PTJ: Physical Therapy Continuity of Care Linked to Lower Rate of Surgery, Lower Costs

Patients with low back pain (LBP) who see a single physical therapist (PT) throughout their episode of care may be less likely to receive surgery and may have lower downstream health care costs, researchers suggest in a study published in the December issue of PTJ (Physical Therapy). “Limiting the number of physical therapy providers during an episode of care might permit cost savings,” authors write. “Health care systems could find this opportunity appealing, as physical therapy provider continuity is a modifiable clinical practice pattern.”

Authors examined data from nearly 2,000 patients in Utah’s statewide All Payer Claims Database (APCD) to look for associations between continuity of care for LBP patients and utilization of related services such as advanced imaging, emergency department visits, epidural steroid injections, and lumbar spine surgery in the year after the first primary care visit for LBP. APTA members John Magel, PT, PhDAnne Thackeray, PT; and Julie Fritz, PT, PhD, FAPTA, were among the authors of the study.

Patients were between the ages of 18 to 64 who saw a PT within 30 days of a primary care visit for LBP. Researchers excluded patients with certain nonmusculoskeletal conditions; neurological conditions, such as spinal cord injury, that could affect patient management; and “red flag” conditions such as bone deficit or cauda equina syndrome.

Full story at APTA

Can nanotech slow the progress of osteoarthritis?

There is still no cure for osteoarthritis. However, one innovative nanotechnological approach may help send therapeutic agents deeper into the affected cartilage and remain active for longer.

Predominantly a condition associated with older adults, osteoarthritis is a debilitating condition.

Affecting the cartilage in the joints of the body, osteoarthritis impacts an estimated 26 million people in the United States.

Sometimes, the condition begins with an injury or disease-related damage to the joint.

Full story at Medical News Today

What causes a lateral collateral ligament sprain?

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.

Full story at Medical News Today

Study: Early Physical Therapy for Neck Pain Associated With Lower Imaging Rates, Opioid Prescriptions, and Overall Cost

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.

Full story at APTA

Study: Clinic Ball Pits Carry Bacterial Risks

It’s no secret that when it comes to their potential for bacterial awfulness, the children’s ball pits often found in fast food restaurants are the stuff of a germaphobe’s nightmares. Now it turns out that if not properly maintained, ball pits in physical therapy clinics are capable of inducing shudders too.

In a study recently published in the American Journal of Infection Control, researchers tested 6 ball pits in inpatient and outpatient physical therapy clinics in Georgia to find out what, if anything, those pits were harboring at a microbial level. Authors hope that the study will help to spark a conversation about standards for cleaning the enclosures—standards that they say have remained “elusive” to date.

To conduct the analysis, researchers collected 9 to 15 balls taken from different depths in each ball pit, and then swabbed the entire surface of each ball. Samples were then inoculated on agar plates and allowed to grow for 24 hours at 91.4 degrees Fahrenheit. After the incubation, samples were tested for the number of colony-forming units (CFUS) present. Here’s what researchers found:

Full story at APTA

CSM Delivers: Aging

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.

Full story at APTA

UA scientist hopes to heal bone fractures using combination of 3D printing and adult stem cells

Not all broken bones heal. But one scientist at the University of Arizona hopes to remedy that problem using a combination of 3D printing and adult stem cells.

“Imagine an impact that causes half of a long bone to shatter so that it can’t be put back together – no current surgical treatment can ensure that kind of injury will heal,” explained John A. Szivek, PhD, a scientist at the UA College of Medicine – Tucson. “This is a really big problem for the military, where explosions or combat injuries can cause big bone defects.”

To help military personnel with these devastating injuries, Dr. Szivek, a biomedical engineer and professor of orthopedic surgery, has received a five-year, $2 million grant from the U.S. Department of Defense to launch a study to determine how to heal bone fractures using a combination of 3D printing and adult stem cells.

Full story at news-medical.net

Virtual Reality-based Exercise Fails to Improve Posture Control in Children With CP, Study Shows

A one-week intensive exercise program based on virtual reality (VR) failed to improve posture control in children with cerebral palsy (CP).

These are the preliminary findings of a larger study assessing the effects of a six-week, therapist-monitored home VR gaming program designed for children and adolescents with CP.

The study, “The Effects of a 5-Day Virtual-Reality Based Exercise Program on Kinematics and Postural Muscle Activity in Youth with Cerebral Palsy,” was published in Physical & Occupational Therapy in Pediatrics.

Cerebral palsy comprises a group of disorders that affect posture and restrict movement caused by non-progressive brain lesions that occur during pregnancy or infancy. Children and adolescents affected by CP are more likely to fall and injure themselves due to their lack of balance and posture.

Full story at Cerebral Palsy News Today

What’s New at PTNow? More Guidelines and Systematic Reviews Enrich an Already-Robust Resource

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.

Full story at APTA

Working through pain to get rid of pain: A physical therapist’s perspective

In my job as a physical therapist, the impact of the opioid epidemic is impossible to ignore. A large percentage of my patients are dealing with some degree of pain. For some, it is the result of a surgery, for others, a sports injury, and some have been living in chronic pain for over a decade. I understand why patients are prescribed opioids, and I don’t discount them as a valuable tool in treating acute pain. However, I believe it’s important to match the pharmaceutical intervention to the severity of the condition and provide a treatment plan that ultimately works toward little or no pharmacology whenever possible.

A recent study from Penn Medicine examined emergency room visits in the U.S. for ankle sprains — one of the most common injuries in sports for which the acute treatment is rest, ice, compression and elevation. An anti-inflammatory, such as ibuprofen, helps to reduce swelling and usually provides adequate pain relief. The researchers found on average 25 percent of these patients were prescribed an opioid in the ER. This is an example of a mismatch between injury and medical prescription. An ankle sprain will rarely necessitate an opioid prescription, and this study highlighted the over prescribing practices taking place across the nation — in some states more than others.

Full story at Orlando Sentinel