Critical observations of health, science, and the physical therapy profession.
I've already talked about my experiences at the APTA Combined Sections Meeting (CSM) on my other page, so I won't re-hash that, but I thought it pertinent to recap just how awesome the programming was. CSM is the premier confernce of the year for the profession, and there is just a ton of programming available. You could learn about almost anything you could think of…
By far, the most exciting event at the APTA Combined Sections Meeting in Las Vegas was the launch of a new brand for the profession. The brand itself is pretty slick, but the exciting part lies simply in the fact that this is the first time in the history of the profession that such a monumental effort to define physical therapy has been undertaken.
Today, February 4, 2009 is World Cancer Day. Head over to the website for the Internation Union Againt Cancer to view a striking video and to find out more about their campaign to help promote a healthy, active lifestyle. It seems I've never stopped to take note of World Cancer Day before, but this year it seems more than appropriate.
What are you doing to help? I think if you just stop and notice, it is a start.
For over a decade, physical therapists have been urged to use standardized outcome measures the management of patients. Standardized outcome measures are tools that survey how a patient can perform certain activites. The tools give the therapist a quatitative way to assess a level of disability and clear ways to track progress. Many tools have been developed by investigators and education about the measures is an integral part of physical therapist curriculum. The tools are theorized to improve clinician decision making, improve patient safety, and improve the ability to describe patient progress over time. Interestingly, they have never been equivocally demonstrated in any sort of controlled trial to improve outcomes that I'm aware of. Regardless, there are many good reasons to use these tools, but many physical therapists tend not to use them. The February issue of Physical Therapy Journal includes a nice paper which conducted a survey to assess exactly how many do use the surveys, and why or why not they may do so.
D. U Jette, J. Halbert, C. Iverson, E. Miceli, P. Shah (2008). Use of Standardized Outcome Measures in Physical Therapist Practice: Perceptions and Applications Physical Therapy DOI: 10.2522/ptj.20080234
Physical Therapist and ESPN injury expert, Stephania Bell, is featured in this in-depth article discussing Tiger Woods and his rehabilitation. The article ranges from Tiger's commitment to understanding the healing process to the basics of core exercise for golfers. This is a very excellent piece, full of insight, that I enjoyed reading.
"I tell the golfers, we [physical therapists] are not here to entertain you," Ferrante said. "We're here to help you focus on the basics and what is specific to your sport."
Back pain is a real problem in the United States. Many people have it and many people end up suffering needlessly with chronic low back pain. I say needlessly because most back pain is easily remedied, most, in fact, gets better on its own. But, most people recieve over-agressive care in the form of drugs, surgery, and expensive imaging. This helps contribute to a widespread misunderstanding about low back pain and creates an environment which enables disability from low back pain.
So, we already know that MRI's are routinely over-prescribed, especially in the case of low back pain. Last year, 1 in 10 people in the U.S. recieved an MRI scan of something. That's a bunch! However, we might not be aware that the rate of injuries and incidents involving MRI scans are skyrocketing, beyond that which would be accounted for by increases in volume.
From CNN Health we are given this list of upcoming trends in healthcare for 2009:
The other day the LA Times had a feature piece by Amber Dance on low back pain. Quite a few physical therapists I know got excited about the article, as it showed the profession in a positive fashion. Go click here and read the article. How many times did you see any mention of physical therapists? Twice? In passing?
"When you do magnetic resonance imaging or computerized tomography scans of the spine, you sometimes see horrible things in normal people," Deyo says. One-fourth of people under 60 have a herniated disc, he says, and half have a bulging or degenerated disc. "And yet these are people who have no back pain."
The other goat grabbing portion of this option had to do with the lack of focus on physical therapists. Physical therapists are a key cog in the arena of low back pain care, yet were underrepresented in the article. There are litterally thousands upon thousands of orthopaedic physical therapists, and far and away, the most common diagnosis we see is for low back pain. It drives the profession in many ways. We have a lot of work to do to be recognized by the general public for the work we do with back pain.
I get a lot of follow-up questions about using Google Reader from audience members when I present on using feeds to enhance evidence gathering for clinical practice. The official Google Reader Blog has made some new videos which may prove a helpful resource. Check them out!
