UAB orthopaedics investigates speeding up recovery after ankle fractures

Speeding up the recovery time for patients following ankle or tibial plateau fracture is the goal of a new study in the Department of Orthopaedic Surgery at the University of Alabama at Birmingham.

The multi-center study, funded by the United States Department of Defense, will evaluate whether early weight-bearing following ankle or lower leg fractures will allow a patient to recover faster and return to work or duty more quickly.

The study will call for appropriate patients to begin weight-bearing two weeks after a surgical repair rather than the current standard of care: six to eight weeks following surgery for an ankle fracture and 10 to 12 weeks for a tibial plateau fracture. 

Full story at UAB

BU researcher receives NIH grant for clinical research in rheumatology

David Felson, MD, MPH, professor of medicine and epidemiology at Boston University Schools of Medicine (BUSM) and Public Health (BUSPH), was awarded a National Institute of Health (NIH) P30 Center Grant.

The five-year, $3.6 million award will allow for further clinical research in rheumatology at the Boston University Core Center for Clinical Research, and will provide broad clinical research expertise to a large multidisciplinary group of investigators whose research focuses on osteoarthritis and gout with a secondary emphasis on scleroderma, spondyloarthritis, osteoporosis and musculoskeletal pain.

The Center includes researchers from BU, Boston Children’s Hospital, the Beth Israel Deaconess Hospital, Massachusetts Institute of Technology, Northeastern University and different groups at Harvard University. This group is comprised of individuals with backgrounds in rheumatology, physical therapy, engineering, epidemiology, biostatistics, genetics, evolutionary biology and behavioral science, who critically review projects, provide methodologic guidance to research and creates new multidisciplinary collaborations.

Full story at News Medical

Exercise especially important for older people with heart disease

It is well-known that exercise is good for cardiac health, but older adults tend to fall through the cracks when it comes to rehabilitation programs. Now, a study has shown that these individuals have the most to gain.

Heart disease is the leading cause of death for both men and women in the United States, being responsible for 1 in 4 deaths. Every year, approximately 610,000 people in the U.S. die of heart disease, while about 735,000 people have a heart attack.

Adults over the age of 65 years are more likely than younger people to have heart disease because the heart changes with age. Heart disease is a significant cause of disability, according to the National Institute on Aging, who note that it affects the ability of millions of older people to be active and have a good quality of life.

Full story at Medical News Today

Caution urged in reducing opioids for pain

After years and decades in which healthcare providers were freely prescribing opioids for all sorts of painful conditions, the US Centers for Disease Control and Prevention (CDC) published guidelines to help bring down opioid prescription rates and with them, addiction and overdose-related death rates. Though these were not binding, they urged physicians to be cautious in dealing with opioids when prescribing for pain.

The result was predictable: many doctors and patients, as well as advocacy groups, reacted strongly, claiming that many patients with severe chronic pain had been on opioids for years at high doses, yet had not developed addiction. They also claimed that the guidelines had caused many such patients to go without the pain relief they required. Over 300 doctors also formalized their protests in a letter to the CDC in the first part of 2019.

In clarification, the CDC countered by saying that its guidelines were not meant to force patients or healthcare providers to suddenly stop taking opioids or sharply reduce the dosage, and called upon doctors to understand its stance properly before applying the guidelines. The new guide shows potential sources of harm to patients who are abruptly taken off opioids, and describes factors that must be kept in mind when opioid tapering is considered. The CDC has also included several tapering protocols, to reinforce the message that abruptly stopping opioid use patterns could harm the patient.  

Full story at News Medical

Dog ownership associated with longer life, especially among heart attack and stroke survivors

Dog ownership may be associated with longer life and better cardiovascular outcomes, especially for heart attack and stroke survivors who live alone, according to a new study and a separate meta-analysis published in Circulation: Cardiovascular Quality and Outcomes, a journal of the American Heart Association.

“The findings in these two well-done studies and analyses build upon prior studies and the conclusions of the 2013 AHA Scientific Statement ‘Pet Ownership and Cardiovascular Risk’ that dog ownership is associated with reductions in factors that contribute to cardiac risk and to cardiovascular events,” said Glenn N. Levine, M.D., chair of the writing group of the American Heart Association’s scientific statement on pet ownership. “Further, these two studies provide good, quality data indicating dog ownership is associated with reduced cardiac and all-cause mortality. While these non-randomized studies cannot ‘prove’ that adopting or owning a dog directly leads to reduced mortality, these robust findings are certainly at least suggestive of this.”

Full story at Medical Xpress

Target introduces adaptive Halloween costumes for kids with disabilities

Halloween costumes are more inclusive than ever before, thanks in part to Target’s latest innovative options. Target’s Hyde and Eek! Boutique range has introduced four new Halloween costumes adapted for kids with disabilities. 

One of the designs allows kids to transform their wheelchair into a pirate ship, complete with a Jolly Roger flag and with waves for wheels. The other turns it into a luxurious purple princess carriage. Both wheelchair covers use “hook-and-loop closures for a secure fit,” and can fit on a variety of chair sizes, according to the Target website. 

The actual pirate and princess costumes are sold separately. They are specifically designed for ease of dressing for wheelchair users, with openings in the back and wide pant legs. 

Full story at CBS News

Biased? Me? PT in Motion Magazine Takes a Look at Unconscious Cultural Attitudes

Want to get an up-close glimpse at a person with cultural biases? Follow these instructions:1. Grab a mirror.
2. Look into it.

That’s one way to summarize the starting point for “Battling Bias’s Distorted Images,” the cover story for the October issue of PT in Motion magazine. The article makes the case that while unconscious bias—also known as implicit bias—is very much a part of the human condition, it’s something that can be acknowledged and managed in ways that minimize its impact on relationships. For health care providers including physical therapists (PTs) and physical therapist assistants (PTAs), that’s an important step to take in effective patient care.

Through interviews with PTs in a variety of settings, author and Associate Editor Eric Ries explores how implicit bias—and these PTs’ recognition of it in themselves—has impacted and changed their lives, particularly at the professional level. Several describe the journey as a path that’s not always easy, but absolutely crucial to providing the best possible person-centered care.

Full story at APTA

Interprofessional education aims to foster learning, collaboration among healthcare students

A virtual world may be a feasible learning platform for bringing together students from different healthcare professions and enhancing their understanding of collaborative patient care and knowledge of other health professions, according to a pilot study led by researchers from Tufts University School of Medicine and published online in the Journal of Interprofessional Care.

Interprofessional education (IPE) aims to foster learning and collaboration among healthcare students from different professions, with a goal of enhancing patient care. Scheduling face-to-face learning between students in different programs, however, is one of the largest barriers to implementing this type of learning. The study evaluated a virtual educational environment for its ability to provide IPE in palliative care, which is interdisciplinary by nature.

Full story at News Medical

Where Things Stand, What APTA’s Doing: Fee Schedule, SNF, and HH Rules From CMS

The Centers for Medicare and Medicaid Services (CMS) spends much of its spring and summer churning out regulatory rules for the coming fiscal and calendar years. That means it’s an equally busy time for APTA, its members, and other stakeholders to stay on top of the proposals, respond to whatever challenges emerge, and advocate for change when needed.

This year’s standout challenge: advocacy efforts around the CMS proposed physician fee schedule (PFS). The rule as proposed includes at least 2 troubling provisions that demanded a strong response—1 around how CMS would go about determining whether therapy services were delivered “in part” by a physical therapist assistant (PTA) or occupational therapy assistant (OTA), and another that proposes an estimated 8% cut to reimbursement for physical therapists (PTs) and several other professions.

APTA has been aggressively fighting these changes through comments, creating a platform to facilitate a flood of individual member letters to CMS, multiprovider organization sign-on letters, meetings with CMS representatives, and the latest: a bipartisan letter signed by 55 members of Congress urging CMS to rethink the cuts.

Full story at APTA

Wrist-worn step trackers accurate in predicting patient health outcomes

Determining how far patients with pulmonary disease can walk in six minutes has long been an effective clinical tool to help physicians determine their exercise capacity, as well as to aid in predicting health outcomes and mortality.

Now, in a new study, researchers at Intermountain Healthcare in Salt Lake City found that steps measured through a step tracker worn on the wrist can be used to estimate exercise capacity and determine the health status of patients, rather than the standardized six-minute walk distance test, which is usually conducted in a clinical setting.

Using the wrist-worn step trackers, researcher found data may be used in clinical care at higher intervals to effectively monitor patient progress and disease management. Researchers say the results are another example in how wearable and monitoring devices like Fitbits and Apple Watches can be used in patient care to improve outcomes.

Full story at Medical Xpress