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Patients with a particular type of knee pain are more overweight: Association between the two has not been clearly evaluated Knee osteoarthritis (OA) is a condition in which cartilage that normally protects the knee gradually wears down over the course of time. It is one of the leading causes of pain and disability throughout the world, affecting about 10% of men and 13% of women over the age of 60 in the U.S. The patellofemoral joint connects the kneecap (patella) with the upper leg bone (femur), and symptoms of knee OA frequently occur in this area. This joint also plays a critical role in the function of the knee, as it allows individuals to complete many daily activities like squatting and climbing or descending stairs. Due to its role, though, the patellofemoral joint may be negatively affected by forces that are too strong, such as excessive weight. Overweight or obese individuals with a high body mass index (BMI) put lots of stress on their knees, which may increase the risk for pain in the patellofemoral joint and knee OA, but this association has not yet been clearly evaluated. For this reason, a powerful pairing of studies called a systematic review and meta-analysis were conducted to determine if high BMI is a risk factor for patellofemoral pain and knee OA. 52 studies are accepted into the review Researchers performed a search of six major medical databases for studies that included information on the associated between BMI and patellofemoral pain or knee OA. This search led to a total of 7,894 studies being evaluated, and from these, 52 met the necessary criteria and were accepted into the review. The findings of each of these studies were then evaluated and compared to one another, and the quality was ranked to determine how reliable their data was. Studies were given a rating from 1 (strong evidence) to 5 (conflicting evidence). Adults—but not adolescents—with patellofemoral pain and knee OA have a higher BMI The results of this systematic review and meta-analysis showed that the BMI of adults with patellofemoral pain and knee OA was generally higher than the BMI of healthy individuals without knee pain that they were compared to. When it came to adolescents with patellofemoral pain, however, the same type of association was not found. As for why this association was found it, adults, it likely has to do with the fact that individuals with a higher BMI generally reduce their activity levels due to the persistent pain that is brought on by their condition. In turn, reduced activity levels can actually lead to more weight gain and more stress on the knees, which can create a vicious cycle that makes their condition even worse. This study, therefore, shows how important it is for those with a high BMI to reduce their weight, as doing so may also lower their chances of developing knee pain due to the involvement of the kneecap. Physical therapists can help in their pursuit by prescribing specific exercises and offering advice on how to increase physical activity levels, and those with patellofemoral pain are encouraged to seek out their services for additional guidance. -As reported in the May '17 issue of the British Journal of Sports Medicine http://dlvr.it/QTGgYV
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Patients who undergo therapy before surgery spend less on care after: Surgery has become the treatment of choice for patients with severe hip or knee arthritis Arthritis is one of the most common causes of disability in the U.S. Approximately 50 million Americans have been diagnosed with some form of arthritis, and about one of every three of these patients has reported being physically limited due to their condition. Osteoarthritis-often referred to as wear-and-tear arthritis is the most common form of the disease, and it can be especially troubling. In this type of arthritis, protective cartilage at the ends of bones gradually wears away, sometimes to the point where the bones begin rubbing against one another. Osteoarthritis that progresses to this point is referred to as end-stage arthritis, which often requires aggressive treatment. Total joint replacement surgery has now become the treatment of choice for end-stage arthritis of the hip or knee, and the rate of this surgery is only expected to increase in the future. To improve the outcomes and reduce the costs for patients who undergo surgery, physical therapy is commonly recommended before the procedure. Preoperative physical therapy, or "prehabilitation," prepares patients' bodies for the procedure and teaches them what to expect; however, research is limited on its effectiveness. For this reason, a study was conducted to investigate the association between prehabilitation and the use of care after surgery, as well as the associated costs of this treatment. Data collected on nearly 5,000 patients To conduct the study, researchers looked for medical records of patients who received treatment after having surgery for hip or knee osteoarthritis. This search led to a total of 4,733 patients being identified who fit the necessary criteria, and data related to their treatment was collected and analyzed. Researchers were particularly concerned with the care these patients received within 90 days after being discharged from the hospital, and the impact that pre-habilitation had on their use of care and its costs. Pre-habilitation associated with a reduced use of care after surgery Results showed that overall, 77% of the patients studied used some type of care services after having surgery. In patients who did not receive prehabilitation, 79.7% used these services, compared to only 54.2% of those who received prehabilitation. With further analysis, it was found that the prehabilitation was associated with a 29% reduction in after-surgery care. This reduced use of care resulted in a total savings of $1,215 per patient, which was mainly the result of fewer payments to skilled nursing facilities and home health care. These findings support the use of preoperative physical therapy-or prehabilitation-in patients preparing for hip or knee replacement surgery, as it can reduce the need for patient care and its associated costs following the procedure. Individuals who are scheduled to have this type of surgery should therefore consider having a short course of physical therapy prior to their surgery date, in order to increase their chances of a successful outcome and quicker recovery. - As reported in the October '14 issue of The Journal of Bone and Joint Surgery http://dlvr.it/QT8JFQ
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Recipe Wednesday - Japanese-Style Beef and Noodle Soup: Flavorful, healthy, and simple -- Sign us up! Click here for the recipe! http://dlvr.it/QT1slP
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Hands- on therapy is beneficial for carpal tunnel and reduces pain: Individuals with this condition may have to miss work due to symptoms Carpal tunnel syndrome (CTS) is a condition that results from pressure being placed on a nerve in the wrist. This compression of the median nerve can come from swelling or anything else that makes the carpal tunnel smaller, and it leads to numbness, weakness, tingling and other problems in the hand. CTS affects up to 3.8% of the population, and its symptoms often make it difficult for working individuals to complete their jobs. This may lead to absence from work and a decline in work performance. Effective treatment is therefore needed to address CTS, and there are many options available. One option that may be used is physical therapy, especially if it includes manual therapy, an intervention in which the therapist performs various manipulations with their hands. Unfortunately, evidence to support physical and manual therapy is lacking, and these treatments are often ignored in reviews. For this reason, a powerful study called a randomized-controlled trial (RCT) was conducted that compared manual therapy to another type of treatment called electrophysical therapy for CTS. Patients randomly assigned to one of two groups Patients diagnosed with CTS were invited to participate in the study and screened to determine if they were eligible. This process led to a total of 140 patients being accepted to the RCT, who were then randomly assigned to either the manual therapy group or the electrophysical group. Patients in both groups underwent a 10-week physical therapy treatment program, but the specific parts of the program were different in each group. In the manual therapy group, the physical therapist performed a massage and various mobilizations of the median nerve, which was carried out during two weekly sessions for 20 sessions total. The electrophysical therapy group also consisted of 20 sessions total, but patients were treated with a red laser that was pointed at their wrist for two minutes and 40 seconds. The goal of this intervention is to stimulate the immune system to release chemicals that will heal the area and restore balance to the wrist, and was followed by another similar treatment called ultrasound. All patients were evaluated using a number of outcome measures at the beginning of the study and after the treatment was completed. Both groups improve, but manual therapy brings about greater changes Results showed that both treatments led to improvements, as patients experienced less pain, greater function, and fewer symptoms after completing the interventions. Patients in the manual therapy group, however, reported even greater improvements than those in the electrophysical therapy group in all three of these measurements. Another finding showed that the average reduction in pain was 290% in the manual therapy group and only 47% in the electrophysical therapy group. Based on these results, it appears that manual therapy is more beneficial for patients with CTS than electrophysical therapy. Patients dealing with CTS should, therefore, seek out the services of a physical therapist that offers this type of intervention in order to experience similar outcomes as the participants of this current study. -As reported in the April '17 issue of the Journal of Manipulative and Physiological Therapeutics http://dlvr.it/QSn5mz
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Happy Mother's Day! http://dlvr.it/QShCkD
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PT after knee surgery leads to improvements in function & flexibility: Many patients who have surgery go on to experience lingering issues The meniscus is a piece of cartilage shaped like a wedge that rests between the thighbone and the shinbone. There are two of these in each of your knees, and the job of each meniscus is to stabilize the knee joint and absorb shock. Meniscus tears are very common, and surgery to repair these injuries is currently one of the most frequently performed procedures. In most cases, knee arthroscopy procedures are used to treat these tears, and it's estimated that 636,000 of these are performed each year. Arthroscopy is minimally invasive, which means that only small incisions and instruments are used in order to reduce the risk of complications. But many patients who undergo arthroscopic surgery to remove the damaged meniscus still experience issues like pain, loss of range of motion (ROM) and strength, and reduced quality of life (QoL) after the procedure. This is why physical therapy is commonly recommended after surgery to help patients recover more quickly and avoid these complications. But even though it is popularly used, evidence is lacking on the overall effectiveness of physical therapy and which treatments should be recommended. For this reason, a powerful pair of studies called a systematic review and meta-analysis was conducted. 18 high-quality studies are included To conduct the review and analysis, researchers performed a search of 11 major medical databases for relevant studies on the topic. Only randomized-controlled trials (RCTs) were accepted, which are considered the gold standard of individual studies for determining if a treatment is beneficial. From this search, 1,028 articles were identified, and 18 of these fit the necessary criteria to be included in the systematic review. Due to certain inconsistencies in these studies, only six were included in the meta-analysis. Once collected, the findings of the included studies were evaluated and compared to one another to determine if physical therapy was indeed effective after arthroscopic meniscectomy and which treatments were best. Physical therapy benefits patients, especially when a home-exercise program is involved Results of the systematic review and meta-analysis were generally supportive of the use of physical therapy after meniscus surgery. This was based on several studies that found a positive effect of various types of physical therapy treatments utilized during the recovery period. But the most effective intervention appeared to be combining an outpatient physical therapy program-meaning it was performed at a designated clinic-with a home-exercise program. When this type of combination was used, patients experienced notable improvements in their knee function, ROM, as well as reduced swelling. Based on these findings, it appears that sending patients to physical therapy after meniscus surgery can help them to improve more rapidly, and this process can be improved further by including a home-exercise program. Individuals who are considering or preparing for this type of surgery should therefore ask their doctors about treatment following their procedure and ensure that physical therapy is included in their recovery process. - As reported in the Aug. '13 edition of JOSPT http://dlvr.it/QSNNhW
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Motivational Monday: -Winston Churchill http://dlvr.it/QS1L74
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PT after shoulder surgery responsible for a faster recovery: Surgery only recommended if other treatments don't lead to improvements Subacromial impingement syndrome (SIS), sometimes referred to as shoulder tendinitis, is a painful condition in which certain structures in the shoulder become compressed by bones in that region. Patients with SIS are usually managed with of a number of nonsurgical treatments, including rest, injections and physical therapy. In most cases, surgery is only considered for patients that do not improve after attempting several nonsurgical treatments. After surgery, physical therapy is typically recommended to help patients regain shoulder function. Although this approach is commonly utilized, there is no consensus about the most appropriate strategy, and little is known about the effectiveness of different types of exercise programs. It's also possible that patients who have trouble returning to normal activities may require additional efforts to help in their recovery. For this reason, a high-quality study called a randomized-controlled trial (RCT) was conducted. In this RCT, patients with SIS who had surgery were randomly assigned to one of two treatments to determine which was more effective for helping them recover. Patients treated with either physical therapy or usual care Patients with SIS who had a surgical procedure called arthroscopic subacromial decompression were recruited for the study between 8-12 weeks after surgery. A total of 126 patients fit the necessary criteria and were randomly placed into either the physical therapy group or the usual care group. Patients in the physical therapy group followed a program that consisted of a combination of both supervised training sessions and home-exercise training. They received between 8-15 training sessions during the first eight weeks. Over the next four weeks, the frequency of these sessions varied depending on how patients responded, and they were told to perform their home exercises more regularly. Sessions lasted up to one hour each which consisted of aerobic exercise on a stationary bicycle, manual therapy performed by the physical therapist, and seven exercises that specifically targeted the shoulder. Patients were also instructed to become physically active at a moderate or high intensity for at least 30 minutes three times a week. Patients in the usual care group did not receive any specific treatments, but were told to continue the postoperative treatments recommended by the hospital. All patients were assessed before being assigned to their groups, and then again three and 12 months later for a variety of outcomes, including strength, range of motion and quality of life. Following a course of physical therapy should be the norm after surgery Results showed that after 12 months, patients in the physical therapy group improved significantly more than those who received usual care. This was based on better questionnaire scores showing that patients who had physical therapy had improved shoulder function and less fear about their condition than the other group. They were also found to be more physically active and had a better overall impression of the changes they experienced from treatment. This RCT, which is the largest study that's ever been performed on the topic, clearly shows that physical therapy leads to numerous improvements for patients with SIS after having surgery. Based on these findings, physical therapy should be considered a necessary component of recovery following surgery, and it's recommended that a treatment program similar to the one used here is followed to increase the chances of a positive outcome. - As reported in the June '16 issue of Physical Therapy http://dlvr.it/QRjsp7
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Could this help you, your family, a friend?: Could this help you, your family, a friend? Here is our latest monthly video. http://dlvr.it/QRctfx
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Recipe Wednesday - Kasha With Bell Pepper Confetti: Ready for a flavorful meal?! Click here for the recipe! http://dlvr.it/QRTxjp
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