How to stretch your hands and wrists

Wrist pain can be frustrating and inconvenient. It can also make work or basic day-to-day activities, such as using a computer or cooking a meal, more difficult.

Exercises can improve mobility and decrease the chance of injury or reinjury. Wrist stretches are easy to do at home or at the office. When done properly, they can benefit a person’s overall wrist and hand health.

Anyone experiencing chronic pain or pain with numbness should visit a doctor for a thorough diagnosis.

Full story at Medical News Today

DEFINING THE SHAPE OF COOL

People are great at detecting cold temperatures and also the cool sensation induced by natural substances like menthol, which is common in remedies used to soothe aching muscles. But it hasn’t been entirely clear how we do this.

About a year ago, a group of researchers led by Seok-Yong Lee, Associate Professor of Biochemistry in the Duke University School of Medicine, figured out the architecture of the human and animal cold-sensing protein, an ion channel called TRPM8, which gave them some insight into its function but also raised more questions.

Now, Lee’s team has determined the structure TRPM8 assumes when it is bound to menthol and to another synthetic cooling agent called icilin. The findings, which will appear in Science on Feb. 8, could pave the way toward new treatments for chronic pain and migraine and help patients who suffer from extreme cold sensitivity.

Full story at Duke.edu

Spinal cord is ‘smarter’ than previously thought

We often think of our brains as being at the centre of complex motor function and control, but how ‘smart’ is your spinal cord?

Turns out it is smarter than we think.

It is well known that the circuits in this part of our nervous system, which travel down the length of our spine, control seemingly simple things like the pain reflex in humans, and some motor control functions in animals.

Now, new research from Western University has shown that the spinal cord is also able to process and control more complex functions, like the positioning of your hand in external space.

Full story at Medical Xpress

LAMPREYS CAN REGENERATE SEVERED SPINES MORE THAN ONCE

The study opens up a new path for identifying pro-regenerative molecules and potential therapeutic targets for human spinal cord injury.

Spontaneous recovery from spinal cord injury is almost unheard of in humans and other mammals, but many vertebrates fare better. The eel-like lamprey, for instance, can fully regenerate its spinal cord even after being severed—within three months the lamprey is swimming, burrowing, and flipping around again, as if nothing had happened.

“We’ve determined that central nervous system regeneration in lampreys is resilient and robust after multiple injuries. The regeneration is nearly identical to the first time, both anatomically and functionally,” says senior author Jennifer Morgan, director of the University of Chicago-affiliated Marine Biological Laboratory’s Eugene Bell Center for Regenerative Biology and Tissue Engineering.

Morgan’s lab has been focusing on the descending neurons, which originate in the brain and send motor signals down to the spinal cord. Some of these descending neurons regenerate after central nervous system injury in lamprey, while others die.

Full story at futurity.org

Magic-themed Therapy May Help Hand and Arm Function in Children with Unilateral Cerebral Palsy, Study Says

A type of intensive therapy that asks children with unilateral cerebral palsy (CP) to learn and practice magic tricks may help improve their hand and arm function and enhance their ability to do everyday tasks, a study reports.

The study, “Upper Limb Function of Children with Unilateral Cerebral Palsy After a Magic-Themed HABIT: A Pre-Post-Study with 3- and 6-Month Follow-Up,” was published in the Journal of Physical & Occupational Therapy in Pediatrics.

Children with unilateral CP have movement limitations mainly on one side of the body, affecting their ability to perform daily activities that require the use and coordination of both hands.

Hand-arm bimanual intensive therapy, or HABIT, is based on the principles of motor learning theory and neuroplasticity through structured, playful, and activity-based tasks involving two hands. HABIT includes motor learning principles of task selection, a structured practice of grading tasks, feedback, and home practice. In this way, children are engaged in fun activities and supportive environments that are different from typical therapy.

Full story at Cerebral Palsy News Today

Automated Text Messages Improve Outcomes after Joint Replacement Surgery

An automated text messaging system increases patient engagement with home-based exercise and promotes faster recovery after total knee or hip replacement surgery, reports a study in the January 16, 2019 issue of The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer.

Patients receiving timely texts showed improvement in several key outcomes, including fewer days on opioid pain medications, more time spent on home exercises, faster return of knee motion, and higher satisfaction scores, according to the research by Kevin J. Campbell, MD, of Rush University Medical Center, Chicago, and colleagues. “A chatbot that texts timely, informative and encouraging messages to patients can improve clinical outcomes and increase patient engagement in the early postoperative period after total joint replacement,” Dr. Campbell comments.

Automated Texts Lead to Improved Outcomes of Surgery

The randomized trial included 159 patients undergoing primary total knee or hip replacement. All received standard education, including instructions on home exercises after surgery.

Full story at News Wise

Shedding light on spinal cord injuries

Thousands of people worldwide suffer severe spinal cord injuries each year, but little is known about why these injuries often continue to deteriorate long after the initial damage occurs.

Yi Ren, a professor of biomedical sciences at the Florida State University College of Medicine, is making progress in understanding why such significant harm is inflicted in the weeks and months after a spinal injury. In a study published today in the journal Nature Neuroscience, Ren explained how a natural immune system response may contribute to additional injury.

When spinal cord damage occurs, the endothelial cells that line blood vessels are activated to remove potentially harmful material, like myelin debris, from the site of the injury. However, Ren and her team discovered that this process may be responsible for causing further harm.

“The consequences of the effort of endothelial cells to clear myelin debris is often severe, contributing to post-traumatic degeneration of the spinal cord and to the functional disabilities often associated with spinal cord injuries,” said Ren, whose team conducted the study over a period of five years.

Full story at Science Daily

New recovery pathway could speed up time to next treatment for pancreatic cancer patients

Pancreaticoduodenectomy, or the Whipple operation, is one of the most complex abdominal surgeries, and is commonly prescribed as a first line of therapy for cancer located within the pancreatic head. It remains the most effective treatment method associated with prolonged survival. The surgery involves removal of parts of the pancreas, bile duct, and small intestine, requiring careful reconstruction of the organs involved. Clinicians at Jefferson have now shown that providing patients intensive care after surgery can help reduce hospital stay and reduce time to eligibility for adjuvant chemotherapy. The prospective, randomized, controlled study was published in the Journal of the American College of Surgeons.

“The trial was so successful that we were able to halt the study early and change our standard practice to providing this accelerated post-operative care to all eligible patients,” said Harish Lavu, MD, Associate Professor of Surgery at Jefferson (Philadelphia University + Thomas Jefferson University) and researcher with the NCI-Designated Sidney Kimmel Cancer Center – Jefferson Health.

Full story at news-medical.net

Why it’s never too late to start lifting weights

It may not be how you intended to spend older age, but there it is; a study by researchers at the University of Dublin has shown so conclusively how much older people benefit from resistance training – working their muscles, even drinking protein shakes – that they have concluded GPs should prescribe it.

Twenty to 25 minutes of activity, four days a week at home, with an emphasis on a high-protein diet, is ideal.

Dorian Jones, who runs the London-based Marigold Fitness classes, may be the country’s foremost senior-trainer. The 42-year-old is a certified boxing coach, a level three personal trainer and used to be on the basketball team for the police force, but he developed a passion for working with older people. Most of his clients are in their 70s or 80s. A handful are in their 90s. “I had a woman who was 102, and she unfortunately passed. But she looked amazing!”

Full story at The Guardian

New CPT Codes Allow PTs to Conduct, Bill for Remote Monitoring

Sure, the biggest news from the 2019 Medicare physician fee schedule is the new reporting and payment system for many physical therapists (PTs), but that’s not the whole story: the 2019 rule also includes new current procedural terminology (CPT) codes that allow PTs to conduct and bill Medicare for remote monitoring of patient factors such as weight, blood pressure, and pulse oximetry.

Many questions remain as to how the US Centers for Medicare and Medicaid (CMS) will implement the new codes, and APTA is developing online resources that will supply further details as they become available.

Here’s what APTA knows so far: the new CPT codes apply to chronic care, and they allow physicians, clinical staff, or “other qualified healthcare professionals” to conduct remote monitoring in certain circumstances. Because PTs are included in the American Medical Association’s definition of  “qualified healthcare professionals” they are able to participate in the remote monitoring to the extent allowed by state and scope-of-practice laws.

Full story at APTA