Cardio-respiratory synchronization may represent a new measure of health and fitness

Observation of extended episodes of one-to-one synchronization between heart rate and breathing rate for athletes suggests their training specifically contributes to an enhanced connection within the nervous system.

Researchers from the School of Engineering at the University of Warwick have managed to expand the knowledge of the cardio-respiratory system after conducting an experiment measuring heart rate during fast-paced breathing.

Published in Scientific Reports, the paper “Control of heart rate through guided high-rate breathing” shows how researchers found it is possible to reliably observe a one-to-one relationship between heart beats and breaths, when breathing is controlled at a speed exceeding resting heart rate.

Full story at Medical Xpress

Childhood Obesity: How We Are – and Aren’t – Making Progress

Obesity among children is a fairly new problem in the United States. Rates of childhood obesity in the 1960s and 1970s were relatively low, with only 5 to 7 percent of kids qualifying as having obesity.

Today, the Centers for Disease Control and PreventionTrusted Source puts the rate of childhood obesity at 18.5 percent, with roughly 13.7 million children and adolescents being affected. That’s a huge leap over the course of just a few decades.

But recent researchTrusted Source points to a potential decline in those numbers.

Full story at HealthLine

Athletes at a higher risk for ACL injury after return to sport

Young athletes who do not achieve a 90 percent score on a battery of tests that measure fitness to return to athletic competition, including quadricep strength, are at increased risk for a second knee injury, according to research presented at the Annual Meeting of the American Orthopedic Society of Sports Medicine.

Orthopedic surgeons and sports medicine professionals have established return-to-sports criteria to help guide patients as they consider participating in athletic competition after injury. Researchers pointed to the strength of the quadricep as one of the most important measures to predict risk for further injury to the anterior cruciate ligament.

Researcher Dr. Mark V. Paterno, Division of Sports Medicine, Cincinnati Children’s Hospital, Cincinnati, and fellow researchers followed 181 patients, average age 16 years old, for two years.

Full story at Science Daily

Study reveals long-term benefits of stress urinary incontinence surgery

One of the most commonly performed surgeries to treat stress urinary incontinence in women may have better long-term results than another common surgical technique, according to a study led by Mayo Clinic researchers.

The retrospective study of more than 1,800 cases at Mayo Clinic from 2002 to 2012 found that the need for additional surgery was twice as high after a transobturator sling surgery compared with a retropubic sling procedure.

Reoperation rates within eight years after surgery were 11.2% for patients in the transobturator group compared with 5.2% in the retropubic group, according to the study, which will be published in the journal Obstetrics and Gynecology in August.

Full story at news-medical.net

Proposed Home Health Rule Moves Ahead With New Payment System, Allows Therapist Assistants to Furnish Maintenance Therapy

The US Centers for Medicare and Medicaid Services (CMS) intends to go full steam ahead with its plans to shift to a new payment system for home health beginning in 2020. The plans are accompanied by other changes that include allowing maintenance therapy to be furnished by physical therapist assistants (PTAs) and occupational therapy assistants (OTAs), providing a payment “add on” for rural home health care, and adopting an APTA-supported “notice of admission” requirement to avoid duplicate billing. The new provisions, which include a 1.3% payment increase, are included in CMS’ proposed rule released on July 11.

The biggest shift has been more than a year in the making: a transition to a new payment system known as the Patient-Driven Groupings Model (PDGM). The PDGM moves care from 60-day to 30-day episodes and eliminates therapy service-use thresholds from case-mix parameters. Instead, the system classifies 30-day care 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. APTA offers extensive information on the new system and will participate in a live August 5 webinar on the model jointly hosted by APTA, CMS, the American Occupational Therapy Association, and the American Speech-Language-Hearing Association. APTA members can participate in this webinar.

Full story at APTA

Soccer headgear may not reduce sport-related concussion

In season-long tests, soccer headgear didn’t reduce the overall number or severity of concussions experienced by high school players, U.S. researchers say.

Some of the five headgear models used in the trial, however, may have been better at reducing impact forces that lead to concussions, particularly among female players, the study authors report in the British Journal of Sports Medicine.

“Female soccer is late to the party in terms of recognizing the number of injuries. So much focus has been on football that we haven’t recognized that females are more at risk for knee injuries and concussions,” said Timothy McGuine of the University of Wisconsin School of Medicine and Public Health in Madison, who led the study.

Full story at Reuters

The Power of One Push-Up

The numbers used to assess health are, for the most part, not helpful.

There are the vital signs: heart and respiratory rates and body temperature. Sometimes blood pressure. These are critical in emergencies. If you’ve been stabbed in the chest, paramedics want to know no numbers more than these.

But in day-to-day life, the normalcy of those numbers is expected. It doesn’t so much grant you a clean bill of health as indicate that you are not in acute danger. What if you just generally want to know whether you’re on pace to live an average life or longer?

The most common numbers are age and body weight. The U.S. health-care system places tremendous value on the latter, in the form of body-mass index, or BMI, a simple ratio of weight over height. BMI is used to define obesity and “overweight,” and so to stratify risks in insurance and health-care industries. This number has come to be massively consequential in the lives of millions of people, and to influence the movement of billions of dollars.

Full story at The Atlantic

Nerve transfer surgery restores upper limb function in people with tetraplegia

13 young adults with tetraplegia are able to feed themselves, hold a drink, brush their teeth, and write as a result of a novel surgical technique which connects functioning nerves with injured nerves to restore power in paralyzed muscles. Nerve transfer surgery has enabled 13 young adults with complete paralysis to regain movement and function in their elbows and hands, according to the largest case series of this technique in people with tetraplegia (paralysis of both the upper and lower limbs), published in The Lancet.

During the surgery, Australian surgeons attached functioning nerves above the spinal injury to paralyzed nerves below the injury. Two years after surgery, and following intensive physical therapy, participants were able to reach their arm out in front of them and open their hand to pick up and manipulate objects. Restoring elbow extension improved their ability to propel their wheelchair and to transfer into bed or a car.

They can now perform everyday tasks independently such as feeding themselves, brushing teeth and hair, putting on make-up, writing, handling money and credit cards, and using tools and electronic devices.

Full story at news-medical.net

Expanded Health Reimbursement Arrangement Rule May Widen Use of the Employer Offering

A final rule from the US Department of Health and Human Services (HHS) will expand small employers’ ability to offer Health Reimbursement Arrangements (HRAs), a change that may make it easier for more Americans to purchase health insurance that they don’t receive from their jobs. While it’s still too early to tell if the change will significantly impact patients seen by physical therapists (PTs), APTA’s advice is to keep an eye open, and be aware of the nuances of HRA payment.

The new rule, set to go into effect January 1, 2020, will allow qualified small employers to offer what’s being called an “Individual Coverage HRA” as an alternative to traditional group coverage plans. The idea behind HRAs is that employers provide a monthly tax-free allowance to employees, who can be reimbursed for health care-related expenses up to the allowance limit. The changes set to go into effect next year would permit HRAs to be used to pay for health insurance purchased on the individual market, and allow employers to offer “excepted benefit” HRAs to supplement employer-sponsored insurance—even if the employee isn’t enrolled in the group plan.

Full story at APTA

Low vitamin K may reduce mobility in older adults

Older adults with insufficient vitamin K are likely to be at higher risk for mobility disability, according to new research.

Dietary sources of vitamin K include kale, spinach, broccoli, and other leafy greens. Some dairy foods also contain vitamin K.

The investigators who carried out the study say that their findings “suggest vitamin K may be involved in the disablement process in older age.”

Full story at Medical News Today