falls, many experts see an opportunity for EDs to play a role in reducing future falls among older adults who are at high risk.

Full story at news-medical.net

What are the causes of unexplained muscle aches?

Muscle aches can occur in adults and children. In many cases, sore and aching muscles are nothing to worry about and will resolve without medical treatment. However, muscle aches can sometimes be a symptom of an underlying illness.

Common causes of muscle aches include:

  • overexertion
  • trauma to an area of the body
  • viral infections

Muscle aches, also known as myalgia, can be felt in any area of the body that has muscles. Depending on the cause, the discomfort may be mild or extremely severe.

Full story at Medical News Today