| |
|
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
| 6/10/2008 |
Arthritis may be triggered by environmental exposures? |
| |
A number of environmental exposures, including trauma, are associated with the onset of inflammatory arthritis in patients with psoriasis, findings published in the Annals of the Rheumatic Diseases indicate. "Psoriatic arthritis can be considered as a 'disease within a disease'," Dr. Ian N. Bruce, of the University of Manchester, UK, and colleagues write. Psoriatic arthritis is "inflammatory arthritis on a background of pre-existing or future development of psoriasis."
"Usually arthritis post-dates, often by several years, the onset of psoriasis," they note. So for patients with psoriasis, it is would be helpful to know what factors increase their risk of developing this condition. To investigate, the researchers compared 98 patients who developed inflammatory arthritis within the past 5 years to a "control group" of 163 patients with psoriasis but not arthritis. A postal questionnaire was used to assess potential factors associated with the development of inflammatory arthritis.
Exposures before the onset of arthritis that positively correlated with the condition included rubella vaccination (4.6 percent for psoriatic arthritis patients vs 0.7 percent for controls); trauma requiring medical care (14.9 percent vs 7.9 percent); and recurrent oral ulcers (25.3 percent vs 8.9 percent). Psoriatic arthritis patients were more likely to have moved than were controls (30.3 percent vs. 18.2 percent, respectively). Psoriatic arthritis patients were also more likely than controls to have had a bone fracture that required hospital admission (50 percent versus 9 percent).
These finding need to be replicated, especially for those exposures that increase the risk of arthritis that have not previously reported, Bruce and colleagues note. A better understanding of the triggers that contribute to the development of psoriatic arthritis might also elucidate the biological mechanisms that underlie this disease.
SOURCE: Annals of the Rheumatic Diseases, May 2008 fron the National Library of Medicine: MEDLINE PLUS |
|
| 4/3/2008 |
Occupational Therapy and Home Health -- Making Progress? |
| |
The Medicare Home Health Flexibility Act was introduced by Rep. John Lewis (D-GA). The bill would allow occupational therapists to conduct the initial assessment for Medicare home health beneficiaries when occupational therapy is included on the physician's referral along with physical therapy and/or speech therapy. The bill is actively supported by AOTA and the National Association of Home Care and Hospice (NAHC). Look for additional information on the AOTA Legislative Action Center in the future. |
|
| 4/3/2008 |
Therapy Out-Patient Medicare CAP (ONCE AGAIN) But we need your help |
| |
The six month extension on the exceptions process and the fee schedule fix expire on June 30. The AOTA has made it very easy to get involved. We need everyone to contact their state representatives. Please help the profession and put this cap to rest once and for all. The form literally only takes 2.5 minutes TOPS to complete. AOTA could not have made it any easier. Please get involved and help your profession. Thank you! Click here: http://capwiz.com/aota/issues/alert/?alertid=10910161 |
|
| 2/19/2008 |
Osteoarthritis Pain in the Hands |
| |
According to research presented at the annual meeting, European League Against Rheumatism, June 2007 in Barcelona, Spain people with hand OA experience a significant increase in pain and loss of hand function in just TWO years. This is significant because this is much earlier than previously believed. Typically, x-rays are not helpful in the early states of OA because subtantial joint destruction often happens before it is detected on xrays. However, at the annual meeting in Spain researchers stated that progression hand OA could be seen on x-rays in 20%. This is significant for therapists as we LISTEN to our patients andimplement pain relieve, joint protection, ergonomics, and activity modification into the early states of OA. |
|
| 1/8/2008 |
Alcohol Good? Smoking Bad? Breastfeeding? |
| |
Acording to Australian researchers, male smokers experienced greater cartilage loss and increased pain from osteoarthritis vs men who did not smoke. Reports that smoking increased symptoms in knee OA was released in 12/2006 via ithe online issue of the Annal for the Rheumatic Disease and recently in the Australian research report May 2007 issue of Arthritis and Rheumatism. However there was evidence presented at the European League against Rheumatism June 2007 in Spain that suggests drinking more than 3 drinks a weeks may reduce the risk of developing RA. The presentors stated the more alcoholic beverages consumed (specifically wine) the greater their protecion against developing RA. However, if one smokes and drinks; unfortunately, smoking negated some of the protective benefits of the alcohol. Also, interesing in this same study presented in Spain, researchers found that babies that breastfeed longer than 13 months MAY have protection against developing RA. Obviously more research is needed to understand how alcohol comsumption and prolonged breastfeeding may protect against RA. As always, don't over drink and the researchers caution that excessive amounts of alcohol can have more negative effects on your health than benefits. |
|
| 12/31/2007 |
Physician and Outpatient FEE services |
| |
On December 19, 2007 the House overwhelmingly approved S.2499, the Medicare, Medicaid and SCHIP Extension Act of 2007 by a vote of 411-3. President Bush signed into law in December. This law provides a 0.5% update to the Medicare physician reimbursement rate through June 30, 2008. If this was not passed Medicare payments to Physicians would have decreased by 10% as a result of a formula used to calculate the Sustainable Growth Rate (SGR). The SGR is intended to keep spending on physician services consistent with a target based on growth in the natinal economy. If actual spendin is greater than the target (as it has been since 2002) then physicians receive a negative update on fees. This Extension Act of 2007 is only a temporary fix. So please visit AOTA or APTA and get involved with sending you senators and Representatives emails to find a more permanent solution to this annual reimbursement dilemma. |
|
| |
The Therapy Cap restrictions have been extended for 6 months until June 2008. Please continue to contact your congress and senators as this issue is only delayed not defeated. You can find more information at Centers for Medicare Services (CMS.gov) as well as AOTA. |
|
| 12/11/2007 |
Out Patient Therapy CAP |
| |
The congressionally mandated outpatient therapy cap for CY 2008 will be $1,810 per beneficiary for OT and $1,810 per beneficiary for PT and SLP combined. As in previous years, the outpatient therapy cap does not apply to outpatient hospital settings. In the final rule, CMS acknowledges that they received many comments in opposition to the therapy caps, but states that CMS does not have the regulatory authority to end the caps or to extend the cap exceptions process from CY 2007; such changes can only be made by Congress. Therapists need your help by DEC 31, 2007. AOTA has been very instrumental by representing the best interests of the public and stopping the therapy CAPS. AOTA continues to lobby against these cuts but Congress must hear from you to understand the importance of getting legislation passed that will extend the therapy cap exceptions process for 2008 and 2009. To contact your congress AOTA has set up a user friendly email. Please Click Here! |
|
| 11/3/2007 |
The OT Profession is Bouncing Back |
| |
Due to federal legislation limiting and/or restructing reimbursement in the late 90s and early 2000 was difficult for the OT, PT, and SLP professions resulting in layoffs, cutbacks, as well as pay and position freezes. Well, now the rehab. profession is on a comeback. The traditional settings of hospitals, schools and out-patient remain strong; a new emerging field in geratrics is on the rise. OTs skills are sought after to help the elderly stay in their own home vs going to long term care facilities. Other professional areas OTs are finding rewarding is driver assessments, ergonomic consulting and technology assistive device development and consulting servies. OTs can be creative and design their own plan to enter into the area of the aging American. |
|
| 10/21/2007 |
Need YOUR HELP to STOP the Therapy Cap |
| |
Call Stop the Therapy Capstoll-free call-in line October 29 through November 2. Call 866-346-2770 from October 29 to November 2 and be briefed on the key message to share with your Congressional office on the therapy cap and then be patched directly to your Members of Congress. It is important Congress hears from all of us. We must take action.l For more detail go to http://www.aota.org/News/AOTANews/40831.aspx |
|
| 9/18/2007 |
Carpal Tunnel Syndrome - What are the causes? |
| |
Some people believe that work activities that involve overuse of the wrist and hand, repetitive impact on the palm and tools that vibrate can cause CTS," said Dr. Hartigan. "Extremes of wrist flexion and extension have been shown (experimentally) to elevate pressure within the carpal tunnel. However, the relationship between repetitive work activity and CTS has never been objectively demonstrated." A new study appearing in the September 2007 issue of the Journal of the American Academy of Orthopaedic Surgeons navigates through CTS. Click here |
|
| 8/6/2007 |
Osteoporosis drug may help decrease symptoms of OA |
| |
Calcitonin is a hormone used to treat postmenopausal women for bone loss due to osteoporosis. Calcitonin is also used to treat high amounts of calcium in blood & Pagent's disease of the bone. Preliminary studies show that rats slowed or stopped erosion OA of the knee joint when using this drug. This drug is administered via injection or nasal spray. Although this is encouraging, these findidngs are in its earsly stages of research (Arthritis & Rheumatism August 2007 Vol 56). This is something to keep an eye on. |
|
| 7/6/2007 |
Promising non-surgical treatment for Dupuytren's Disease |
| |
Currently in the process of FDA approval is the injection of collagenase.
In phase III of Food and Drug Administration (FDA) approval Collagenase injection is another promising therapy to treat DD. This procedure is similar to needle aponeurotomy, however the chords are weakened through the injection of small amounts of an enzyme that dissolves them. Collagenases are enzymes that break the peptide bonds in collagen. They assist in destroying extracellular structures in bacteria pathogenesis. Collagenase is being used for treating Dupuytren's Disease via an injection.
Below is a list of non-surgical treatments for DD:
*Radiation therapy (specifically in early stages inhibits development of contracture)
*Triamcinolone (kenalog) injections provide some relief
Treatment of Dupuytren's disease with low energy x-rays (radiotherapy) may cure Morbus Dupuytren on a long term, specifically if applied in early stages of the disease.
*Needle aponeurotomy (release of the contracture) is a minimal invasive technique where the cords are weakened through the insertion and manipulation of a small needle. Once weakened, the offending cords may be snapped by simply pulling the finger(s) straight. The nodules are not removed and might start growing again. This is usually performed in the doctor's office. |
|
| |
If you are keeping up on the DME news there is bidding occuring now. CMS has opened the bid window for the first round of the Medicare DMEPOS competitive bidding program. All bids are due by 9:00 p.m. prevailing Eastern Time on July 13, 2007. Click HERE and look at the box to the left for specific milestones, topics, and rulings. |
|
| 5/14/2007 |
What is New with CMS Competitive Bidding |
| |
Occupational Therapists in private practice are exempt from CMS competitive bidding requirements. The AOTA advocacy is a great link to ensuring this success. In its final rule on DMEPOS competitive bidding, published in the Federal Register April 5, 2007, CMS specifically exempted occupational therapists in private practice (OTPPs) from participating in the competitive bidding process to allow OTPPs to continue to furnish certain types of competitively bid items (namely, off-the-shelf orthotics such as splints) to their own patients when these items are furnished as part of their professional services under a plan of care. AOTA is pleased to announce this win after advocating rigorously to CMS over the past 3 years for OT exemption from competitive bidding. However, all DMEPOS suppliers must obtain accrediation from an approved organization.
To read the CMS final rule in its entirely click here |
|
| 4/26/2007 |
Arthritis Prevention, Control & Cure Act Introduced to 110th Congress |
| |
Arthritis Prevention, Control and Cure Act (S. 626 / H.R. 1283)
Arthritis Prevention, Control, and Cure Act proposes to strengthen arthritis public health initiatives, which would ensure that more people are diagnosed early and avoid pain and permanent disability. While there are several new medicines available to treat the symptoms of arthritis, there is no cure. The legislation proposes to ensure that limited federal funding for arthritis research is used in the most strategic manner possible through the formation of a federal interagency coordinating committee. Finally, early diagnosis and aggressive treatment are critical for children with arthritis. Learn more go to Arthritis Foundation by Click HERE |
|
| 4/12/2007 |
Oppose Legislation Permitting "Incident-To" Billing for Therapy Services by Non Qualified Therapists |
| |
The AOTA posted an ACTION ALERT to protect Occupational Therapy's Scope of Practice. Action is needed immediately. Please Contact your Representatives and urge their opposition to this legislation. After you click the link provided below, you will be directed to the AOTA website where you can read a brief history, AOTA's position and the ACTION needed. At the bottom of the AOTA page is a user friendly form to fill out that will automatically be sent to your Representatives (your zip code will direct the email to the correct Representatives). Thank you for your support. Click Here! |
|
| 3/26/2007 |
April is OT Month - AOTA Raising Awareness for our Colleagues Serving in the Military |
| |
OT month is a great opportunity for OT to get recognition. Occupational Therapists and Assistants throughout the country raise awareness in support of their profession every April. Occupational Therapists are creative and many projects from news releases to community involvment have been successfully organized. This year the AOTA is focusing on treatment given to our military. Have fun organizing and designing your campaign to promote OT. For more information about the AOTA or to check out the promotional items check out AOTA |
|
| 3/22/2007 |
New Surgical Instruments for Distal Radius Fracture |
| |
The University of Pennsylvania Health System, particularly the Penn Orthopedic Institue is looking at a series of low profile locking plates that combine pins and plates to treat complex or challenging distal radius fractures in the older patient. According to PENN Today Online, "In the past, some surgeons may have used external fixation, but we've found that internal fixation, and low profile plates in particular, provide technically better control," says David Steinberg, MD, director of the hand and upper extremity fellowship at the Penn Orthopaedic Institute. "The plates allow us to align the bones better and patients are able to rehab faster" |
|
| 3/20/2007 |
PENN Orthopedic Flexor Tendon Research on the Cutting Edge |
| |
The Penn Orthopaedics laboratory is one of the top three U.S. centers for National Institutes of Health-funded tendon research. A particular area of interest is the flexor tendon and what can be done medically or surgically to reduce scarring and promote healing in this delicate area. At present research is being conducted on the cellular level of the tendon and tendon healing. The researches feel their work will carry over into how we treat flexor tendons in the clinical setting for both surgeons and therapists. Click Here to learn more: |
|
| 3/18/2007 |
Older adults are more active. Good and Bad |
| |
More adults are active. That is good news. Unfortunately, the bad news is there seems to be a rise in sports related injuries, according to Mayo Clinic. Sports Injuries increased 54% for adults 65 years and older from 1990 to 1996 according to the Consumer Product Safety Commission ( this is the most recent data available). Most of the injuries were associated with active sports such as biking, skiing, tennis and skating. Often, injuries were related to inflammation and simple wear and tear aggravated by overuse. We as therapists, have the opportunity to educate seniors on proper pre and post exercise stretching, pain management, warm up and cool down routines. Recommend seniors to instructors (sports pros) for their sport so they can learn proper playing technique(s). Also the sport pros can assist the senior in purchasing good fitting equipment to help decrease the risk of injury. Ensure your patient knows that pain usually means their body is "screaming to be heard" and they should listen and implement the above recommendations vs thinking they have to work through the pain ("no pain - no gain" is not good advice). |
|
| 3/15/2007 |
Osteoporosis and osteoporotic fracture |
| |
We, as hand therapists, treat patients who have been diagnoised with osteoprosis. We most likely are seeing them because they had a fracture. Often patient's ask therapists about osteoprosis. Although we always refer them back to their doctors for medical advice, it is important for us to understand osteoprosis and risk factors. According to the North American Menopause Society (NAMS), advancements in management in osteoprosis has prompted new evidence based guidelines. One factor doctors are taking into consideratio is the patient's lifestyle. Lifestyle modifications that include a balanced diet, adequate calcium and vitamin D intake, appropriate exercise, avoidance of smoking and excessive alcohol use, and fall prevention are encouraged for all postmenopausal women. Boggs said the importance of vitamin D, in addition to calcium, plays a great role in osteoporosis management. To read the story CLICK HERE |
|
| 2/28/2007 |
Reimbursement Issues for Medicare |
| |
OT services will not be cut the expected 5% for Medicare. There is a 0% or no change for one year. AOTA and others have been working diligently to ensure OT services were not cut in reimbursement. |
|
| 2/7/2007 |
Occupational Therapy Featured in U.S. News & World Report |
| |
Occupational Therapy is ranked as a top career according to the U.S. News & World Report. The article briefly describes the importance of OT for daily tasks and how Ots help maintain indpendence. Click HERE for more details: |
|
| 2/7/2007 |
Political Victory |
| |
There is yet another one year extension on the Medicare Part B out-patient OT cap. This means that if your clinical setting is an outpatient facility, CORF, or CARF you do not have a manual cap on the amount Medicare will reimburse. The down side is, as in the past, it is only a one year extension so the political fighting must continue. We need to keep this alive in the minds of Congress to once and for all eliminate the out-patient Medicare Part B Cap. |
|
|
|
| |
|
|
|
| |
|
