If part of a hospital stay is to recover from a procedure or illness, why is it so hard to get any rest?
There is more noise and light than is conducive for sleep. And nurses and others visit frequently to give medications, take vitals, draw blood or perform tests and checkups — in many cases waking patients to do so.
Some monitoring is necessary, of course. Medication must be given; some vital signs do need to be checked. And frequent monitoring is warranted for some patients — such as those in intensive care units. But others are best left mostly alone. Yet many hospitals don’t distinguish between the two, disrupting everyone on a predefined schedule.
Peter Ubel understands the problem as both a physician and patient. When he spent a night in the hospital recovering from surgery in 2013, he was interrupted multiple times by blood draws, vital sign checks, other lab tests, as well as by the beeping of machines. “Not an hour went by without some kind of disruption,” said Dr. Ubel, a physician with Duke University. “It’s a terrible way to start recovery.”
A lateral collateral ligament sprain occurs when the ligament on the outer side of the knee tears. This type of sprain is most common in people who play contact sports, such as football.
While knee injuries represent up to 39 percent of all injuries in athletes, lateral ligament injuries are less common. Many lateral collateral ligament (LCL) injuries occur alongside other knee damage.
The LCL connects the thighbone to the smaller calf bone. It controls the sideways movement of the knee, and, alongside the medial collateral ligament on the inner knee, it contributes to knee stability.
In findings on neck pain that echo the results of similar studies on low back pain, researchers have identified an association between early consultation with a physical therapist (PT) and lower rates of opioid prescription, imaging, and injections. Those lower-use rates contributed to significant cost savings over a 1-year study period compared with patients who waited 90 days or more before seeing a PT, according to the study’s authors.
The study, published in BMC Health Services Research, looked at health care utilization over 1 year among 308 patients who presented with neck pain. The patients were divided into 3 groups: an “early” group that consulted a PT within 14 days, a “delayed” group that received a PT consultation between 15 and 90 days after initial health care provider consultation, and a “late” group that waited from between 91 and 364 days to consult with a PT. All patients were members of the University of Utah Health Plans, either through private insurance or via Medicaid, and none had a recorded health care encounter for neck pain in the 90 days preceding initial consultation. APTA members Maggie Horn, PT, DPT, PhD; and Julie Fritz, PT, PhD, FAPTA, coauthored the study.
As the US population continues to age, physical therapists (PTs) and physical therapist assistants (PTAs) will take on an even more transformative role in the health of society. Are you ready?
The 2019 APTA Combined Sections Meeting, set for January 23-26 in downtown Washington, DC, can help keep you on top of some of the latest issues in healthy aging. Check out these suggestions, and find other relevant programming by searching the CSM programming page.
Geriatric Low Back Pain: Managing Influences, Experiences, and Consequences
This session focuses on the biological, psychological, cognitive, and social influences of geriatric low back pain (LBP), and presents a comprehensive model of geriatric LBP that accounts for the interface between pain and impaired movement, as well mobility and health risks associated with geriatric LBP. Find out about age-appropriate measurement tools and interventions for geriatric LBP and learn how to implement a comprehensive, standardized management approach that optimizes recovery and mitigates health risks associated with geriatric LBP. Friday, January 25, 8:00 am–10:00 am.
The range of conditions that physical therapists (PTs) and physical therapist assistants (PTAs) face every day can be expansive, and staying on top of the latest effective treatment approaches can seem like an impossible task. PTNow is helping to change all that by bringing members the evidence they need in just a few clicks.
Best of all, the association’s flagship site for evidence-based practice resources continues to expand in ways that help PTs and PTAs easily find an even wider array of information. If you haven’t visited the site lately, check it out soon. Here’s a quick take on the latest additions.
You want blunt? The US Department of Health and Human Services can do blunt—at least when it comes to physical activity (PA) recommendations for Americans.
“Adults should move more and sit less throughout the day,” HHS says in its latest edition of nationwide guidelines for PA. “Some physical activity is better than none.”
That’s the bottom-line recommendation that HHS rolled out this week in its revised Physical Activity Guidelines for Americans. And there’s arguably little room for nuance: according to HHS, 80% of all Americans are not meeting current PA recommendations, a failure that is contributing the prevalence of a host of chronic health conditions.
The new guidelines, with their emphasis on the importance of movement to prevent disease and extend life no matter an individual’s age, echo many perspectives long-championed by APTA and its members.
THE THING ABOUT building muscle, cutting fat and otherwise getting in shape is, well, you have to work out. No fair, right? But what if someone – or something – else could do a lot of the work for you? Such is the commonly perceived promise of electrical muscle stimulation training, aka EMS, a type of technology that activates your muscles from the outside while you activate them from the inside.
“It’s an efficient workout,” says Jackie Wilson, a lawyer-turned-personal trainer who founded NOVA Fitness Innovation, a network of boutique fitness studios in New York City that offers one-on-one EMS training sessions.
While the specifics vary depending on the model of equipment itself and the type of supervision you’re under, in Wilson’s studios, the training involves wearing a wetsuit-like outfit embedded with 20 electrodes that sit atop major muscle groups like the pecs, biceps and quads. As clients go through a body weight or lightly weighted workout – say, a circuit including squats, pushups and jumping jacks – he or another trained staff member uses a wireless device to send impulses of varying intensities to those muscles that are contracting.
The underlying structure-function relationship of living tissues depends on structural and hierarchical anisotropy. Clinical exploitation of the interplay between cells and their immediate microenvironment has rarely used macroscale, three-dimensional (3-D) constructs. Biomechanical robustness is an important biomimetic factor that is compromised during biofabrication, limiting the relevance of such scaffolds in translational medicine.
In a recent study, Zu-Yong Wang and co-workers have detailed a polymeric three-dimensional scaffold engineered with tendon-like mechanical properties and controlled anisotropic microarchitectures. The construct is composed of two distinct portions for high porosity while retaining tendon-like mechanical properties. When tendon cells (tenocytes) were cultured on the scaffold in vitro, phenotypic markers of tenogenesis such as type-1 collagen, decorin, and tenascin were expressed more significantly than in non-anisotropic controls. Now published in Science Advances, the results demonstrated a highly aligned intracellular cytoskeletal network with high nuclear alignment efficiencies. The study also suggests that microstructural anisotropy may play the role of epigenetic mechanotransduction. The work further included an in vivo study where the biomaterial was implanted in a micropig model, with resulting neotissue formed on the scaffold to resemble native tendon tissue in both composition and structure.