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Bangalore, Karnataka, India
Physiotherapist and Research Scholar, ESIC Model Hospital & PG Research Institute- ESICPGIMSR (Under Govt of India),Rajaji Nagar, Bangalore and General Secretary of Bangalore Physiotherapist Network (BPN) 2017-2020

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30 Mar 2015

Physiotherapy is Cost Effective - Research Update

Study: Costs reduced when low back pain treatment begins with Physical therapy:

A study in the Scientific Journal Health Services Research showed that initial referrals for physical therapy for patients with new episodes of low back pain (LBP) resulted in less than half the cost of imaging and generated lower costs associated with use of health care resources over time.

Physical therapist researchers Julie M. Fritz, PT, PhD, FAPTA, Gerard P. Brennan, PT, PhD, and Stephen J. Hunter, PT, PhD, OCS, analyzed utilization records and other health information for patients who consulted with a primary care provider about uncomplicated LBP and were referred for management outside primary care within 6 weeks. They found that physical therapy was the less costly approach—initial referral for physical therapy cost $504 on average (for an average 3.8 visits), compared with an average of $1,306 for magnetic resonance imaging (MRI). Also, average subsequent costs over the next year were nearly 72% lower for patients who began with a physical therapy referral—$1,871, compared with $6,664 for the imaging group over the same time period.

Authors discovered that patients who receive imaging as a first referral increased the likelihood of surgery and injections as well as specialist and emergency department visits within a year. They noted that advanced imaging often 'labels' a patient's LBP that might otherwise be viewed as nonspecific and uncomplicated, causing heightened concern in some patients and providers, motivating them to seek additional care. Authors said that physical therapy may provide patients with an active approach to LBP, enhancing patients' perceived ability to self-manage their condition. Authors acknowledge that their study was limited to newly reported and uncomplicated LBP, and that patient-centered function or satisfaction outcomes were not recorded.

"This is one of many studies demonstrating that physical therapy is a cost-effective alternative to medication and surgery," said American Physical Therapy Association President Paul Rockar Jr, PT, DPT, MS. "Patients benefit from an active approach to their care and, in turn, society is transformed through the benefits from reduced financial burdens on our health care system."

Oh, my aching wallet: MRI instead of Physical Therapy for low back pain leads to $4,793 higher price

Your back hurts (join the club) and you go to see your primary care physician. Most of the time, your doctor will tell you to rest, maybe take some ibuprofen or ice the affected area.

But when researchers looked at 841 people who needed additional care,  they found that the ones sent first for MRIs were more likely to have surgery or injections, see a specialist or visit an emergency room than those who were first sent to physical therapists. And they (or their insurance companies) paid an average of $4,793 more.

The reasons, said the study's lead author, are more likely found in the heads of patients and doctors than in anyone's back. MRIs tend to turn up all kinds of benign changes in spines and backs that occur as we move through life. But those prompt patients to look for fixes and to pressure doctors to refer them for those.

"The patient may feel and exert some pressure to wanting to work it up more," said Julie Fritz, a professor of physical therapy at the University of Utah. "It just changes the mind set of everyone involved. It tends to accelerate the course of intervention."

Take degenerative disc disease,  for example. Most people older than 40 or 50 have it to some degree, Fritz said, but often not to the extent that it causes pain or other symptoms. But when an MRI turns up that ominous-sounding bit of news, patients often ask for therapy and primary care doctors can succumb, she said.

"It motivates patients to want to do more to look for fixes for that problem, when it probably should be [considered] more like wrinkles and gray hair," she said.
Another possibility is that some physicians have financial interests in imaging services, the study notes.

Low back pain is incredibly common and debilitating. According to one study, it causes more time disabled around the world than HIV, road injuries, tuberculosis, lung cancer, chronic obstructive pulmonary disease and pre-term birth complications. In the United States, Fritz's team noted in its paper, the direct cost of treating low back pain was $86 billion in 2005.

An MRI exam can cost $1,000 or $1,500 and while many are covered by insurance, patients often have to put up co-payments and meet deductibles. Several studies have shown no evidence of benefits to low back patients unless there are specific symptoms, according to Fritz's paper, which was published March 16 in the journal Health Services Research. [Fritz is a professor of physical therapy herself, but the paper is a peer-reviewed study, not her opinion.]

Fritz and her colleagues set out to compare what happens to patients sent first for MRIs versus those sent directly to physical therapists. "Patients have expectations around receiving something perceived as beneficial," they wrote. "Breaking an expectation by denying imaging may be unacceptable to patients or providers. Consumer research suggests offering an alternative to replace the broken expectation is important to patients."

In addition to seeking less invasive follow-up care, the people who went directly to physical therapists spent an average of $1,871, while those whose first move was an MRI spent an average of $6,664 in the year following their initial complaint to their doctors. With only a few hundred people in each sample, Fritz acknowledged, the cost figure was somewhat skewed by a small number of very expensive surgeries among those who had MRIs first. But overall, the cost difference is very clear.

Physical therapy focuses on educating patients about what might be causing their back pain, assuring them that most problems subside in time, and engaging them in their therapy, even if the therapist is providing hands-on aid, Fritz said. Perhaps people who choose that option are more motivated to be part of clearing up their problem, or they may just profit from the approach; the research doesn't make that clear.

Either way, "we think this is an area where our profession has something to offer, especially when it's timed correctly," Fritz said. "There's a place for advanced imaging. It's just not early in the course of care for most patients."

References & Sources:



3. Health Services Research Journal

4. American Physical Therapy Association (APTA)


Compiled by: Physiotherapy Jobs Portal

Physiotherapy Jobs Portal is a Registered Job Portal for Indian Physiotherapists for Job Search, Assistance and Career building (Service Tax Code & Registration Number: DSFPS4451BSD001)





28 Mar 2015

Physiotherapist Vacancies– Updated on March 28, 2015

Physiotherapist Vacancies in UAE, Saudi Arabia, Hyderabad, Bangalore, Mumbai, New Delhi . For details register in Physiotherapy Jobs Portal www.physiotherapyjobs.co.in
– Updated on March 28, 2015

Website:
www.physiotherapyjobs.co.in
-A Registered Job Portal for Indian Physiotherapists for Job Search, Assistance and Career building
(Service Tax Code & Registration Number: DSFPS4451BSD001)




25 Mar 2015

Physiotherapist Vacancies– Updated on March 25, 2015

March 25-Physiotherapist Vacancies in UAE, Qatar, Saudi, Bangalore, Chennai, Kerala, Mumbai, Delhi NCR . For details register in Physiotherapy Jobs Portal www.physiotherapyjobs.co.in
– Updated on March 25, 2015

Website:
www.physiotherapyjobs.co.in
-A Registered Job Portal for Indian Physiotherapists for Job Search, Assistance and Career building
(Service Tax Code & Registration Number: DSFPS4451BSD001)



22 Mar 2015

Physiotherapy Jobs-Updated on March 22, 2015

March 22-Physiotherapist Vacancies in UAE, Chennai, New Delhi, Chandigarh, Thiruvananthapuram, Amritsar, Bangalore . For details register in Physiotherapy Jobs Portal www.physiotherapyjobs.co.in
– Updated on March 22, 2015

Website:
www.physiotherapyjobs.co.in
-A Registered Job Portal for Indian Physiotherapists for Job Search, Assistance and Career building
(Service Tax Code & Registration Number: DSFPS4451BSD001)




21 Mar 2015

Microsoft Technology in Physiotherapy to help patients in their Post-Knee or Hip Replacement exercise programs at home

Brooks Rehab bringing Microsoft technology for Physical therapy into patients’ homes:

Brooks Rehab’s latest high-tech innovation might seem more at home in an arcade than a physical therapy office.

In partnership with medical software developer Reflexion Health, the Jacksonville (USA)-based rehabilitation network is employing interactive gaming technology from Microsoft to help patients in their post-knee or hip replacement exercise programs at home.

The two organizations will use a Microsoft Kinect-based physical therapy program to monitor patients as they perform rehabilitation exercises at home. Kinect is a gaming platform that uses a motion sensor device and a webcam to pick up on a person’s movements and gestures. Reflexion’s use of the program in a clinical environment is being beta tested with a select group of health care providers.

Said Michael Spigel, President and COO of Brooks Rebab, “Reflexion shares our commitment to innovation. By repurposing gaming technology to digital therapy, the aim is to better engage the patient in their recovery thereby bringing about a higher level of, patient satisfaction, and outcomes.”

The program coaches patients through physical therapy exercises while sending information and qualitative data back to clinicians and allows the patient and physical therapist to interact in real time through video. Therapists can also review videos taken while the patient is exercising, and based on the results, quickly assess areas where a patient may be having difficulty.


“One of the features I’ve been most impressed with is the system’s ability to capture subtle deviations from optimal form," said Drew Kayser, the clinical orthopedic therapy coordinator at Brooks Home Care. "If a patient is trying to move their hip to the right but they twist their hip, the system will provide feedback on the screen telling them how to perform the exercise correctly. It picks up the nuances that are really important to a physical therapist,”-Update by Physiotherapy Jobs Portal

News Source: http://www.bizjournals.com/jacksonville/news/2015/03/19/brooks-rehab-bringing-microsoft-technology-for.html?s=image_gallery

Physiotherapy Jobs Portal: www.physiotherapyjobs.co.in

Physiotherapy Jobs Portal is India’s first and Exclusive Registered Job Portal for Indian Physiotherapists for Job Search, Assistance and Career building since 2010.
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19 Mar 2015

Physiotherapist Vacancies- Maldives, Gulf and India– Updated on March 19, 2015

March 19-Physiotherapist Vacancies in Maldives, Gulf, Bangalore, Chennai, Hyderabad, Mumbai, Kerala, Gurgaon, Delhi, Kolkata, Chandigarh, Gujarat. For details register in Physiotherapy Jobs Portal www.physiotherapyjobs.co.in
– Updated on March 19, 2015

Website:
www.physiotherapyjobs.co.in
-A Registered Job Portal for Indian Physiotherapists for Job Search, Assistance and Career building
(Service Tax Code & Registration Number: DSFPS4451BSD001)




16 Mar 2015

Physiotherapist Vacancies in Oman, Qatar, UAE, Bangalore, Hyderabad, Madurai, Mumbai, Ahmedabad, New Delhi, Gurgaon – Updated on March 16, 2015

March 16-Physiotherapist Vacancies in Oman, Qatar, UAE, Bangalore, Hyderabad, Madurai, Mumbai, Ahmedabad, New Delhi, Gurgaon. For details register in Physiotherapy Jobs Portal www.physiotherapyjobs.co.in
– Updated on March 16, 2015

Website:
www.physiotherapyjobs.co.in
-A Registered Job Portal for Indian Physiotherapists for Job Search, Assistance and Career building
(Service Tax Code & Registration Number: DSFPS4451BSD001)






13 Mar 2015

Physical Therapy as Good as Surgery for Osteoarthritic Knees and Torn Meniscus:

Physical Therapy as Good as Surgery for Osteoarthritic Knees and Torn Meniscus:

Arthroscopic knee surgery for osteoarthritis is one of the most unnecessary surgeries performed today, as it works no better than a placebo surgery.

Proof of this is a double blind placebo controlled multi-center (including Harvard’s Mass General hospital) study published in one of the most well-respected medical journals on the planet, the New England Journal of Medicine (NEJM) over 10 years ago.

Despite this monumental finding, some 510,000 people in the United States undergo arthroscopic knee surgery every year. And at a price of anywhere from $4,500 to $7,000 per procedure, that adds up to billions of dollars every year spent on this surgery.

Osteoarthritis of the knee is one of the primary reasons patients receive arthroscopic surgery. This is a degenerative joint disease in which the cartilage that covers the ends of the bones in your joint deteriorates, causing bone to rub against bone.

Arthroscopic knee surgery is also commonly performed to repair a torn meniscus, the crescent-shaped fibrocartilaginous structure that acts like a cushion in your knee.

Many might think that this problem, surely, would warrant surgery. But recent research shows that physical therapy can be just as good as surgery for a torn meniscus, adding support to the idea that when it comes to knee pain, whether caused by osteoarthritis or torn cartilage, surgery is one of the least effective treatments available...

Physical Therapy as Good as Surgery for Torn Cartilage and Arthritis

The featured study, also published in NEJM, claims to be one of the most rigorous studies yet comparing treatments for knee pain caused by either torn meniscus or arthritis. According to the Washington Post (The Washington Post March 18, 2013)

“Researchers at seven major universities and orthopedic surgery centers around the U.S. assigned 351 people with arthritis and meniscus tears to get either surgery or physical therapy. The therapy was nine sessions on average plus exercises to do at home, which experts say is key to success.

After six months, both groups had similar rates of functional improvement. Pain scores also were similar.

Thirty percent of patients assigned to physical therapy wound up having surgery before the six months was up, often because they felt therapy wasn’t helping them. Yet they ended up the same as those who got surgery right away, as well as the rest of the physical therapy group who stuck with it and avoided having an operation.”

Another study published in 2007 also found that exercise was just as effective as surgery for people with a chronic pain in the front part of their knee, known as Chronic patellofemoral syndrome (PFPS), which is also frequently treated with arthroscopic surgery.

The study compared arthroscopy with exercise in 56 patients with PFPS. One group of participants was treated with knee arthroscopy and an eight-week home exercise program, while a second group received only the exercise program. At the end of nine months, patients in both groups experienced similar reductions in pain and improvements in knee mobility.

A follow-up conducted two years later still found no differences in outcomes between the two groups.

In an editorial about the featured study, Australian preventive medicine expert Rachelle Buchbinder of Monash University in Melbourne urges the medical community to change its practice and use physical therapy as the first line of treatment, reserving surgery for the minority who do not experience improvement from the therapy.

“Currently, millions of people are being exposed to potential risks associated with a treatment that may or may not offer specific benefit, and the costs are substantial,” she writes. “These results should change practice. They should also lead to reflection on the need for levels of high-quality evidence of the efficacy and safety of surgical procedures similar to those currently expected for nonoperative therapy.”-Update by Physiotherapy Jobs Portal (www.physiotherapyjobs.co.in)

Sources and References:


Surgery versus physical therapy for a meniscal tear and osteoarthritis: http://www.ncbi.nlm.nih.gov/pubmed/23506518

A controlled trial of arthroscopic surgery for osteoarthritis of the knee: http://www.ncbi.nlm.nih.gov/pubmed/12110735?dopt=Abstract










12 Mar 2015

Physiotherapy Jobs -Kuwait, UAE, Saudi and India – Updated on March 12, 2015

March 12-Physiotherapist Vacancies in Kuwait, UAE,  Saudi, Bangalore, Chennai, Coimbatore, Hyderabad, Delhi NCR, Mumbai. For details register in Physiotherapy Jobs Portal www.physiotherapyjobs.co.in
– Updated on March 12, 2015

Website:
www.physiotherapyjobs.co.in
-A Registered Job Portal for Indian Physiotherapists for Job Search, Assistance and Career building
(Service Tax Code & Registration Number: DSFPS4451BSD001)


9 Mar 2015

Physiotherapist Jobs iIn UAE, Qatar, Oman & India- Updated on March 09 2015

Physiotherapist Vacancies in UAE, Qatar, Oman, Bangalore, Chennai, Hyderabad, New Delhi, Mumbai, Ahmedabad, Chandigarh. For details register in Physiotherapy Jobs Portal www.physiotherapyjobs.co.in
– Updated on March 09, 2015

Website:
www.physiotherapyjobs.co.in
-A Registered Job Portal for Indian Physiotherapists for Job Search, Assistance and Career building
(Service Tax Code & Registration Number: DSFPS4451BSD001)



6 Mar 2015

Physiotherapist Vacancies in UAE, Saudi Arabia, Qatar, Bangalore, Hyderabad, Chennai, Coimbatore, New Delhi, Pune, Mumbai-March 06 2015

Physiotherapist Vacancies in UAE, Saudi Arabia, Qatar, Bangalore, Hyderabad, Chennai, Coimbatore, New Delhi, Pune, Mumbai. For details register in Physiotherapy Jobs Portal www.physiotherapyjobs.co.in
– Updated on March 06, 2015
Website: www.physiotherapyjobs.co.in
-A Registered Job Portal for Indian Physiotherapists for Job Search, Assistance and Career building 
(Service Tax Code & Registration Number: DSFPS4451BSD001)



3 Mar 2015

Physiotherapist Jobs in Gulf and India- March 03 2015

March 03-Physiotherapist Vacancies in Gulf,Chennai,Gurgaon,New Delhi, Bangalore,Hyderabad,Pune,Mumbai,Chandigarh. For details register in Physiotherapy Jobs Portal www.physiotherapyjobs.co.in
– Updated on March 03, 2015

Website:
www.physiotherapyjobs.co.in
-A Registered Job Portal for Indian Physiotherapists for Job Search, Assistance and Career building
(Service Tax Code & Registration Number: DSFPS4451BSD001)





2 Mar 2015

Physiotherapy helps Parkinson’s Patients Think Big

Parkinson’s disease, a progressive disorder of the nervous system, affects your movement, causing stiffness in your muscles and tremors in your hands. 

According to the Mayo Clinic, “Over time, Parkinson’s disease may reduce your ability to move and slow your movement, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk, or you may find it difficult to get out of a chair. Also, you may drag your feet as you try to walk, making it more difficult to move.”

With this disease, even small movements become a challenge. At Conshohocken Physical Therapy in Conshohocken, however, Parkinson patients are encouraged to think big. Physical therapy has been proven as a great way for these patients to gain more functional independence.

Dr. Jory Davis, who is a LSVT-certified specialist, leads her patients struggling with Parkinson’s symptoms on a journey to relearn how to create normal movements. She becomes a partner with her patients and their families to help them combat and manage the symptoms of Parkinson’s disease. As a patient’s condition changes, their treatment program will be adjusted to help them be as independent and as active as possible.

“With high amplitude and intensity, they are able to make bigger movements, move quicker and be able to do activities they weren’t able to do before.”

“Parkinson patients might have a freezing spell going from sitting to standing. We want to help break that cycle of being frozen.”

She added that the exercises promote neuroplasticity which refers to the brain’s ability to reorganize itself.

“It is just very rewarding to see how much change is possible in such a short time,” she said. “To help them discover how they can fight through the disease. To see a patient walking slowly shuffling their feet first coming into the office and then later coming in walking faster with a big small on their face.”-Update by Physiotherapy Jobs Portal


Link for Parkinson’s Physiotherapy Treatment Guidelines: http://www.appde.eu/pdfs/Dutch%20Parkinson's%20Physiotherapy%20Guidelines.pdf


Compiled by Physiotherapy Jobs Portal: www.physiotherapyjobs.co.in
 
-International and National Physiotherapy Jobs.
Physiotherapy Jobs Portal is a registered recruitment service for Indian Physiotherapists.
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1 Mar 2015

Physiotherapist Jobs-Updated February 28 2015

February 28-Physiotherapist Vacancies in Singapore,UAE,Saudi,Kuwait, Bangalore, Chennai,Delhi NCR,Mumbai,Kolkata. For details register in Physiotherapy Jobs Portal www.physiotherapyjobs.co.in
– Updated on February 28, 2015

Website:
www.physiotherapyjobs.co.in
-A Registered Job Portal for Indian Physiotherapists for Job Search, Assistance and Career building
(Service Tax Code & Registration Number: DSFPS4451BSD001)