Just make sure the patients aren't Medicare
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Or you will be in trouble!
Great work University of Kentucky.
larry@physicaltherapist.com
Source: MyPhysicalTherapySpace.com - May 16, 2008 Authors: Larry Benz Tags: In the News
Sensorimotor disturbances in chronic neck pain--range of motion, peak velocity, smoothness of movement, and repositioning acuity.
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Sjölander P, Michaelson P, Jaric S, Djupsjöbacka M The purpose of this pilot study was to evaluate sensorimotor functions in patients with chronic neck pain with objective and quantitative methods. A group of 16 patients with chronic idiopathic neck pain...
Source: Physiospot - Musculoskeletal - May 16, 2008 Authors: Rachael Lowe
Sacroiliac joint fusion and the implications for manual therapy diagnosis and treatment.
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Dar G, Khamis S, Peleg S, Masharawi Y, Steinberg N, Peled N, Latimer B, Hershkovitz I The present paper examines gender differences and changes in prevalence of ankylosed sacroiliac joint (SIJ) with age. SIJs of 287 patients, aged 22-93 years,...
Source: Physiospot - Musculoskeletal - May 16, 2008 Authors: Rachael Lowe
AAOMPT Annual Conference 2008
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AAOMPT
Annual Conference
October
29-November 2, 2008
Seattle, Washington
Pain:
From Science to Solutions
On-line
Registration and Program Information is Now Available!
The 2008 AAOMPT
Annual Conference is the national conference where persons having a common
interest in orthopedic manual physical therapy (OMPT) may meet, confer and
promote research, practice, and patient care.
The conference
programming will focus on the various types and causes of pain providing
attendees with state of the art treatment strategies.
Don’t miss this
opportunity to participate in this important conference with y...
Source: MyPhysicalTherapySpace.com - May 15, 2008 Authors: courses Tags: Announcements
the Team Approach
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When I was working the National ski team, one aspect that I enjoyed the most was the true team approach. Every single staff member, from coaches, doctors, technicians and media personnel worked together with myself to do what was best for the athlete. Every decision was based on this. Once I returned to clinic work after 3 years of this, I was disheartened with the lack of teamwork from the practitioners within the community. There are professionals out there who believe they have all the answers and disregard any other options. This is especially bothersome when they employ unsupported techniques and are not backed up by ...
Source: Vancouver Sports Physio - May 13, 2008
I'm famous! (joke)
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This is just some fun news, nothing important.Some of the pictures from our Envision Physiotherapy website, made it onto the cover of the new physio directory. I know my modelling career wouldn't have taken off, because, as you can see from the picture they used on the BC Physio website, my back is turned.Oh well, I guess I'll have to keep my day job.
Source: Vancouver Sports Physio - May 13, 2008
Girl Power
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A couple of truths:
1. The real health care decision making is made by women.
2. Women are way more apt to tell folks about the value of your service thru word of mouth marketing than men.
3. Women are much more likely to look up information about their healthcare than anybody else.
4. The typical PT patient is a slightly older soccer mom.
5. If you had to choose to provide the best in customer service to one patient, it had better be a woman. Per EVEolution “Women don’t buy brands, they join them”.
So, why the fuss about women on the EIM blog? First, I believe that the value of out...
Source: MyPhysicalTherapySpace.com - May 13, 2008 Authors: Larry Benz
Biochemical basis of the effect of chondroitin sulphate on osteoarthritis articular tissues
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J Monfort, J-P Pelletier, N Garcia-Giralt, J Martel-Pelletier Osteoarthritis is a chronic disease characterised by irreversible damage to joint structures, including loss of articular cartilage, osteophyte formation, alterations in the subchondral bone and synovial inflammation. Pain, functional disability and impairment...
Source: Physiospot - Musculoskeletal - May 13, 2008 Authors: Rachael Lowe
Open versus closed kinetic chain exercises for patellar chondromalacia.
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This study was designed to compare the effect of straight leg raise (SLR) and semi-squat exercises on the treatment of patellar chondromalacia. 32 participants with patellar chondromalacia were randomly assigned to either SLR or semi-squat exercise....
Source: Physiospot - Musculoskeletal - May 13, 2008 Authors: Rachael Lowe
The Most Important Issue in the PT Profession.
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And I really mean it.
There is a raging debate within the PT profession. Over past several weeks, I have seen it as part of many discussions and it was recently manifested on a PT listserve of the administrative section of APTA. I know that listserves are “old technology” but it actually works well for PT’s who tend to be slow adapters and certainly if it isn’t broke, don’t fix it!
The debate is centered over a seemingly growing movement that unfortunately has far reaching consequences: Do all services rendered within a PT clinic have to be one on one and performed by a PT ...
Source: MyPhysicalTherapySpace.com - May 10, 2008 Authors: Larry Benz Tags: Healtcare Quality
Exercise for Fibromyalgia: A Systematic Review.
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This study evaluated the effects of exercise training on global well-being, selected signs and symptoms, and physical function in individuals with fibromyalgia (FM). Metaanalysis of 6 studies provided moderate-quality evidence...
Source: Physiospot - Musculoskeletal - May 10, 2008 Authors: Rachael Lowe
Differences in Standing and Forward Bending in Women With Chronic Low Back or Pelvic Girdle Pain: Indications for Physical Compensation Strategies.
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The objective of this study was to determine whether subcategories of back pain patients could be distinguished by motion characteristics of the pelvis and lumbar spine. It compares motion characteristics during forward bending...
Source: Physiospot - Musculoskeletal - May 10, 2008 Authors: Rachael Lowe
Reduction of experimental muscle pain by passive physiological movements
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Michael Møller Nielsen, Anne Mortensen, Jakob Kierstein Sørensen, Ole Simonsen and Thomas Graven-Nielsen The purpose of this study was to examine the effect of passive physiological movements (PPMs) on deep-tissue pain sensitivity. Seventeen healthy subjects participated in one session where...
Source: Physiospot - Musculoskeletal - May 9, 2008 Authors: Rachael Lowe
Influence of elbow flexion angle on mobilization of the proximal radio-ulnar joint: A motion analysis using cadaver specimens
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Sadanori Ohshiro, Egi Hidaka, Shigenori Miyamoto, Mitsuhiro Aoki, Toshihiko Yamashita and Haruyuki Tatsumi The purpose of this study was to determine the most effective elbow joint flexion angle for mobilization of the proximal radio-ulnar joint. Five fresh-frozen cadaveric elbows were...
Source: Physiospot - Musculoskeletal - May 9, 2008 Authors: Rachael Lowe
Outcome following a physiotherapist-led intervention for chronic low back pain: the important role of cognitive processes
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The objective of this study was to examine whether patients with chronic low back pain exhibit changes in cognitive factors following Interactive Behavioural Modification Therapy (IBMT), delivered by...
Source: Physiospot - Musculoskeletal - May 9, 2008 Authors: Rachael Lowe
Intra- and interexaminer reliability of four manual shoulder maneuvers used to identify subacromial pain
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The objective of the study was to assess intra- and interexaminer reliability for four manual shoulder maneuvers; the Neer impingement sign, the Hawkins–Kennedy impingement test, the Patte maneuver, the Jobe supraspinatus test. The four standardised...
Source: Physiospot - Musculoskeletal - May 9, 2008 Authors: Rachael Lowe
Individual patient education for low back pain.
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A Engers, P Jellema, M Wensing, DAWM van der Windt, R Grol, MW van Tulder This is a systematic review from the Cochrane Library looking at the effect of individual information on non specific lower back pain. The review aims...
Source: Physiospot - Musculoskeletal - May 9, 2008 Authors: Paula Fitzpatrick
Rush towards Virtual Practice
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Rush Presbyterian in Chicago has been refining a Virtual Integrated Practice (VIP) for the past four years. The project has had multiple goals with the major goals noted as:
Refining
the VIP intervention and implementing it over an 18 month period in
four practice sites focusing on patients with diabetes type II, chronic
obstructive pulmonary disease and urinary incontinence.
Evaluate
the efficacy of the intervention with regard to consistency, costs,
patient and provider perception, selected patient indicators of health
status and changes in disease specific health parameters.
...
Source: MyPhysicalTherapySpace.com - May 7, 2008 Authors: James Glinn Tags: Healtcare Quality
PT Whore of the Month Club #4
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As we catch up with our PT "Whore of the Month" Club award winners, we have named the April 2008 winner below. Before we do that, I will call attention to the ongoing debate about the name of the award itself, which continues to receive much scrutiny (which we welcome) as you can see from the comments posted to the March 2008 winner. We are still not convinced that the name should be changed but appreciate that the name is not endorsed by 100% of our readers. Btw, in response to some of the comments, we have issue whatsoever in naming a female for this award since definition #4 below applies. ...
Source: MyPhysicalTherapySpace.com - May 4, 2008 Authors: John Childs Tags: In the News Practice
Ain't Gonna Ruin My Derby Week
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At first, I thought it was the greatest May fool’s joke that I have ever seen, even though May 1st isn’t till tomorrow (In feat of symbolism this is how we celebrate it in KY-one month behind everybody else).
Of course I am talking about the front cover of the PT Magazine of Phys (can’t tell what else it says as some kid who is playing the wii’s head is covering the rest of the magazine title). This is the glossy mag that accompanies our official Journal-Physical Therapy.
It has been posted many times here, here, here, and here about what I will now refer as “the Paris Hilton of Phy...
Source: MyPhysicalTherapySpace.com - April 30, 2008 Authors: Larry Benz Tags: In the News
The influence of expectation on spinal manipulation induced hypoalgesia: an experimental study in normal subjects.
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Bialosky JE, Bishop MD, Robinson ME, Barabas JA, George SZ The purpose of this study was to determine the effect of subject expectation on hypoalgesia associated with SMT. Sixty healthy subjects agreed to participate and underwent quantitative sensory testing (QST)...
Source: Physiospot - Musculoskeletal - April 30, 2008 Authors: Rachael Lowe
What PT looks like without medicare and regulations?
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At Least We are #5 on Somebody's list.
From the Tehran Times, Iran’s leading International Daily in an article entitled: Need a less stressful career? Here are eight secrets to work
5. Physical therapy assistant Whether giving and receiving backrubs at a massage therapy school, or practicing flexibility techniques in a physical therapy assisting program, you can learn how to help people maximize relaxation. And if you incorporate some of these exercises into your own daily routine, you could have a recipe for a tension-free workday.
My favorite- help “people maximize relaxation”.
I wish I could make this stuff up....
Source: MyPhysicalTherapySpace.com - April 28, 2008 Authors: Larry Benz Tags: In the News
Glucosamine/chondroitin combined with exercise for the treatment of knee osteoarthritis: a preliminary study.
discuss this article
This study sought to determine whether using 1500/1200mg of glucosamine hydrochloride and chondroitin sulfate (GH/CS) is effective, both separately and combined with...
Source: Physiospot - Musculoskeletal - April 27, 2008 Authors: Rachael Lowe
Progressive resistance training in patients with shoulder impingement syndrome: A randomized controlled trial
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Império Lombardi Jr., Ângela Guarnieri Magri, Anna Maria Fleury, Antonio Carlos Da Silva, Jamil Natour The purpose of this study was to assess pain, function, quality of life, and muscle strength in patients with shoulder impingement syndrome who participated in...
Source: Physiospot - Musculoskeletal - April 27, 2008 Authors: Rachael Lowe
Reducing joint loading in medial knee osteoarthritis: Shoes and canes
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This study evaluated the effects of shoes and a cane on knee load in people with knee OA. Forty people with medial knee OA underwent 3-dimensional...
Source: Physiospot - Musculoskeletal - April 27, 2008 Authors: Rachael Lowe
Disability in patients with chronic patellofemoral pain syndrome: A randomised controlled trial of VMO selective training versus general quadriceps strengthening
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This study compared the effects of rehabilitation with emphasis on retraining the vastus medialis (VMO) component of the quadriceps femoris muscle and rehabilitation with emphasis on general strengthening of the quadriceps...
Source: Physiospot - Musculoskeletal - April 27, 2008 Authors: Rachael Lowe
Looking for a Brand - Nice Job AHRQ!
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Check out the new PSAs
from the US Dept. of Health and Human Services' Agency for Healthcare and
Research and Quality (AHRQ),
and the Ad Council. The tag line: "Real Men Wear Gowns" is
catchy. The website link from the ads states:
"Whether it’s time for you to get a blood test or that test,you’re not
just doing it for yourself. You’re doing it for your family and loved ones,
because Real Men Know the Facts:
One in 5 American men has heart disease.
One in 3 American adults has high blood pressure.
Three in 4 American men are overweight.
Nine in 10 lung cancer deaths are cau...
Source: MyPhysicalTherapySpace.com - April 26, 2008 Authors: jwmatheson
ACN/United want the Tricare Contract
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I received the following message on a PT listserve:
I received a letter from ACN/UNITED stating they are bidding for management of TRICARE.
If you think it's a good idea to let TRICARE know of your experiences with the American Chiropractic Network (ACN) and UNITED, write a real quick letter of recommendation, or lack thereof, to the TRICARE address below. Action must be taken now as the contract is awarded "mid 2007." No one will act for you. TRICARE MANAGEMENT ACTIVITYSKYLINE 5SUITE 8105111 LEESBURG PIKEFALLS CHURCH, VA 22041-3206
I must commend ACN/United on their moxie to send a letter to PT providers. They are ...
Source: MyPhysicalTherapySpace.com - April 26, 2008 Authors: Larry Benz Tags: Healtcare Quality
What the week meant to Renee...
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When we arrived in Guatemala and looked around we began to get a feel for the extreme poverty that many people lived in. It was hard to imagine how 11 people and 20 tubs of supplies in 5 days could really make a difference. However one day while we were treating, a little girl came in with butterfly AFO’s. The therapists told us that those AFOs had been brought down by last year’s team. Later in the week when treating a child with severe RA, we were discussing with the therapists the importance of working on his respiration and they brought out bubbles that were also brought by the team last year. I realized that we wi...
Source: Physical Therapy Missions Blog - April 24, 2008 Tags: Guatemala 2008
One way
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To buck the trend toward insurance companies decreasing reimbursement. How did this clown end up with 4 clinics?
larry@physicaltherapist.com
Source: MyPhysicalTherapySpace.com - April 24, 2008 Authors: Larry Benz Tags: In the News
PT Whore of the Month Club #3
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The PT "Whore of the Month" Club continues to be received with great fanfare, despite some strong objections to the label we have put on what has turned out to be a very popular feature. In light of our very transparent disclaimer below regarding which definition of "Whore" we are intending, we have elected to stay with the current title. Feel free to continue hammering us in your comments if you disagree, but plain language works well here and frankly the definition could not be more apropos. We were delinquent in publishing a March winner so will be catching up in the coming weeks. The&...
Source: MyPhysicalTherapySpace.com - April 22, 2008 Authors: John Childs Tags: In the News Practice
Wii are Human Movement Specialists?
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As many of you are aware, the APTA has recently undertaken a strategic planning effort, which we have previously blogged about here (and are big proponents of its getting done). However, there is some early feedback about intentions to brand PTs as practitioners of choice for "human movement disorders" rather than using plain language that consumers and payers will actually understand. Think about it. Go ask 20 of your neighbors what a "human movement disorder" is and if they've ever had one. It's rather silly actually.
I don't want to be too critical until we see the final version of the strategic pla...
Source: MyPhysicalTherapySpace.com - April 21, 2008 Authors: John Childs Tags: Announcements Consumers Practice
Do ‘sliders’ slide and ‘tensioners’ tension? An analysis of neurodynamic techniques and considerations regarding their application
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Michel W.Coppieters and David S. Butler The aim of this cadaveric biomechanical study was to measure longitudinal excursion and strain in the median and ulnar nerve at the wrist and proximal to the elbow during different types of nerve gliding...
Source: Physiospot - Musculoskeletal - April 21, 2008 Authors: Rachael Lowe
Effects of patellar taping on knee joint proprioception in patients with patellofemoral pain syndrome
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Michael J.Callaghan, James Selfe, Alec McHenry and Jacqueline A. Oldham The aim of this study was to assess the effect of patellar taping of the proprioceptive status of patients with patellofemoral pain syndrome (PFPS). 32 subjects with PFPS were tested...
Source: Physiospot - Musculoskeletal - April 21, 2008 Authors: Rachael Lowe
Effect of Home Exercise of Quadriceps on Knee Osteoarthritis Compared with Nonsteroidal Antiinflammatory Drugs: A Randomized Controlled Trial.
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The objective of this study was to examine the effect of home-based exercise on knee...
Source: Physiospot - Musculoskeletal - April 19, 2008 Authors: Rachael Lowe
Cost-effectiveness evaluation of an RCT in rehabilitation after lumbar spinal fusion: a low-cost, behavioural approach is cost-effective over individual exercise therapy.
discuss this article
The objective of this study was to conduct an evaluation to investigate the cost-effectiveness of (1) a low-cost rehabilitation regimen with a behavioural element and (2) a regimen of individual exercise therapy,...
Source: Physiospot - Musculoskeletal - April 19, 2008 Authors: Rachael Lowe
Role of the Vastus Medialis Obliquus in Repositioning the Patella
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Lin, Y.-F., Lin, J.-J., Jan, M.-H., Wei, T.-C., Shih, H.-Y., Cheng, C.-K. The purpose of this study was to analyse if the morphologic characteristics of the vastus medialis obliquus correlate to patellar malalignment in patients with patellofemoral pain syndrome. In...
Source: Physiospot - Musculoskeletal - April 19, 2008 Authors: Rachael Lowe
More Fuel For the Primary Care Physician Fire
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For those of you following, I have had multiple posts here, here, and here regarding an initiative that I think we need to get aggressive on-branding with primary care physicians for musculoskeletal exam and treatment. This is due in large part to the shortage of primary care docs that will be around for awhile as well as the transition of our own profession to direct access and autonomous providers. Others, namely nurses are aggressively pushing this extender position and we need to put ourselves in a similar position.
This blog post appropriately titled, The End of the Primary Care Physician further adds fuel...
Source: MyPhysicalTherapySpace.com - April 17, 2008 Authors: Larry Benz Tags: Practice
Attention Physical Therapists- Speak Truth to Power
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I was hoping to sit down to a glass of wine and relax tonight...but the recent issue of JAMA has raised my blood pressure and reversed the positive health effects of moderate alcohol intake. I encourage all members of the MyPhysicalTherapySpace community to read the 2 recent papers on the continuing saga of Merck, Vioxx, and a pharmaceutical industry that continues to place profits over patients. The first paper describes the disturbing fact that of a number of clinical trial manuscripts related to rofecoxib (Vioxx) were authored by Merck employees but often the first authorship was at...
Source: MyPhysicalTherapySpace.com - April 16, 2008 Authors: Tim Flynn
Evidence for High Resistance AND Low Resistance
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Most of you probably contemplate new evidence as it becomes published. What factors do you consider relevant if you determine to implement the evidence?
The recent research comparing high resistance and low resistance exercise intensity for patients with knee osteoarthritis has me reflecting on how this could be implemented while considering all the stakeholders. It's great to know that exercise resistance at 80% of 1 repetition maximum (performing 3 sets of 8 repetitions) OR at 10% of 1 repetition maximum (performing 10 sets of 15 repetitions) both have favorable outcomes. On the surface it appears to b...
Source: MyPhysicalTherapySpace.com - April 16, 2008 Authors: Selena Horner Tags: Research
Quotes of the Year
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By crime novelist and professor of pediatrics and psychology at USC Dr. Jonathan Kellerman who wrote an opinion piece for WSJ.
The health insurance model is closest to the parasitic relationship imposed by the Mafia and the like. Insurance companies provide nothing other than an ambiguous, shifty notion of “protection.” But even the Mafia doesn’t stick its nose into the process; once the monthly skim is set, Don Whoever stays out of the picture, but for occasional “cost of doing business” increases. When insurance companies insinuate themselves into the system, their first step is figuring ou...
Source: MyPhysicalTherapySpace.com - April 15, 2008 Authors: Larry Benz Tags: Healtcare Quality
Maine Physical Therapists Allowed to Proceed
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Recently a judge gave the nod for a class action suit. Christy Stout, PT and all licensed physical therapists in Maine who were participating providers with Anthem Health Plans just had to have been ecstatic with the news. It's been two years since the beginning of the dispute and there is still a long way to go.
I loved this quote by their attorney: “Anthem cannot be allowed to unilaterally dictate a payment rate that jeopardizes the ability of physical therapists to continue to provide high quality services to the citizens of Maine.”
I know I'll be cheering for the underdog!
Selena
Source: MyPhysicalTherapySpace.com - April 15, 2008 Authors: Selena Horner Tags: In the News
Hip strength and hip and knee kinematics during stair descent in females with and without patellofemoral pain syndrome.
discuss this article
The objective of this study was to determine if females presenting with patellofemoral pain syndrome (PFPS) from no discernable cause other than overuse demonstrate hip weakness and increased hip internal rotation, hip...
Source: Physiospot - Musculoskeletal - April 15, 2008 Authors: Rachael Lowe
Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial.
discuss this article
The objective of this study was to evaluate the efficacy...
Source: Physiospot - Musculoskeletal - April 15, 2008 Authors: Rachael Lowe
Changes in plasma concentration of serotonin in response to spinal stabilisation exercises in chronic low back pain patient.
discuss this article
Sokunbi O, Watt P, Moore A The purpose of this study was to investigate the changes in the plasma levels of serotonin in response to spinal stabilisation exercises in participants with chronic low back pain. Plasma levels of serotonin were...
Source: Physiospot - Musculoskeletal - April 15, 2008 Authors: Rachael Lowe
What is grossly missing from the analysis
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Multiple choice question-something you won’t see on a PT licensure exam soon I hope.
All of the following are true except:
A. About 2.2% of medicare part B expenditures are for outpatient PT/OT/SLP of which 75% or roughly $3 billion is on PT. 9.7% of medicare beneficiaries access outpatient therapy.
B. Data demonstrates that between 2006 there was an increase of 3.5% beneficiaries accessing outpatient therapy but a reduction of 4.7% in medicare expenditure for outpatient therapy
C. The medicare cap and exemption process caused a reduction in expenditures between 2004 and 2006
D. All of the above are...
Source: MyPhysicalTherapySpace.com - April 13, 2008 Authors: Larry Benz Tags: Legislative
Vastus medialis activation during knee extension exercises: evidence for exercise prescription.
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The objective of this studt was to compare vastus medialis (VM) activation during a SLR and weight bearing exercises. Fifteen healthy subjects had electromyographic amplitudes for the VM expressed as a percent maximum voluntary...
Source: Physiospot - Musculoskeletal - April 12, 2008 Authors: Rachael Lowe
CPRs In The Movies: Ottowa Knee Rule
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A lot of attention has been given to CPRs that predict outcome (rightfully so). However, CPRs for the purpose of screening can be immensely helpful, in particular for PTs practicing in a Direct Access environment.
Despite the fact that many screening CPRs have only a few items, it isn't too difficult to forget the items that make up the rule if the rule isn't used on a regular basis. That is where "CPRs at the Movies" come in. Several students at Texas State University put together this CPR movie that once viewed, will no doubt help you remember the items comprising the Ottowa Knee Rule....
Source: MyPhysicalTherapySpace.com - April 11, 2008 Authors: Rob Wainner
Pay For Caps
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Forget about P4P measures as a way to control growth and ensure quality in outpatient physical therapy. According to CSC reports, the caps and the exemption process controlled growth while simultaneously did not restrict beneficiary access to physical therapists (and OT’s and SLP).
Although the report which is based on 2006 data cannot identify POPTS, the reports show a decrease in spending for PT overall compared to prior years and is roughly 3 billion for the PT component (which represents about 75% of total outpatient therapy). I believe this report is a serious blow to the POPTS argument that utilization is...
Source: MyPhysicalTherapySpace.com - April 11, 2008 Authors: Larry Benz Tags: Legislative
AAOMS Supports Physical Therapy Intervention
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Wow! Did the APTA team up with the AAOMS?
HR 5590 was introduced on March 11, 2008. I'm surprised the APTA hasn't disseminated information about this particular bill.
Nice to know that another organization and dentists see value in the skill and knowledge physical therapists offer. (I hope there isn't some dream plan that dentists can increase their profit margins by including physical therapy as an ancillary service.) HR 5590 isn't completely in line with The Vision, but a bill always goes through changes, so it can be altered if anyone believes it should be altered.
HR 5590 is a really short bi...
Source: MyPhysicalTherapySpace.com - April 11, 2008 Authors: Selena Horner Tags: Legislative
