Physical Activity May Decrease Mortality Risk in Frail Older Adults, Say Researchers

While previous research has found that physical exercise decreases fall risk and improves mobility, researchers at the Universidad Autónoma de Madrid (UAM) in Spain wondered whether physical activity could reduce frailty-associated mortality risk. In their study, published in the Journal of the American Geriatrics Society, authors found that physical activity decreased mortality rates for healthy, prefrail, and frail adults over age 60.

Authors used data from a nationally representative sample of 3,896 community-dwelling individuals to explore any “separate and joint associations between physical activity and frailty” and all-cause and cardiovascular disease (CVD) mortality rates.

At baseline, in 2000–2001, researchers interviewed participants at home about their “leisure-time” physical activity: inactive, occasional, several times a month, or several times a week. They administered both the Fatigue, Resistance, Ambulation, Illness, and weight Loss (FRAIL) scale and 3 items from the 36-item Short-Form Health Survey (SF-36) to measure frailty, fatigue, resistance, ambulation, and weight loss. Participants also were asked whether they had been diagnosed with pneumonia, asthma or chronic bronchitis, hypertension, coronary heart disease, stroke, osteoarthritis or rheumatism, diabetes mellitus, depression under drug treatment, hip fracture, Parkinson disease, or cancer.

Full story at APTA

CDC: 1 in 4 Americans Have Multiple Chronic Conditions, With Wide Variation Among States

According to the US Centers for Disease Control and Prevention (CDC) one-quarter of the US adult population has multiple chronic conditions (MCCs), but that average doesn’t reflect regional differences, which include state MCC rates as low as 1 in 5 residents to a high of more than 1 in 3.

The report, based on results of a 2014 National Health Interview Survey of 36,697 results, tracks the prevalence of adults who reported having 2 or more of 10 chronic conditions: arthritis, cancer, chronic obstructive pulmonary disease, coronary heart disease, diabetes, hepatitis, hypertension, stroke, or weak or failing kidneys. Respondents included Medicare beneficiaries and the privately insured.

Full story of Americans with multiple chronic conditions 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

Raising the Priority of Lifestyle-Related Noncommunicable Diseases in Physical Therapy Curricula

Given their enormous socioeconomic burdens, lifestyle-related noncommunicable diseases (heart disease, cancer, chronic lung disease, hypertension, stroke, type 2 diabetes mellitus, and obesity) have become priorities for the World Health Organization and health service delivery systems. Health care systems have been criticized for relative inattention to the gap between knowledge and practice, as it relates to preventing and managing noncommunicable diseases. Physical therapy is a profession that can contribute effectively to patients’/clients’ lifestyle behavior changes at the upstream end of prevention and management. Efforts by entry-to-practice physical therapist education programs to align curricula with epidemiological trends toward best health care practices are varied. One explanation may be the lack of a frame of reference for reducing the knowledge translation gap. The purpose of this article is to provide a current perspective on epidemiological indicators and societal priorities to inform physical therapy curriculum content. Such content needs to include health examination/evaluation tools and health behavior change interventions that are consistent with contemporary values, directions, and practices of physical therapy.

Full story on lifestyle-related noncommunicable diseases at APTA

Study: Primary Prevention Key to Decreasing Disparity in Black-White Stroke Mortality Rate

Reducing the stark disparity in stroke mortality between black and white Americans requires a focus on risk prevention in primary care and public health, say authors of a new study. But, they add, those efforts need to “go further upstream” by examining the reasons for the higher prevalence of stroke risk factors among black Americans, including consideration of what authors call “nontraditional risk factors.”

While overall stroke mortality and risk factors such as hypertension have declined over the years for both groups, black Americans at age 45 are more than 3 times as likely as their white peers to die of the disease. Although this difference has existed for decades, it wasn’t clear, based on evidence, where and how to target interventions accordingly.

The big question, according to authors, has to do with whether black Americans are having more strokes than white Americans, or whether strokes are more often fatal for black Americans. The answer could help health care providers, including physical therapists, understand the best way to approach this public health issue.

Full story of disparity in black-white stroke mortality rate at APTA

From PTJ: New Recommendations for PT Treatment of Childhood Obesity

Primary care providers, rather than simply prescribing physical activity to young patients with obesity, should involve physical therapists (PTs) who can assess the child’s risk factors and evaluate and monitor the child’s increasing level of physical activity, say authors of a clinical recommendation in Physical Therapy(PTJ), APTA’s science journal.

While children with obesity need to increase their level of physical activity, they also are more likely to have comorbid conditions such as diabetes, asthma, or hypertension, and they also are at increased risk of injury from exercise. The authors, who represent the Belgian Physical Therapy Association (AXXON), present clinical recommendations for “first-line” PTs treating children and adolescents with obesity in a private practice or home care setting.

Full story on PT treatment for childhood obesity at APTA

Obesity, Physical Inactivity Rates Mostly Stable 2013-2014

The good news: obesity rates in the United States may have stabilized in 2014. The bad news: that’s not good news.

The most recent “State of Obesity: Better Policies for a Healthier America” study, released in September, finds that 2014 adult obesity rates in the US were 20% or more in every state, with 22 states having rates above 30%. That rate does not represent a significant change from 2013. Averaged across the country, more than 30% of adults and 17% of children are considered obese.

The report tracks state-by-state levels of obesity, diabetes, hypertension, and physical inactivity over time (ranges vary by topic), and provides state ratings in each category. In state-by-state analysis of adult obesity, Arkansas topped this year’s list with a 35.9% rate, followed by West Virginia (35.7%), and Mississippi (35.5%). The 3 states with the lowest adult obesity rates were Colorado at 21.3%, followed by the District of Columbia (21.7%), and Hawaii (22.1%).

Full story of stable obesity and physical inactivity rates at APTA

Monday’s medical myth: bed rest is best for back pain

By Michael Vagg

Bed rest for back pain

Severe low back pain is a common and dreaded problem that that rivals only hay fever, asthma, hypertension and dermatitis as Australia’s leading cause of long-term illness.

The instinctive response to severe pain is to rest the injured body part and reduce normal activities while it heals.

But from the mid-1990s, studies comparing bed rest to more active treatment for acute back pain have reached the same conclusion: bed rest is not best for pack pain.

Light activity – such as short walks around the house or sitting upright for brief periods throughout the day – reduces the requirement for medication, shortens absences from work and results in fewer visits to health-care professionals.

Full story at The Conversation