How to stretch your hands and wrists

Wrist pain can be frustrating and inconvenient. It can also make work or basic day-to-day activities, such as using a computer or cooking a meal, more difficult.

Exercises can improve mobility and decrease the chance of injury or reinjury. Wrist stretches are easy to do at home or at the office. When done properly, they can benefit a person’s overall wrist and hand health.

Anyone experiencing chronic pain or pain with numbness should visit a doctor for a thorough diagnosis.

Full story at Medical News Today

DEFINING THE SHAPE OF COOL

People are great at detecting cold temperatures and also the cool sensation induced by natural substances like menthol, which is common in remedies used to soothe aching muscles. But it hasn’t been entirely clear how we do this.

About a year ago, a group of researchers led by Seok-Yong Lee, Associate Professor of Biochemistry in the Duke University School of Medicine, figured out the architecture of the human and animal cold-sensing protein, an ion channel called TRPM8, which gave them some insight into its function but also raised more questions.

Now, Lee’s team has determined the structure TRPM8 assumes when it is bound to menthol and to another synthetic cooling agent called icilin. The findings, which will appear in Science on Feb. 8, could pave the way toward new treatments for chronic pain and migraine and help patients who suffer from extreme cold sensitivity.

Full story at Duke.edu

Crazy Little Thing Called (APTA) Love

APTA members are sharing the APTA love—and their stories are all about finding community in the association, no matter the paths they took to get there.

In the spirit of Valentine’s Day, APTA asked members to share their “APTA love stories” by recounting how they first came to join the association, and what made them feel a true connection to the organization and fellow members. The results are being posted to social media and have been collected on a special “APTA Love Stories” webpage.

The stories reflect the diversity of the APTA membership. From a then-DPT student who questioned a program’s membership requirement only to come to see the value in the connections she made, to an aspiring physical therapist (PT) who asked to join APTA before she’d even entered school, to longtime PTs who’ve spent their careers involved in the association, the details are varied. The common thread: each member discovered the ways APTA builds connections, strengthens the profession, and provides opportunities for professional growth.

Full story at APTA

Spinal cord is ‘smarter’ than previously thought

We often think of our brains as being at the centre of complex motor function and control, but how ‘smart’ is your spinal cord?

Turns out it is smarter than we think.

It is well known that the circuits in this part of our nervous system, which travel down the length of our spine, control seemingly simple things like the pain reflex in humans, and some motor control functions in animals.

Now, new research from Western University has shown that the spinal cord is also able to process and control more complex functions, like the positioning of your hand in external space.

Full story at Medical Xpress

Best exercises and remedies for plantar fasciitis

Foot stretches and exercises can help plantar fasciitis by relieving pain, improving muscle strength, and promoting flexibility in the foot muscles and ligaments.

Overuse, strain, and inflammation on the plantar fascia ligament that connects the heel to the toes cause the foot injury that doctors refer to as plantar fasciitis. The tissue that the condition affects is under the arch of the foot but can cause a stabbing pain in the heel.

Plantar fasciitis usually resolves within 6 to 18 months without treatment. With 6 months of consistent, nonoperative treatment, people with plantar fasciitis will recover 97 percent of the time.

Full story at Medical News Today

New solutions needed to improve care and reduce cost of high-need, high-cost patients

By many estimates, only 5% of U.S. patients are high-need, high-cost (HNHC), yet they account for about 50% of health care spending. It has become a national priority to understand the needs of this patient cohort, identify drivers of their utilization, and implement solutions to improve their clinical outcomes while reducing their costs.

High-need, high-cost patients often have multiple chronic conditions, complex psychosocial needs, and limited ability to perform activities of daily living. Care delivery solutions, including care management, telemedicine, and home health visits, have had mixed levels of success for various outcome measures, including system-centric ones such as total cost of services and utilization of secondary care (emergency department [ED] use and inpatient hospitalization) as well as patient-centered ones such as self-assessed health status.

A possible explanation for the variable success could be that many solutions are designed primarily by health system administrators, not the patient “customers” who best understand their own needs. Little has been published about patients’ views on the care models that target their complex health care needs, which aspects of current care delivery high-need, high-cost patients find beneficial, nor how health systems can partner with patients to design and implement solutions. Better serving high-need, high-cost patients must begin with improving our understanding of their needs and perspectives.

Full story at news-medical.net

Exercise Benefits Brains and Blood Flow Changes in Older Adults

Exercise training alters brain blood flow and improves cognitive performance in older adults, though not in the way you might think. A new study published by University of Maryland School of Public Health researchers in the Journal of Alzheimer’s Disease showed that exercise was associated with improved brain function in a group of adults diagnosed with mild cognitive impairment (MCI) and a decrease in the blood flow in key brain regions.

“A reduction in blood flow may seem a little contrary to what you would assume happens after going on an exercise program,” explained Dr. J. Carson Smith, associate professor in the Department of Kinesiology. “But after 12-weeks of exercise, adults with MCI experienced decreases in cerebral blood flow. They simultaneously improved significantly in their scores on cognitive tests.”

Dr. Smith explains that for those beginning to experience subtle memory loss, the brain is in “crisis mode” and may try to compensate for the inability to function optimally by increasing cerebral blood flow. While elevated cerebral blood flow is usually considered beneficial to brain function, there is evidence to suggest it may actually be a harbinger of further memory loss in those diagnosed with MCI. The results of the study by Dr. Smith and his team suggest exercise may have the potential to reduce this compensatory blood flow and improve cognitive efficiency in those in the very early stages of Alzheimer’s Disease.

Full story at NeuroScience News

Systematic Review: LBP Studies Make the Case for Early Physical Therapy

Authors of a new systematic review of 11 studies on low back pain (LBP) have found that despite sometimes-wide variation in research design, a picture of the value of early physical therapy for the condition is emerging—and the results are encouraging.

According to the review, e-published ahead of print in the Archives of Physical Medicine and Rehabilitation, evidence supports the cost-effectiveness and better patient outcomes of early physical therapy over later physical therapy for LBP, and even points to a correlation between early physical therapy and lower rates of opioid prescription overall. As for utilization and costs associated with early physical therapy versus so-called “usual care” (UC)? Early treatment by a physical therapist (PT) adhering to APTA guidelines could make a positive difference there as well, authors say, but that’s a harder question to answer definitively until studies become more uniform in terminology and design.

Full story at APTA

Automated Text Messages Improve Outcomes after Joint Replacement Surgery

An automated text messaging system increases patient engagement with home-based exercise and promotes faster recovery after total knee or hip replacement surgery, reports a study in the January 16, 2019 issue of The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer.

Patients receiving timely texts showed improvement in several key outcomes, including fewer days on opioid pain medications, more time spent on home exercises, faster return of knee motion, and higher satisfaction scores, according to the research by Kevin J. Campbell, MD, of Rush University Medical Center, Chicago, and colleagues. “A chatbot that texts timely, informative and encouraging messages to patients can improve clinical outcomes and increase patient engagement in the early postoperative period after total joint replacement,” Dr. Campbell comments.

Automated Texts Lead to Improved Outcomes of Surgery

The randomized trial included 159 patients undergoing primary total knee or hip replacement. All received standard education, including instructions on home exercises after surgery.

Full story at News Wise

‘Enhanced recovery’ protocol reduces opioid use in spinal surgery patients

A novel “Enhanced Recovery After Surgery” (ERAS) protocol developed by Penn Medicine for patients undergoing spinal and peripheral nerve surgery significantly reduced opioid use. A new study published in the Journal of Neurosurgery: Spine showed that when an ERAS protocol was employed—which optimizes patients’ surgical care before, during, and after surgery, including patient education, post-operative medications, and recovery plans—fewer patients needed pain medications one month after surgery.

Nearly 75 percent of patients at Penn Medicine who undergo spinal surgeries are opioid naïve—patients who are not chronically taking opioids on a daily basis—putting them at an increased risk for dependency following surgery. Previous studies have also shown that up to 7 percent of all patients who undergo spinal surgeries continue to take opioids one year after surgery. Part of the ERAS protocol at Penn includes a personalized, safe, and effective pain management plan to help prevent opioid dependency, which has rapidly become a public health crisis in the United States.

Full story at Medical Xpress