Much like an APTA white paper on opioids and pain management published in the summer of 2018, a draft report from the US Department of Health and Human Services (HHS) says that it’s time to address the gaps in the health care system that make it difficult to follow best practices in addressing pain—including improved access to and payment for physical therapy. APTA provided comments to the HHS task force that created the report.
The draft “Report on Pain Management Best Practices” now available for public comment aims to identify “gaps, inconsistencies, updates, and recommendations for acute and chronic pain management best practices” across 5 major interdisciplinary treatment modalities: medication, restorative therapies including physical therapy, interventional procedures, behavioral health approaches, and complementary and integrative health. The entire report is predicated on a set of “key concepts” that emphasize an individualized biopsychosocial model of care that employs a multidisciplinary approach and stresses the need for innovation and research.
Increasing one’s level of physical activity may be an effective way to boost one’s mood, according to a new study from a team including scientists at Johns Hopkins Bloomberg School of Public Health in collaboration with the National Institute of Mental Health Intramural Research Program.
The findings were published online December 12 in JAMA Psychiatry.
The researchers found that increases in physical activity tended to be followed by increases in mood and perceived energy level. This beneficial effect was even more pronounced for a subset of the study subjects who had bipolar disorder. For the study, activity trackers and electronic diaries were used for two weeks in a community sample of 242 (150 women and 92 men) adults, ages 15 to 84, with an average age of 48 years. The sample included 54 people with bipolar disorder.
Mobile assessments in the study included wrist-worn devices that automatically recorded levels of physical movement in real time and electronic diaries that assessed mood and perceived energy levels four times per day for two weeks. These real-time mood and energy levels were rated by study participants on a seven-point analogue scale from “very happy” to “very sad” for mood and from “very tired” to “very energetic” for energy.
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.
Patients who underwent physical therapy soon after being diagnosed with pain in the shoulder, neck, low back or knee were approximately 7 to 16 percent less likely to use opioids in the subsequent months, according to a new study by researchers at the Stanford University School of Medicine and the Duke University School of Medicine.
For patients with shoulder, back or knee pain who did use opioids, early physical therapy was associated with a 5 to 10 percent reduction in how much of the drug they used, the study found.
Amid national concern about the overuse of opioids and encouragement from the Centers for Disease Control and Prevention and other groups to deploy alternatives when possible, the findings provide evidence that physical therapy can be a useful, nonpharmacologic approach for managing severe musculoskeletal pain.
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.