The people of Michigan are better off—and the physical therapy profession has reached an important milestone—now that legislation has been signed into law allowing allow patients in Michigan to go directly to a physical therapist (PT) for evaluation and treatment without a physician’s referral. The legislative victory now means that all 50 states and the District of Columbia allow for some form of direct access to PTs for evaluation and treatment.
SB 690, signed into law by Gov Rick Snyder, was sponsored by Sen John Moolenaar and promoted by the Michigan Chapter of APTA (MPTA). The new law creates the option for patients to see a PT without a referral or prescription from a physician for up to 21 days or 10 treatment visits, and will also allow patients to see a PT directly for injury prevention and fitness promotion, with no time or visit limit. SB 690 also strengthens the profession by specifying that only licensed PTs may use the term “doctor of physical therapy” in connection with their services. A similar bill was sponsored in the Michigan House of Representatives by Rep Margaret O’Brien.
A recent Harvard Medical School newsletter article on nonsurgical approaches to joint pain came up short on information about the physical therapist’s (PT) role, and APTA weighed in to provide a more complete picture.
The association released a letter to the editor responding to a May 29 healthbeat newsletter article titled “4 ways to put off joint replacement.” The article listed weight loss, proper joint use, injections of steroids or other compounds, and pain reduction through NSAIDS, but made no mention of the ways in which a PT can help.
Oklahomans now have direct access to evaluation and treatment by physical therapists (PTs). On May 23, Oklahoma Gov Mary Fallin signed HB 1020, which allows patients to be evaluated and treated by a PT for 30 days without a referral from a physician or other provider. Previously, state law required a physician referral for any kind of treatment, though PTs were allowed to provide an evaluation without a referral. The new law takes effect November 1, 2014.
“Ensuring patient access is a cornerstone of APTA’s vision and mission,” said APTA President Paul A. Rockar Jr, PT, DPT, MS, in a news release. “I want to thank RepArthur Hulbert, PT, DPT, for authoring this bill, and Rep Sean Roberts, PT, for coauthoring. As physical therapists, Rep Hulbert and Rep Roberts truly understand how important this legislation is and the positive impact it will have on individuals who need the services of physical therapists.”
A new study comparing physical therapy with a sham procedure in the treatment of hip osteoarthritis pain and disability contains some interesting findings—and some notable limitations.
The research, published in the May 21 issue of JAMA, followed the progress of 102 individuals with diagnosed hip osteoarthritis (OA) and accompanying pain and disability, half of whom received physical therapy treatments and home exercises “typical of current practice,” and half of whom received a “sham” procedure involving application of an inactive gel. The results, according to the authors, showed that physical therapy was not more effective than the sham treatment at any evaluation point during the study.
A groundbreaking plan to jumpstart physical therapist research in health services and health policy is about to take a big step toward becoming a reality. The Foundation for Physical Therapy has announced that is has released its request for applications for a $2.5 million grant to create a “Center of Excellence” (COE) that would serve as a one-of-a-kind center focused on providing physical therapists with the training they need to expand the profession’s research portfolio into underrepresented areas.
The 5-year grant will be awarded to an institution or health systems network to create and oversee the Center of Excellence in Physical Therapy Health Services and Health Policy Research and Training, whose goal is to “develop sustainable research infrastructure and centralized resources to enhance interdisciplinary health services/health policy research by physical therapist scientists,” according to the request document.
In a study they describe as the first to incorporate analyses of International Classification of Functioning, Disability, and Heath (ICF) data, researchers make a cautious assertion that for individuals poststroke, the use of virtual reality—including commercially available video game systems—produces “a significant moderate advantage” in ICF outcomes compared with conventional therapies.
The findings were the result of an analysis of 26 randomized controlled trials that focused on the use of virtual reality (VR) to augment or replace conventional therapy in populations largely or solely comprising individuals poststroke. Of the studies analyzed, 4 focused on the use of commercially available gaming platforms such as the Nintendo Wii, while the rest used more specialized virtual environment (VE) equipment designed for rehabilitation. The study was published in the March 28, 2014, edition of PLoS ONE.
Dry needling is now included in the scope of practice for licensed physical therapists (PTs) in Utah thanks to legislation signed into law by Utah Governor Gary R. Herbert on April 1.
“We are pleased that the Utah Chapter took this legislative action to ensure that physical therapists in the state are able to legally provide the full range interventions within the physical therapist scope of practice,” said APTA President Paul A. Rockar Jr, PT, DPT, MS, in an APTA press release. “This is a step in the right direction to ensure that all patients have access to the care they need from their physical therapists.”
Layered compression bandages may be the “gold standard” in treatment of venous leg ulcers, but according to a new study, 2-layer hosiery is just as effective—and less costly. Rates of adherence, however, may mean that the approach is “not suitable” for all patients, according to researchers.
The study, which appears in the March 8 edition of The Lancet (abstract only available for free, but see note at the bottom of this story for additional access information), analyzed treatment results among 453 patients with venous leg ulcers at 34 facilities in England and Northern Ireland. The patients were divided evenly into 2 groups—1 receiving 4-layer compression bandage treatment that authors said is regarded as the “gold standard,” and the other receiving 2-layer hosiery (understocking and overstocking). Each group was monitored to assess healing rates and proportions.
$27.00 [3.00 CE Hours]
This course reviews rehabilitation guidelines following Autologous Chondrocyte Implantation (ACI) on the tibiofemoral joint. This surgical technique, which has become an established technique for repair of full-thickness chondral defects, is discussed as well as the factors proposed to influence patient outcomes. Components of pre-operative patient education and conditioning are presented as well as the 7 stages of post-operative rehabilitation.
$18.00 [2.00 CE Hours]
This course reviews a clinical study that evaluates the effectiveness of cervical traction in addition to exercise for patients with cervical radiculopathy. This common diagnosis is based clinically on the presence of neck pain extending into the arm accompanied by signs of nerve root compression during physical examination. Patients were randomized to 4 weeks of treatments with exercise, exercise with mechanical traction, or exercise with over-door traction. A discussion of the results indicate which treatments demonstrated lower disability and pain.
A new code for the use of a modality to heal wounds using sound energy has been made available to physical therapists (PTs) in the 2014 version of the Current Procedural Terminology (CPT) document maintained by the American Medical Association (AMA).
The new active wound care management code—97610—replaces Category III code 0183T. The modality uses acoustic energy to atomize saline and deliver ultrasound energy by way of a continuous mist to the wound bed and surrounding tissue, and is identified as “low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day.”