Risk of Falling Linked to Fear

A study of older adults, primarily African-American women, found that fear—linked to lower self-confidence and poorer balance and stability—increases the risk of falling.

“It’s important for us to recognize that older adults might be afraid of falling; and just like with falls, they are reluctant to report this because they don’t want to lose their independence,” says researcher Roberta Newton, PhD, PT.

Newton conducted this study at Temple University School of Medicine, Philadelphia, and participants consisted of 204 older adults who were discharged from the emergency department after suffering a fall.

Newton, who measured sociodemographics, activities of daily living, physical activities, balance, mobility, endurance, and stability, found that, for those who have fallen either at home or in a nursing home, fear can be as high as 75%. According to the study, fear of falling occurs in both individuals who have fallen and those who have not fallen, and it can lead both older adults and caretakers to unnecessarily restrict their activity. The study also found that decreased physical activity saps strength and stability, leaving people more vulnerable to falling.

Will Alternative Therapies Decrease in Popularity?

According to a recent survey for the National Council on Aging, older osteoarthritis (OA) sufferers who are turning to alternative therapy are not happy with the results.

According to the survey, compared to 1 year ago, higher percentages of OA patients aged 50-65 are pursuing alternative treatment options, such as relaxation techniques and natural herb remedies, however, many of the OA patients are dissatisfied with their current treatments and are possibly under-treating or not treating their joint pain.  

Interestingly, results of a randomized trial published in the Lancet UK medical journal, conducted at Charite University Medical Center, Berlin Germany, suggests that acupuncture, a popular alternative therapy, could reduce pain and improve joint functioning in the short-term for those suffering with osteoarthritis of the knee.

An estimated 300 patients with chronic osteoarthritis of the knee were randomly assigned to acupuncture, minimal acupuncture (superficial needling at non-acupuncture points), or a waiting list control group. Patients were allowed to use nonsteroidal anti-inflammatory drugs throughout the study. The patients were administered acupuncture and minimal acupuncture in 12 sessions over 8 weeks. The patients completed questionnaires at the start of the treatment, and after 8 weeks, 6 months, and 1 year.

After 8 weeks, patients who were given acupuncture had a substantially lower score on an osteoarthritis index than patients in the control group. Minimal acupuncture also had short-term benefits compared with no acupuncture. A 1 year follow-up found no significant difference in scores between the the three groups.

Obesity Increases Health Care Costs

According to a study conducted at Emory University in Atlanta, money spent treating obese patients rose from $3.6 billion in 1987 to $36.5 billion in 2002. In 2001, overweight adults with private health insurance had increased insurance payments of $1,244 per person when compared with normal-weight adults.

From the perspective of hospitals and other facilities that treat obese patients, such as physical therapy and rehabilitation clinics, there are options for decreasing costs associated with managing bariatric patients. For example, if a clinic’s main patient base is normal-weight adults, and treatment of obese patients is a rarity, savings can be realized with rental equipment versus purchased equipment, according to Michael Dionne, PT, lead therapist at Choice Physical Therapy Inc, Gainesville, Ga.

“The advantage in the rental option for the facility that rarely sees obese patients is that both the medical equipment and the billing can follow the patient from the intensive care unit, to acute care, to transitional care, rehabilitation, long-term care, and even into the home,” says Dionne. “In this case, it would not make sense for each of these system providers to purchase equipment in each environment. It would be more cost-effective for that system to have established a relationship with a rental agency and have the equipment follow the patient through the system.”

Prolonged Rehabilitation Recommended for Hip Fractures

A study published in the Journal of the American Medical Association found that extending supervised outpatient rehabilitation by 6 months helps older patients recover better from hip fractures.  

The study, conducted at Washington University, St. Louis, Mo, followed 90 hip fracture patients (women and men), 65 years or older, who had undergone surgical repair of a proximal femur fracture no more than 16 weeks prior and had completed standard physical therapy. The study participants were randomly assigned to 6 months of either supervised extended rehabilitation physical therapy that focused on flexibility, balance, coordination, motor speed, and strength or home exercise. Patients were evaluated at baseline, at 3 months, and at 6 months.

The study found that 6 months of extended physical therapy lead to significantly greater improvements than the control condition in measures of muscle strength, walking speed, balance, and perceived health, but not bone mineral density or fat-free mass. Additionally, the study results showed that these older patients, who were previously thought to be too frail for weight training, can benefit from resistance training, which helps to improve physical function and quality of life and reduce disability compared with low-intensity home exercise.

Provox Technologies Awarded Patent for Template Technology

Provox Technologies Corp, Roanoke, Va, provider of speech-recognition-based medical-documentation and workflow-management systems, has announced that it has been issued a patent for its automation technology that is used to build medical specialty-specific templates based on procedure codes.

“Combining structured reporting with speech recognition enables physicians to dictate less and improve the quality and completeness of patient documentation,” said Shelley Newman, CEO of Provox.

Patent No 6,834,264 B2, “Method and Apparatus for Voice Dictation and Document Production,” describes the system and methods that enable a document to be produced from external data with variable data-entry fields using speech-recognition technology. This patent provides the foundation for procedure-driven structured reporting with flexible speech-recognition field dictation.

Provox’s SmartMacro Templates simplify the radiology-reporting and clinical-documentation processes for each specialty and every procedure. A rules engine is used to augment the procedure-driven templates for each patient using patient demographic data. Patient data can also be populated into each template, as well as be interpreted into a new result, such as birthday into age.

“This patent affirms Provox’s technology leadership in the field of medical-based speech-recognition documentation solutions,” said Newman.

APTA Endorses Appointment-Scheduling Software

The American Physical Therapy Association (APTA) has announced its endorsement of the AppointmentsPRO™ appointment-scheduling software by SpectraSoft Inc, Tempe, Ariz.

APTA product endorsements are statements to its membership and to the general public that a product is worthy of consideration. Review criteria include benefits to the user, product efficacy, and cost-efficiency.

“It is an honor to be recognized by APTA in this way,” said Steve Petrie, CEO of SpectraSoft Inc. “Our focus has always been on physical therapy—to create products that meet the specific needs of rehabilitation professionals, instead of forcing solutions on them that are designed for other health care applications.”

Altimate Medical Receives 2005 MNSHARP Award

At the Governor’s Safety Award Luncheon on May 13, 2005, Altimate Medical, Morton, Minn, was presented with a 2005 MNSHARP Award for meeting the requirements of the Minnesota Safety and Health Achievement Recognition Program. The award is effective through May 2007.

MNSHARP Awards are granted by the Minnesota Department of Labor and Industry’s Occupational Safety and Health Administration. This is the fifth MNSHARP award that Altimate Medical has received since 1998.