Study finds different amounts of physical therapy for stroke patients

Medicare-covered stroke patients receive vastly different amounts of physical and occupational therapy during hospital stays despite evidence that such care is strongly associated with positive health outcomes, a new study by Brown University researchers found.

The research team, led by Amit Kumar, an adjunct assistant professor at Brown’s School of Public Health, analyzed Medicare claims data from 2010 for approximately 104,000 stroke patients. They found that 15 percent of patients received no physical therapy (PT) or occupational therapy (OT), while on average stroke patients received 2 hours of therapy during their hospital stay. Some patients received almost 4 hours of therapy, but these tended to be patients with the longest hospital stays, Kumar added.

“For stroke patients, rehabilitation services are one of the most important components in providing treatment after they are stabilized in the acute setting,”said Kumar, who is also an assistant professor of physical therapy at Northern Arizona University. “This is the only treatment that helps patients regain activities for daily living, such as walking or using the restroom independently. So it’s really important to start physical therapy and occupational therapy as early as possible.”

Full story at news-medical.net

Shedding light on spinal cord injuries

Thousands of people worldwide suffer severe spinal cord injuries each year, but little is known about why these injuries often continue to deteriorate long after the initial damage occurs.

Yi Ren, a professor of biomedical sciences at the Florida State University College of Medicine, is making progress in understanding why such significant harm is inflicted in the weeks and months after a spinal injury. In a study published today in the journal Nature Neuroscience, Ren explained how a natural immune system response may contribute to additional injury.

When spinal cord damage occurs, the endothelial cells that line blood vessels are activated to remove potentially harmful material, like myelin debris, from the site of the injury. However, Ren and her team discovered that this process may be responsible for causing further harm.

“The consequences of the effort of endothelial cells to clear myelin debris is often severe, contributing to post-traumatic degeneration of the spinal cord and to the functional disabilities often associated with spinal cord injuries,” said Ren, whose team conducted the study over a period of five years.

Full story at Science Daily

Future doctors learn how to prescribe physical activity for their patients

An initiative adopted by Lancaster University to embed physical activity into the training for medical students has been showcased at a national and international level.

Lancaster Medical School was the first school in the UK to fully embed the Movement For Movement physical activity resources into the undergraduate programme and all medical schools and schools of health now have access to the resources, reaching a potential 120,000 students across the UK.

This Movement For Movement initiative, led by Ann Gates has been shared with all medical schools and visits to a sample of schools was funded by Public Health England and Sport England.

Full story at Lancaster University

Early physical therapy associated with reduction in opioid use

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.

Full story at news-medical.net

Patellofemoral Pain: 2018 Consensus statement on exercise therapy and physical interventionsns

Patellofemoral Pain (PFP) is an umbrella term that describes peripatella or retropatella pain in the absence of other pathologies. Other descriptions for PFP include patellofemoral pain syndrome, anterior knee pain and chondromalacia patellae (Brukner et al, 2017) and is common in loading activities such as squatting, running and stair ambulation (Crossley et al, 2016).

Although numerous intra and extra articulating structures could be responsible for the production of PFP, the actual cause is not entirely understood (Collado and Fredericson, 2010). One consideration is that PFP is a result of an increased loading through the knee, causing peripatella synovitis or damaging the articulating patellofemoral cartilage which, although avascular and aneural could result in an inflammatory cascade that produces synovial irritation (Brukner et al, 2017).

PFP has shown to affect adolescents, young adults, elite athletes as well as members of the general population with incidence rates varying between 15%-45% and is considered one of the most common types of knee pain (Smith et al, 2018).

Full story at PhysioSpot

More doctor visits can lower risk of suicide attempts in fibromyalgia patients

Fibromyalgia patients who regularly visit their physicians are much less likely to attempt suicide than those who do not, according to a new Vanderbilt University Medical Center study published in Arthritis Care & Research.

Patients who did not attempt suicide were at the doctor an average of 50 hours per year versus less than one hour per year for the group who committed self-harm, according to lead author Lindsey McKernan, PhD, assistant professor of Psychiatry & Behavioral Sciences, Physical Medicine & Rehabilitation.

“Fifty hours versus one hour – that’s a staggering difference,” McKernan said. “They might have been at one appointment in a year and this disorder, fibromyalgia, takes a lot to manage. It takes a lot of engagement.”

Full story at news-medical.net

What are the causes of unexplained muscle aches?

Muscle aches can occur in adults and children. In many cases, sore and aching muscles are nothing to worry about and will resolve without medical treatment. However, muscle aches can sometimes be a symptom of an underlying illness.

Common causes of muscle aches include:

  • overexertion
  • trauma to an area of the body
  • viral infections

Muscle aches, also known as myalgia, can be felt in any area of the body that has muscles. Depending on the cause, the discomfort may be mild or extremely severe.

Full story at Medical News Today

Treatment after Traumatic Shoulder Dislocation. A Systematic Review.

The shoulder is the most commonly dislocated large joint and it is often occurred by additional soft tissue injuries such as labral tears. Dislocations can occur in two directions: anterior and posterior with trauma being the leading cause of injury. Most often the trauma is from a posterolateral force on the shoulder with the arm in an abducted, externally rotated and extended position, dislocating the shoulder anteriorly. There are many other factors and causes which can contribute to a dislocation however let’s focus on trauma.

If you dislocate your shoulder, let’s say on the rugby field, there is usually only one treatment option and that is a closed reduction. This can happen immediately or once you arrive at a hospital in the emergency department either way it is potentially risky as may caused secondary damage. Interestingly there are over 20 different manoeuvres described for how to reduce a dislocated shoulder. If you’re interested in what technique to use and when to use it then there is a technical report linked below. *Disclaimer this article in no way suggests you should perform a reduction unless you have undergone appropriate training and have experience.*

Full story at Physiospot

Study: Estimated 1 in 3 Medicare Beneficiaries Receiving Inpatient/SNF Rehab Report No Improvement in Function

Authors of a new study on inpatient and skilled nursing facility (SNF) rehabilitation say that when it comes to patients’ own opinions of their progress, an estimated 1 in 3 Medicare beneficiaries are likely to report experiencing no improvement in functioning while they were receiving rehabilitation in those settings. And those rates can trend higher depending on certain demographic and health-related variables.

The study, published in the Journal of the American Medical Directors Association, analyzes survey responses from 479 Medicare beneficiaries who received inpatient or SNF rehabilitation between 2015 and 2016. Data were drawn from the National Health and Aging Trends Study (NHATS), with respondents comprising a nationally representative sample of the Medicare population.

Full story at APTA

Father’s and son’s injuries lead to the mother of all therapy bills

“So you have to take your block of wood, shape it, sand it, paint it, use your imagination,” Lopez said, pointing to some favorites from derbies past that sit on a shelf in his home office — cars in the shape of an ice cream cone, a penguin and an Altoids peppermint box.

But one derby project lives in infamy: an S. Pellegrino bottle on wheels. It was the brainchild of his son Theo, then 9, in the fall of 2016, a time when Lopez recalls he was frantically busy at work.

Full story at news-medical.net