Researchers Identify Factors That May Keep Some Patients From Making Optimal Gains in Cardiac Rehab

Authors of a new study say they’ve found a set of predictors that could help providers identify which cardiac rehabilitation (CR) patients are at risk of making lower gains in exercise capacity (EC) from the intervention.

Researchers analyzed before-and-after results from the 6-minute walk test (6MWT) among 541 patients enrolled in the Mayo Clinic Florida’s CR program, tracking distance as well as heart rate and blood pressure before and after each test. Next they compared post-CR 6MWT results with a range of health and demographic data including type of initial cardiac procedure, age, sex, body mass index (BMI), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (LDL), triglycerides, and use of lipid-lowering drugs (LLD) at baseline. Results were published in the American Journal of Cardiology.

When they looked at who didn’t achieve optimal EC after CR, researchers found a constellation of factors that they believe may be predictive of an individual’s likelihood of making substandard gains. In all, 9 major predictors were identified (listed here in descending order of effect): baseline distance on 6MWT, age, percutaneous coronary intervention (or PCI, as opposed to coronary artery bypass graft, or CABG), LDL-C level, gender, the interaction of LDL-C while on LLDs, systolic BP at rest, BMI, and triglyceride levels.

Full story of key factors identified that prevent gains in cardiac rehab at APTA

PTs Encouraged to Verify Their PQRS Data Before It Hits Physician Compare

Did you participate in the Physician Quality Reporting System (PQRS) in 2014? If so, did you report measure #128, “Preventive Care: General Health, Body Mass Index (BMI) Screening and Followup”? That data, linked to your name, will soon be posted to the Physician Compare website, and you should verify its accuracy while you can.

The Centers for Medicare and Medicaid Services (CMS) has opened the 30-day preview period for the 2014 quality measures that will be reported later this year to Physician Compare, the CMS website that provides the public with searchable information on health care providers, including physical therapists (PTs) who participated in PQRS in 2014.

Full story of PTs verifying their PQRS data at APTA

For Millions of Americans, ‘Heart Age’ Outpaces Actual Age

Forget about staying young at heart. For most Americans, simply having a cardiovascular system that isn’t lapping them in the race to old age is a challenge, according to a new report that says 69 million US adults have a “heart age” that is, on average, 7 years older than their chronological age.

The findings were released in a “Vital Signs” report from the US Centers for Disease Control and Prevention (CDC). To arrive at a heart age, CDC calculated the age of a person’s cardiovascular system based on risk factors that include high blood pressure, cigarette smoking, diabetes status, and body mass index (BMI). CDC researchers used data collected from every US state and information from the Framingham Heart Study in what they describe as the first to provide population-level estimates of heart age.

Although the older heart age phenomenon was pervasive, the range of differences play out across demographic lines. Half of American men aged 30-74, for example, have an estimated heart age that is, on average, 8 years older. Among women in the same age range, 2 in 5 have an estimated heart age that is an average of 5 years older.

Full story of heart age outpacing actual age at APTA

FDA Approves Electronic Stimulation Device as Obesity Treatment

The US Food and Drug Administration (FDA) has approved a first-of-its-kind weight loss device the uses surgically implanted electrodes to block nerve activity between the stomach and brain.

Called the Maestro Rechargeable System , the new device uses a rechargeable electronic pulse generator that sends intermittent pulses to the trunks of the nerves responsible for signaling whether the stomach feels empty or full. According to an FDA news release, although it’s clear that the impulses block nerve activity, “the specific mechanisms for weight loss due to use of the device are unknown.”

The system was evaluated in a clinical trial of 233 patients with a BMI of 35 or more that recorded weight loss of 8.5% more than a control group after 12 months. According to the FDA, just over half of the participants in the experimental group lost at least 20% of their excess weight.

Full story of electronic stimulation for obesity treatment at APTA

Obesity Goes Global

A new study published in the May 29 Lancet reports the results of a worldwide study of obesity and overweight, and found that rates have increased between 1980 and 2013 by 27.5% for adults and 47.1% for children. Although rates vary by region, increases can be found almost everywhere in the world, authors write, and when it comes to the battle against obesity, “no national success stories have been reported in the past 33 years.”

During the 33-year timeframe reviewed, worldwide obesity rates rose from 28.8% to 36.9% in men, and from 29.8% to 38% in women. Children and adolescents also experienced “substantial” increases in obesity and overweight, with developing countries rising from 8.1% to 12.9% in boys, and from 8.4% to 13.4% in girls. Among developed countries, the child and adolescent rates rose from 16.9% to 23.8% of boys, and from 16.2% to 22.6% of girls. Authors defined overweight as BMI between 25 and 30 kg/m2 and obesity as BMI of 30 kg/m2 for adults, and used the International Obesity Task Force definition for children.

Full story of global obesity at APTA