Study: Low-Intensity Pulsed Ultrasound Ineffective in Speeding Recovery From Tibial Fractures

Authors of a new study say that when it comes to healing and functional recovery after a tibial fracture, the home use of low-intensity pulsed ultrasound (LIPUS) devices doesn’t help speed things along. Researchers believe that in addition to altering some orthopedic surgeons’ treatment approaches, their findings may also underscore a flawed US Food and Drug Administration (FDA) device approval process.

The study, published in BMJ, monitored the progress of 481 adult patients who had experienced a tibial fracture that required intramedullary nail fixation. All patients received a LIPUS device, with education on proper use, and instructions to administer the ultrasound once a day for 20 minutes. However, only half of the devices actually transmitted ultrasound—the others were sham devices that looked and behaved exactly like their operational counterparts.

Full story of LIPUS device treatment for tibial fractures at APTA

Does Meniscal Surgery Increase Risk of OA?

Surgery for meniscal tears may increase the risk of osteoarthritis and cartilage loss, according to results of a study presented at the annual meeting of the Radiological Society of North America (RSNA) on December 3.

According to an RSNA press release, the study examined magnetic resonance imaging of 355 knees that developed osteoarthritis in the past 5 years—31 knees that had meniscal surgery a year prior to the arthritis diagnosis, and 281 knees that had meniscal damage but no surgery. The study group was compared with a control group with no meniscal damage, matched for age, gender, BMI, and arthritic severity. Patients in the study were mostly overweight with an average age of 60.2. Two-thirds of the subjects were women.

RSNA reports that “‘all 31 of the knees that underwent meniscal surgery during the prior year developed osteoarthritis, compared with 165 (59%) of the knees with meniscal damage that didn’t have surgery.”

Full story of meniscal surgery at APTA

Move Forward Radio: Getting an Athlete’s Head Around Playing Again

For athletes who have suffered an injury, return to play may depend on how well they tackle their fear of getting hurt again.

That’s the focus of the latest Move Forward Radio, which examines the psychological toll of sports injuries and its potential effect on an athlete’s return to play. The podcast was recorded in light of studies indicating that fear of re-injury is common among athletes with anterior cruciate ligament (ACL) tears who don’t return to their sport.

“With something like ACL injury, there’s strength gains to be had, but then there’s that neurological control and that confidence in the limb,” said Carol Ferkovic Mack, PT, DPT, SCS, CSCS, of the Cleveland Clinic’s Sports Health Center, one of the podcast’s featured guests. “If those aren’t there, then that’s the percentage that’s not going to return to sport.”

Full story of fear in athletes after injury recovery at APTA

Stem Cells Restore Movement to Mice With MS-Like Symptoms

Although far too early to know if the treatment will be effective on humans, researchers have been able to restore movement to mice disabled by a multiple sclerosis (MS)-like condition by using human stem cell transplants. The recovery was quick, long-lasting, and present even though the stem cells themselves had been rejected by the mice.

According to the study’s authors, mice disabled by a virus that mimics MS began walking 10 to 14 days after receiving spinal injections of human neural stem cells, and continued to walk and engage in other movements after 6 months.

Full story of stem cell restoration at APTA

NPR Story Describes New Leg Brace, Interviews PT

A new leg brace that is reducing amputations and allowing wounded soldiers to run again was the focus of a recent National Public Radio feature story that included an interview with the physical therapist (PT) involved in the project.

The story, which aired during the March 31 broadcast of “All Things Considered,” describes the success of the IDEO brace, a “deceptively simple” device that is being used on wounded veterans at the Center for the Intrepid facility in the Brooke Army Medical Center near San Antonio, Texas. According to reporter Melissa Block, when used correctly the device allows some wearers to run again, “virtually pain free.”

Full story of new leg brace story at APTA

Running Injuries: Finding the Root Cause

APTA recently spoke with Katie McDonald Netiz, aRunner’s World editor, and James Koo, PT, DPT, OCS, SCS, an APTA member and physical therapist at RunSmart, a running clinic at New York University, for a Move Forward Radio episode called “Waking Sleeping Glutes in Runners.” Neitz, a longtime recreational runner, discusses her visit to RunSmart and how Koo and a team of therapists helped her identify the source of her hamstring pain—a problem that had been nagging her for 6 years.

After a series of tests and evaluations to determine her strengths and weaknesses, Netiz was diagnosed with inactive gluteal muscles.

“I could not squeeze my glutes, which sounds ridiculous that a runner wouldn’t be able to do that, but I couldn’t,” said Netiz. “So I credit my physical therapist at the clinic with giving me that eye-opening moment that really made me realize where my weakness was, and how much work I had to do to get better.”

Full story of running injuries at ATPA

Team USA PT Discusses Skiing and Snowboarding Injuries With Move Forward Radio

Listeners to APTA’s Move Forward Radio can get a firsthand account of how Team USA prepares to go for gold on the slopes of Sochi, Russia, at the Olympic Winter Games—all from a physical therapist’s perspective.

In an episode that aired last week, Amber Donaldson, PT, DPT, SCS, CSCS, describes the training and treatment regimens for Olympic and Paralympic athletes at the United States Olympic Training Center in Colorado Springs, Colorado, before providing injury prevention tips for recreational skiers and snowboarders. In conjunction with the segment, published tips for “Preventing Skiing-Relating Injuries,” and APTA issued a press release about these resources.

Full story on the discussion at APTA

Post-Mastectomy Physical Therapy ‘Widely Improves’ Quality of Life

Postoperative physical therapy that begins as early as 2 days after surgery significantly improves joint mobility and “widely improves the quality of life” for women who underwent mastectomies, according to a new study. Researchers found that women who received physical therapy regained normal glenohumeral function 1 year after surgery and reported less pain, while an untreated control group continued to report limitations.

Italian researchers focused on women scheduled for Madden’s modified radical mastectomy or segmental mastectomy with axillary dissection, dividing a group of 70 women into 2 groups: 1 that received postoperative physical therapy and 1 that did not. Women in the treatment group began physical therapy on the second postoperative day and participated in 40-minute rehabilitation sessions 5 times a week for the duration of the drainage, followed by 20 hour-long sessions after the drainage was removed.

Full story of post-mastectomy life at APTA

New Report on Blast Injuries Cites Research Gaps

Despite the prevalence of blast-related injuries among returning war veterans there are still big gaps in research into long-term effects, according to a newly released study by the National Academy of Science’s Institutes of Medicine (IOM). These gaps exist not only in research into specific injury types, but also in understanding the ways in which blast injuries can involve multiple systems and create “cross system interactions” such as mild traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD).

The new publication, Long Term Effects of Blast Exposure, is the ninth volume in a series of congressionally mandated studies focusing on the health effects of military service. The newest report focuses on blast injury effects present after 6 months, and is based on reviews of nearly 13,000 titles and abstracts and approximately 400 full peer-reviewed journal articles. The report estimates that between 2001and 2011, more than 31,000 soldiers were injured by explosive devices in the Iraq and Afghanistan wars.

Full story of blast injuries at APTA

Heart attack, stroke prevention tool debated

The debate over new heart disease prevention guidelines proposed by U.S. cardiologists is being stirred.

In Tuesday’s issue of the medical journal The Lancet, a U.S. doctor and a researcher call the American Heart Association and American College of Cardiology’s new guidelines a step forward but point to flaws in applying its risk calculator.

In their commentary, Dr. Paul Ridker and Nancy Cook of the Center for Cardiovascular Disease Prevention at Boston’s Brigham and Women’s Hospital raised questions about applying the guidelines for primary prevention in people without a history of heart disease, stroke and few risk factors.

Unlike the previous guideline that focused on cholesterol levels, the latest edition uses a risk calculator based on factors such as age and high blood pressure. But estimates from the new calculator were roughly double the actual heart attacks or strokes observed in three major cohort studies, Ridker and Cook said.

“Reliance on the new risk prediction algorithm could put many primary prevention patients on [cholesterol lowering] statin therapy where there is little trial evidence while potentially denying the drug treatment to others where there is evidence,” the pair said in the commentary.

Full story of heart attacks and stroke at CBC News