Sometimes the journey toward better health must begin at the beginning—with an actual acknowledgement that there’s a problem, and a sense of self-worth strong enough to allow a person reach out for help. Just ask “Greg,” a transgender man who endured pelvic pain for years.
“My body was, for me, this thing that I fed, and got it in a car, and drove places, and it did the work I wanted it to do,” Greg said. “Because I spent so much of my life feeling betrayed by it, it was just this thing I didn’t want to pay attention to.”
Now available on Move Forward Radio: a conversation with Greg and Schoonover, the physical therapist (PT) who helped Greg see his body—and his connection to it—in a new way. The podcast is a must-listen for anyone seeking a better understanding of not just the challenges faced by the transgender population, but the importance of providers honoring the individual stories every patient brings to the clinic.
The use of cardiac rehabilitation (CR) has grown over time, but with that growth comes changes to patient demographics that present new challenges to providers, say researchers who studied the CR patient population in 1 health system over 2 decades. They describe today’s CR patients as older, more overweight, and having a higher prevalence of coronary risk factors than CR patients in the past, with an expanded range of reasons for receiving CR that makes the population more diverse than ever.
The study analyzed data from 5,396 patients who received CR at the University of Vermont Medical Center over a 20-year period between 1996 and 2015, taking in a host of variables, including the reason for participation in CR, the presence of comorbidities, BMI, age, sex, and medications taken. Results were published in the Journal of Cardiopulmonary Rehabilitation and Prevention.
A large study of more than 21,000 people finds that training emergency medical services (EMS) agencies to implement prehospital guidelines for traumatic brain injury (TBI) may help improve survival in patients with severe head trauma. The findings were published in JAMA Surgery, and the study was supported by the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health.
“This demonstrates the significance of conducting studies in real-world settings and brings a strong evidence base to the guidelines,” said Patrick Bellgowan, Ph.D., program director at NINDS. “It suggests we can systematically increase the chances of saving lives of thousands of people who suffer severe traumatic brain injuries.”
Based on scores of observational studies, guidelines for prehospital management of TBI that were developed in 2000, and updated in 2007, focused on preventing low oxygen, low blood pressure, and hyperventilation in people with head injury. Collectively, the studies suggested that controlling those factors before patients arrived at the hospital could improve survival, but actual adherence to the guidelines had not been examined.
Physical exam findings of patellofemoral grind may help predict which patients with knee osteoarthritis (OA) are likely to experience significant worsening of their disease, analysis of data from the Osteoarthritis Initiative showed.
Individuals with persistent patellofemoral grind had a greater annual loss of cartilage volume compared with those without this clinical finding (1.30% vs 0.90%, P<0.001), according to Yuanyuan Wang, MD, PhD, of Monash University in Melbourne, Australia, and colleagues.
They also had twice the risk of having a total knee replacement by 6 years (OR 2.10, 95% CI 1.30-3.38, P=0.002), the researchers reported online in Arthritis Care & Research.
The natural history of knee OA can vary notably among patients, and because of the increasing numbers of affected patients worldwide it has become critical to identify those who are most likely to progress, so as to better target healthcare resources.
Not all rehabilitation is equal for acute care hospital patients with ischemic stroke, say researchers in an article published in the May issue of PTJ (Physical Therapy). Authors found “significant variation” in the use of hospital-based rehabilitation services that “suggest a timely opportunity to standardize rehabilitation service delivery in acute settings for patients with ischemic stroke.”
While current guidelines recommend early mobilization during hospitalization for ischemic stroke, authors write, they do not “provide clear recommendations on the optimal dosage of therapy.” This, combined with no incentive for hospitals to report on functional status to the US Centers for Medicare and Medicaid Services (CMS), led researchers to examine Medicare claims data from 104,295 patients in 2010 to identify what factors were associated with the type and amount of rehabilitation services patients received while in acute care settings.
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.”
A computer science research team at Dartmouth College has produced a smart fabric that can help athletes and physical therapy patients correct arm angles to optimize performance, reduce injury and accelerate recovery.
The proposed fabric-sensing system is a flexible, motion-capture textile that monitors joint rotation. The wearable is lightweight, low-cost, washable and comfortable, making it ideal for participants of all levels of sport or patients recuperating from injuries.
The study, published in Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies, will be presented later this year at the UbiComp 2019 conference in London in September.
The Center on Health Services Training and Research (CoHSTAR) has opened a call for the development of multiple pilot studies that would help set the stage for larger efforts to advance a wide range of health services research. APTA was a major financial contributor to the development of CoHSTAR, having donated $1 million toward the center’s startup in 2015.
The selected pilot studies would address research questions in CoHSTAR’s 4 areas of specialization—analysis of large data sets, rehabilitation outcome measurement, cost-effectiveness, and implementation of science and quality improvement research—and the CoHSTAR Pilot Study Program webpage lists examples of specific types of studies that would qualify for funding. Each pilot study will receive $25,000 in funding for direct costs.
Priorities for funding will be given to applications that align with 1 of the 4 areas of CoHSTAR specialization, have a strong likelihood of leading to broader research with major external funding, and have good potential to result in future research with high societal or policy impact for physical therapy. Principal investigators must include at least 1 physical therapist (PT) who is a US citizen or a certified permanent resident of the United States.
“Collaborative telerehabilitation” isn’t a regular part of care for patients with advanced-stage cancer, but maybe it should be, say authors of a study recently published in JAMA Oncology.They found that the approach, which combines remotely delivered rehabilitation instruction with outpatient physical therapy and regular communication, can reduce pain, improve function, shorten hospital says, and decrease the use of postacute care facilities.
The findings are based on results from the Collaborative Care to Preserve Performance in Cancer (COPE) program, a randomized clinical trial designed to address what the JAMA authors describe as a “knowledge gap” in the application of collaborative care models (CCMs) focused on patient function. The COPE trial includes patients with stage III or IV solid or hematologic cancer with a life expectancy of more than 6 months, and who reported moderate functional impairment (a score of 53-60 on the Activity Measure for Postacute Care assessment, or AM-PAC).
Scientists engineered scaffolds that replicate the physical characteristics of osteochondral tissue—basically, hard bone beneath a compressible layer of cartilage that appears as the smooth surface on the ends of long bones.
Injuries to these bones, from small cracks to pieces that break off, are painful and often stop an athlete’s career in its tracks. Osteochondral injuries can also lead to disabling arthritis.
The gradient nature of cartilage-into-bone and its porosity have made it difficult to reproduce in the lab, but Antonios Mikos, a bioengineer at Rice University and graduate student Sean Bittner used 3D printing to fabricate what they believe will eventually offer a suitable material for implantation.