Millions worldwide suffer from chronic musculoskeletal back pain (lasting more than three months). The problem is so big that in the UK alone, it is estimated that 116m days of work are lost, a million hospital appointments are made and five million GP visits are scheduled – just for low back pain.
The physical agony is often not a standalone problem, however. 35% of people who suffer with low back pain are also diagnosed with depression, anxiety and social isolation.
NICE guidelines suggest that chronic back pain sufferers should have physical therapy as part of a broader package of treatment which includes psychological help. But we have been exploring how one single type of osteopathic treatment can be used to treat both the physical and mental conditions.
Could high-intensity treadmill exercise slow the progression of symptoms among individuals with Parkinson disease (PD)? Authors of a new study say that while more research needs to be done, their randomized clinical trial has proven the intervention to be safe, with indications that sufficiently vigorous treadmill work 3 times a week slowed severity at 6 months.
Their findings, published in JAMA Neurology, are based on a study of 128 patients with stage 1 or 2 PD who were within 5 years of diagnosis. Authors wanted to find out whether endurance exercise—particularly the high-intensity variety—had any effect on PD severity over time. Authors say the study is the first to evaluate the effects of exercise at 80% to 85% of maximum heart rate among patients with PD, and 1 of only a handful that focused on disease severity as an outcome, rather than fitness or functional measures.
In nursing homes and residential facilities around the world, health care workers are increasingly asking dementia patients questions: What are your interests? How do you want to address us? What should we do to celebrate the life of a friend who has passed away?
The questions are part of an approach to care aimed at giving people with memory loss and other cognitive problems a greater sense of control and independence. At its core is the idea that an individual with dementia should be treated as a whole person and not “just” a patient.
Exercise is known to prevent or treat metabolic syndrome, which is a group of health conditions that raise the risk of heart problems and type 2 diabetes. Now, a new study suggests that less than 1 hour per week of resistance training, even without aerobic exercise, can be of benefit.
Lead author Esmée Bakker, of Radboud University Medical Center in Nijmegen in the Netherlands, and colleagues report their findings in the journal Mayo Clinic Proceedings.
Metabolic syndrome is a cluster of health risk factors that make it more likely that a person will develop type 2 diabetes and cardiovascular diseases such as heart disease and stroke.
Tech company developer conferences always feature a wacky demo or three.
But at Build 2017 in Seattle Wednesday, Microsoft went for the waterworks at the conclusion of CEO Satya Nadella’s keynote address: it showcased a prototype watch that temporarily eliminated the arm shaking that often plagues those suffering from the neurological disease Parkinson’s.
After a speech that both heralded and warned about coming leaps in technological power, Nadella screened a video that told the story of two British Microsoft Research employees, Haiyan Zhang and Nicolas Villa, who developed the tremor-interrupting device for a BBC documentary, The Big Life Fix.
Study focused on a single hospital and reviewed 6,246 scheduled physical therapy sessions
Overall, 15.9% of scheduled sessions never occurred
Nontreatment was highest on Sundays (33.8%)
Authors caution against “quick fixes” such as prohibiting Sunday sessions; assert that PTs need to exercise clinical judgment to schedule when needed
Researchers who tracked a hospital found that, on average, more than 15%–and as many as 1in 3–hospital physical therapy sessions never actually took place, depending on the reason for hospitalization and the day of the week treatment was scheduled. Authors of the study say that’s too many, and if other facilities are facing the same issue, fixing the problem will require hospitals to address their “internal culture and weekend staffing policies” and not just look for quick fixes.
When the Jimmo v Sebelius settlement was announced in 2013, patient advocates applauded what they saw as a landmark change for individuals who need care to maintain their medical conditions or slow their declining health. However, 3 years later, many providers and payment adjudicators are still making coverage decisions as if they’re living in a pre-Jimmo world—mostly because the US Centers for Medicare and Medicaid Services (CMS) hasn’t done enough to bring them up to speed, according to an advocacy group supported by APTA.
Recently, APTA provided a supporting declaration to the Center for Medicare Advocacy’s (CMA) efforts to get CMS to do a better job of making it clear that the “Improvement Standard”—the idea that Medicare coverage can only be extended if that care will actually improve the patient’s condition—is a fallacy, and that skilled maintenance care can qualify for payment.
“There are still many providers and contractors who do not know about, understand, or trust the change in the improvement policy,” CMA wrote in a December 2015 letter to APTA and other stakeholders. “We believe this is largely due to the fact that CMS’ Education Campaign was insufficient to make up for the rigor with which Medicare enforced the Improvement Standard—for decades.” According to CMA, CMS conducted only 1 briefing for providers and adjudicators, in early December of 2013. Since that time, CMS “has refused to do more,” CMA writes.
People with mild to moderate Parkinson’s disease do not benefit from physical therapy, researchers in England found in a new study.
Researchers at the University of Birmingham said there were no clinical or lifestyle improvements as a result of physical and occupational therapy, suggesting better programs need to be created to benefit patients.
Parkinson’s disease affects about 7 million people around the world, and 4 percent of people over the age of 80.
The study was focused on patients with mild to moderate Parkinson’s, which some researchers say should be interpreted as narrowing who is referred for physical therapy but should not rule it out. Part of the motivation for the study, the researchers said, was to be sure funds in England’s National Health Service are allocated for effective treatments.
The volume vs value debate, long-familiar to physical therapists (PTs) and physical therapist assistants (PTAs), is now getting wider exposure by way of a recent Wall Street Journal (WSJ), article on the “copious” use of ultrahigh therapy hours billed to Medicare by skilled nursing facilities (SNFs).
In a story published on August 16, WSJ describes results of an analysis it conducted on SNF billing patterns between 2001 and 2013, which found that the use of the ultrahigh category of rehabilitative therapy reimbursement—720 minutes or more a week per patient—has increased from 7% of patient days in 2002 to 54% of patient days in 2013.
While the story acknowledges the benefits of rehabilitative therapy, describing physical therapy, occupational therapy, and speech therapy as often “crucial to recovery,” it also cites interviews with “more than two dozen current and former therapists, rehabilitation directors, and others” who told WSJ reporters that “managers often pressure caregivers to reach the 720-minute threshold.”