Tag: occupational therapy

Patients with newly diagnosed musculoskeletal pain are prescribed opioids more often than recommended

During their first physician visit, patients experiencing newly diagnosed chronic musculoskeletal pain are prescribed opioids more often than physical therapy, counseling, and other nonpharmacologic approaches, according to a new study published in the Journal of Pain. The use of opioids over other approaches stands in contrast with clinical recommendations for the use of nonopioid pain approaches and nonpharmacologic approaches. The study included authors from the National Center for Complementary and Integrative Health (NCCIH), part of the National Institutes of Health; the University of Montreal; and McMaster University in Hamilton, Ontario, Canada.

“Particularly when the patient is experiencing pain that may become chronic, that first clinical encounter can set the course for patient care moving forward,” said Helene Langevin, M.D., director of NCCIH. “This study was designed to assess the ways in which real-world practice compares and contrasts with practice guidelines for these initial patient encounters.”

Full article at National Institute of Health

Navigating Home Modifications Billing for Medicare-Covered Clients

As the population ages, and the majority of older adults express a desire to age in place, the need for home modification evaluations and interventions is expanding. While home modification services are clearly within the scope of occupational therapy, what is not so clear are the options for reimbursement. Many questions arise regarding proper billing.

Medicare-covered clients are entitled, under law, to medically necessary services. Occupational therapy practitioners do NOT have the right, under current statutes, to “opt out” of Medicare. Any occupational therapy practitioner, even those who are not Medicare providers, must directly bill Medicare for any medically necessary skilled therapy services provided to Medicare-covered clients. Whether or not to bill Medicare for home modification OT services must be based on the occupational therapy practitioner’s clinical determination of whether the services are medically necessary.   

This guide first provides a brief overview of the occupational therapy practitioner’s role in home modification and the current Medicare program. Second, case scenarios are provided on some of the factors used in determining whether the services are medically necessary. It should be noted that the scenarios are only examples, and each case requires a unique determination. The occupational therapy practitioner is ultimately responsible for determining Medicare medical necessity for each client.

Full article at AOTA

Small-Scale Study Finds Large-Scale Debt Among Recent DPT Grads

The message
It’s a limited study—based on a small number of respondents who are early-career APTA members in Florida—but the conclusions might sound familiar to recent graduates of DPT programs: The average amount of educational debt owed by entry-level PTs is equal to almost two years’ average salary, a 197% debt-to-income ratio. That’s more than the average debt-to-income ratio for newly minted family medicine physicians and veterinarians, according to the study’s author, and a burden that may affect a PT’s choice of practice setting.

The study
The analysis was developed from surveys administered to members of the Florida Physical Therapy Association’s Early Professional Special Interest Group (SIG) in 2016, all of whom were entry-level professionals (0-5 years after graduation) and practicing as PTs in Florida. The final results were based on responses from 86 individuals (out of approximately 350 PT SIG members) who answered questions related to income, amount of debt held, and clinical practice choices. The study asserts that the sample reflects “all major practice settings.” The study was authored by APTA member Steven Ambler, PT, DPT, MPH, PhD.

Full article at APTA

Woman with severe spinal cord injury recovers after treatment at Danbury Hospital

A freak accident left Katherine (Kathy) Wenning unable to move her upper body. She knew she needed medical attention, but she was at her country getaway in Washington, Connecticut -; two hours by car from her home in Manhattan and the New York medical system she trusted. Kathy put her faith in a neurosurgeon and care team at Danbury Hospital to treat her severe spinal cord injury.

Fateful fall leads to unexpected injury

Kathy, 75, was getting ready for bed when she tripped on her clothes and struck her neck on a shelf inside her closet. She lost consciousness and woke up to pain radiating from her neck down to her arms. Kathy’s husband, Michael, found her lying on the floor of the closet unable to move. She just wanted to go to sleep, hoping she would feel better in the morning.

Full story at News Medical

How To Teach Future Doctors About Pain In The Midst Of The Opioid Crisis

The next generation of doctors will start their careers at a time when physicians are feeling pressure to limit prescriptions for opioid painkillers.

Yet every day, they’ll face patients who are hurting from injuries, surgical procedures or disease. Around 20% of adults in the U.S. live with chronic pain.

That’s why some medical students felt a little apprehensive as they gathered recently for a mandatory, four-day course at Johns Hopkins University in Baltimore — home to one of the top medical schools in the country.

The subject of the course? Pain.

Full story at NPR

How Your Well Intentioned Exercises Can Go Wrong If You’re Not Careful

Exercise prescription is at the heart of every rehab professional’s arsenal.  Whether you are prescribing a simple one such as a straight leg raise or something much more complex involving coordination of proprioception and plyometrics, you are intending to help your patients.  There’s a key component that is often missed during rehab however, and when it is, it can limit your effectiveness.  It may even drive your patients to report increased pain with treatment and in the worst cases, it prevents your patient from achieving their goals.

I don’t believe this is intentionally missed in rehab, but it’s something you will rarely see in research and a component rarely focused on in school.  Is your intervention aimed at the wrong impairment?

Let’s start with this example that’s easier to see and then we’ll move onto one that may be a bit less obvious.

Full story at Physiospot

New York Hospital Using Sailing As Unique Therapy For Disabled And Special Needs Children

Spending a relaxing day on a sailboat can be great medicine for just about anyone.

But for a special group of kids, there’s an even greater benefit.

“I’ve never been sailing,” 10-year-old Alexandria said.

Alexandria is part of a group of patients from the Hospital for Special Surgery, where they’re being treated for conditions such as cerebral palsy, autism, and scoliosis.

HSS arranged a first of its kind sailing trip at the adaptive program at the waterfront center in Oyster Bay, after similar, successful patient outings for horseback riding, surfing, and skiing.

“I think these programs give them the opportunity to move their body in a new way and be open to new opportunities,” Sabrina Cerciello from HSS said.

Cerciello is a physical therapist in pediatric rehabilitation.

Full story at CBS News

Causes and treatments for pain in the arch of the foot

The arch of the foot is an area along the bottom of the foot between the ball and the heel. Pain in the arch of the foot is a common problem, especially among athletes.

The arch is made up of three separate arches that form a triangle. Each arch is made up of bones, ligaments, and tendons.

There are many potential causes of pain in the arch of the foot. Keep reading for more information on these causes, as well as the possible treatments.

Full story at Medical News Today

IRFs Receive 2.5% Increase From CMS in FY 2020; Additional Reporting Requirements in FY 2022

In a final rule from the US Centers for Medicare and Medicaid (CMS), inpatient rehabilitation facilities (IRFs) will see a 2.5% payment increase in the 2020 fiscal year (FY), which begins October 1, 2019—an approximate boost of $210 million. But they’ll also need to prepare for some expanded reporting measures in the years to come—including a requirement to report data on social determinants of health.

Reporting requirements won’t change much in FY 2020. However, beginning with the FY 2022 IRF Quality Reporting Program (QRP), IRFs will be required to provide certain standardized patient assessment data (SPADE) to CMS. The additional SPADE requirements are aimed at bringing IRFs up to speed with provisions of the 2014 IMPACT Act, a law that mandated more uniformity in reporting across postacute care (PAC) settings. In a fact sheet on the final rule, CMS writes that the addition of these SPADES “will improve coordination of care and enable communication.”

Specifically, CMS will adopt the SPADES on pain interference on sleep, therapy, and day-to-day activities, provisions being added in light of the opioid crisis. CMS is considering adding future SPADEs including dementia, bladder and bowel continence, care preferences, advance care directives and goals of care, caregiver status, veteran status, health disparities and risk factors, and sexual orientation. Also on CMS’ radar: assessments related to opioid use, and frequency, exchange of electronic health data, and interoperability.

Full story at APTA

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