Thirty percent increase in risk of fracture after gastric bypass

A study published in the Journal of Bone and Mineral Research shows that the risk of fractures increases by about 30 percent after a gastric bypass operation. It was also discovered that falls increase after these operations.

“Gastric bypass is a well-established method that has proven effective in reducing obesity, diabetes and mortality, so naturally our findings do not mean that you should stop providing these types of operations,” says Mattias Lorentzon, professor of geriatrics at Sahlgrenska Academy, University of Gothenburg, Sweden, and Chief Physician at the University Hospital.

The study is based on the records of 38,971 patients who underwent gastric bypass operations, of which 7,758 had diabetes and 31,213 did not. Those who had had the operation were compared with an equally large group of individuals who had not been operated on and who had the equivalent morbidity and background data.

Full story at Science Daily

Preventing ACL injuries in high school athletes

It’s not an uncommon scenario. An athlete is sailing through the air or making a quick turn when all of a sudden he or she hears a “pop” in the knee. An athlete who experiences this followed by sudden pain and swelling often receives the much-feared diagnosis of an anterior cruciate ligament (ACL) tear.

“Young, growing athletes are at high risk for ACL injuries, so it is important to work with coaches, trainers and medical professionals to minimize the risk of injury today, as well as the likelihood of reinjury or arthritis many years from now,” said Dr. Paul Sherbondy, an orthopedic surgeon at Penn State Health Medical Group – Park Avenue in State College.

According to Sherbondy, the ACL is one of the four major ligaments in the knee and the most commonly injured. It connects the thigh bone to the shin bone and helps stabilize the knee joint. ACL injuries range from a mild overextension to a full tear. “Anyone who has injured this ligament is at higher risk for reinjury, as well as early-onset osteoarthritis of the knee,” he said.

Full story at news-medical.net

Short-Term Insurance Rule Adds More Uncertainty to Care

As APTA continues to advocate for the maintenance of essential health benefits (EHBs) in insurance offered through Affordable Care Act (ACA) marketplaces, the association and other stakeholders are facing another potential challenge to patient access to care: private insurer short-term, temporary health plans that can skirt many ACA requirements around EHBs, preexisting conditions, and continued coverage.

Earlier this month, the Department of Health and Human Services (HHS) adopted a final rule on the short-term plans, allowing the policies to provide 1 year of coverage, renewable for up to 3 years. Previously, the plans could only be used for a maximum of 3 months.

The plans are intended to offer a cheaper insurance alternative than plans available through the ACA (although most individuals who purchase insurance through the ACA marketplaces receive subsidies that lower the out-of-pocket costs). But they are not required to comply with many of the consumer protections included in ACA plans. Instead, the plans are able to deny coverage of a preexisting condition, drop coverage should a customer’s health status change, and refuse coverage for services such as mental health, prescription drugs—and, possibly, physical therapy.

Full story at APTA

Eight exercises for tennis elbow

Tennis elbow is also known as lateral epicondylitis. It occurs when a person strains the tendons in their forearm. People can usually treat tennis elbow at home with rest and over-the-counter medication. Doing specific exercises can also help ease the pain and prevent reoccurrence.

We describe eight exercises to help strengthen muscles in the forearm and prevent tennis elbow from coming back. We also cover causes and symptoms, home treatment, prevention, and when to see a doctor.

Before trying these exercises, wait for any swelling to go down. It is also a good idea to check with a doctor or a physical or occupational therapist first.

Full story at Medical News Today

Animations prove effective in accurately measuring pain

To improve communication about pain between patients and physicians, a team led by researchers from the University of Pittsburgh and UPMC has developed a mobile application called “Painimation” that has the potential to assess and monitor pain better than any previously used measurement tools. Results of the clinical trial were published today in the Journal of Medical Internet Research.

“Currently, our only available tools for patients to communicate their pain is to either give them 0 to 10 scales or a selection of words and phrases to describe their pain, methods that have been used for more than 50 years,” said lead author Charles Jonassaint, Ph.D., M.H.Sc., assistant professor of medicine, social work and clinical and translational science. “Many pain patients will say their pain can’t be measured on the 0-to-10 scale and that it is too challenging to describe their pain using words. As a result, their pain is misunderstood and patients in pain may be prescribed more opioids without always knowing whether they are needed or if they are working.”

Painimation is an electronic assessment tool that uses animations to assess pain quality, type and location. With this app, patients are first provided with a selection of animations that they can use to describe the severity of their pain. These animations can then be increased or decreased in speed, color saturation, focus and size to accurately match their pain experience. The app also provides users with the opportunity to label their pain on a human body, allowing them to identify where and how much of their body is affected by pain.

Full story at Science Daily

Goal Setting in Rehabilitation: What do Patients Think?

We recently finished another round of our increasingly popular Volunteer Orientation Course. As part of the final assignment members were tasked to write an original piece of work to share with the profession, the contributions were of the highest quality. Below is the great piece of work written by  Lauren Lopez.

Goal setting. SMART goals. Client-centred goals. Goal setting and the best way to do it are hot topics in rehabilitation. A quick search through rehabilitation literature reveals a growing body of literature dedicated to the methods and evidence for goal setting with clients during rehabilitation. There is no consensus on a gold standard for a method of goal setting but it is widely held that it is a priority for guiding rehabilitation interventions toward achievable and meaningful outcomes. In the absence of a gold standard there are many research reports documenting health professionals’ opinions on and approaches to goal setting we can refer to. But what about our clients’ perspectives?

Full story at Physiospot

Study highlights need for strength training in older women to ward off effects of aging

Regular physical activity may help older women increase their mobility, but muscle strength and endurance are likely to succumb to the effects of frailty if they haven’t also been doing resistance training.

That is according to the findings of a cross-sectional study led by the University at Buffalo and published in the journal Physical & Occupational Therapy in Geriatrics.

The study underscores the need for older women to build up muscle strength early in the aging process to help ward off the effects of aging, say the study’s lead authors Machiko Tomita, clinical professor, and Nadine Fisher, clinical associate professor, both in the Department of Rehabilitation Science in UB’s School of Public Health and Health Professions.

Full story at buffalo.edu

From PT in Motion Magazine: How to Defend Yourself Against Scams and Cyberattacks

As technology and information sharing evolves at a rapid pace, it becomes harder to keep up with criminals and scammers—even if you are an experienced professional. Last year, a staggering 83% of physicians said they had experienced some form of cyberattack, according to an American Medical Association report. What kind of scams are out there? What should you be wary of? What new threats are emerging?

A feature in this month’s PT in Motion magazine describes common cybercrimes and scams, including data breaches, phishing, and ransomware. Author Katherine Malmo reports that cyberattacks happen to more organizations than we might think, since people don’t want to share their experiences. Robert Latz, PT, DPT, told PT in Motion, “The question is less if there will be a breach and more what to do when the breach happens.”

Full story at APTA

SNF, IRF Final Rules Follow Through on Proposed Shifts in SNF Payment Systems, IRF Reporting Requirements

The final 2019 rules for skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs) are substantially similar to what the Centers for Medicare and Medicaid (CMS) proposed in the spring, but that’s not to say physical therapists (PTs) should assume it’s a “same rule, different year” situation.

In fact, the situation is far from a “same as usual” scenario—at least for PTs in SNF settings, who will be facing a dramatic change in how payment is determined.

The new rules, set to go into effect in October of this year, include increases in payment of 2.4% for SNFS and 0.9% for IRFs, but the heart of the changes have less to do with payment increases and more to do with how payment will be determined and what needs to be reported. For PTs in IRFs, the reporting process could become a bit less burdensome, while PTs in SNFS will need to get up to speed with an entirely new payment system that does away with the Resource Utilization Groups Version IV (RUG-IV) process.

Full story at APTA

How long will my hip or knee replacement last?

For people considering hip or knee replacement surgery, it’s something they want — and need — to know.

In the US alone, surgeons perform more than 600,000 knee replacements and about 330,000 hip replacements each year. These operations can provide a major improvement in quality of life and function for those with severe arthritis. On the other hand, there are risks associated with the operation (as is true for any major surgery), there is a long road to recovery even when all goes well, and these operations aren’t cheap. For knee replacement surgery alone, an estimated $9 billion or more is spent each year in the US (although economic analyses suggest the surgery may actually be cost-saving over the long run).

So, if the first joint replacement is unsuccessful for some reason (such as infection or loosening), a second (or even third) operation may be necessary. And that’s a big deal, especially since “revision surgery” is technically more difficult, recovery can take longer, and success rates may be lower than first operations.

Full story at Harvard Health Edu