Posts Tagged APTA
[WEB SITE] New APTA-Supported CPG Looks at Best Ways to Improve Walking Speed, Distance for Individuals After Stroke, Brain Injury, and Incomplete SCI
(Journal of Neurologic Physical Therapy, January, 2020)
A new clinical practice guideline (CPG) supported by APTA and developed by the APTA Academy of Neurologic Physical Therapy concludes that when it comes to working with individuals who experienced an acute-onset central nervous system (CNS) injury 6 months ago or more, aerobic walking training and virtual reality (VR) treadmill training are the interventions most strongly tied to improvements in walking distance and speed. Other interventions such as strength training, circuit training, and cycling training also may be considered, authors write, but providers should avoid robotic-assisted walking training, body-weight supported treadmill training, and sitting/standing balance that doesn’t employ augmented visual inputs.
The final recommendations in the CPG are the result of an extensive process that began with a scan of nearly 4,000 research abstracts and subsequent full-text review of 234 articles, further narrowed to 111 randomized controlled trials (RCTs), all focused on interventions related to CNS injuries, with outcome data that included measures of walking distance and speed. CPG panelists evaluated the data and developed recommendations, which were informed by data on patient preferences and submitted for expert and stakeholder review.
Development of the CPG was supported through an APTA-sponsored program that assists APTA sections — in the case, the Academy of Neurologic Physical Therapy — in the development stages such as drafting, appraisal, planning, and external review (for more detail on the program, visit APTA’s CPG Development webpage).
- Moderate- to high-intensity (60%-80% of heart rate reserve or up to 85% of heart rate maximum) walking training was associated with the strongest evidence for improvements in walking speed and distance.
- Walking training using VR also fared well, due in part to the ability of a VR treadmill system to allow “safe practice of challenging walking activities,” something that’s hard to do in a more traditional hospital or clinic setting.
- Strength training, while not included among the interventions that should be performed, was designated as an intervention that may be considered. Authors cite inconsistent evidence on the connection between strength training and improved walking speed and distance, but they acknowledge potential benefits.
- Also among the list of interventions that “may be considered”: circuit training, as well as cycling training. In both cases, authors cite a paucity of evidence related to how the interventions affect walking speed and distance. They note that these interventions may be revisited during a future reevaluation of the CPG.
- Body-weight supported treadmill training was labeled as an intervention that should not be performed in order to increase walking speed and distance, with authors finding little evidence supporting the approach, which is often associated with a greater cost. However, they write, the individuals included in the studies reviewed for the CPT were able to ambulate over ground without the use of a body-weight support device, and “different results may occur in those who are nonambulatory or unable to ambulate without the use of [body-weight support].”
- Both static and dynamic (nonwalking) balance training and robotic-assisted walking training were also characterized as interventions that should not be performed. Authors acknowledge the ways that postural stability and balance are associated with fall risk and reduced participation, but they were unable to find sufficient evidence to support these particular interventions as effective in increasing walking speed and distance (although static and dynamic balance training with VR fared a bit better). As for robotic-assisted walking training, CPG authors note that while ineffective for individuals with CNS who were already ambulatory, “this recommendation … may not apply to nonambulatory individuals or those who require robotic assistance to ambulate.”
Why it matters
Authors note that “the implementation of evidence-based interventions in the field of rehabilitation has been a challenge,” and they believe that the new CPG offers a real opportunity for clinicians to “integrate available research into their practice patterns.” Further, they believe that the CPG has arrived at an important moment in the evolution of health care, with its greater emphasis on evidence for the cost-effectiveness and outcomes of various interventions.
More from the study
The CPG also offers tips for clinicians to implement its recommendations, including acquiring equipment to help providers monitor vital signs, implementing “automatic prompts in electronic medical records that will facilitate obtaining orders to attempt higher-intensity training strategies,” providing training sessions for clinicians, establishing organizational policies to promote use and documentation of the recommended interventions, and simply keeping a few copies of the study on hand for easy reference.
Keep in mind …
Authors acknowledged that the CPG has a few limitations. While the review of RCTs only is a strength, they write, some of those studies involved small sample sizes, and many lacked details on intervention dosage. Additionally, the CPG does not fully address the potential costs associated with its recommendations — specifically VR — which could impact a clinic’s ability to implement a particular intervention. Authors also acknowledge that walking speed and distance are not the only important outcomes related to mobility among individuals with CNS injury, and that other factors such as dynamic stability while walking, peak walking capacity, and community mobility may be incorporated in an assessment of walking function.
[NEWS] Bioness Introduces Key Updates to Rehabilitation Technology at the American Physical Therapy Association’s Combined Sections Meeting
VALENCIA, Calif., Jan. 22, 2019 /PRNewswire/ — Bioness, Inc., the leading provider of state-of-the-art, clinically supported rehabilitation and pain management medical devices, will be highlighting key updates to the L300 Go™ FES system and Vector® Gait and Safety System at this year’s American Physical Therapy Association’s Combined Sections Meeting being held in Washington D.C. from January 23-26, 2019.
For the first time ever, Bioness will offer L300 Go Cycle Training Mode which will allow users of the L300 Go System to train and exercise on a stationary bike. Therapists can now use custom timing settings to easily configure stationary bikes for patients to use with the L300 Go in their clinics. In addition, the improved Thigh Stand-Alone with 3D motion detection technology eliminates the need for a foot sensor ensuring a simple and easy setup with accurate stimulation meant to provide patients greater control of flexion or extension of the knee for a more natural gait. It’s Improved Mobility. Made Easier.™
The Vector Gait and Safety System is the global leader in over-ground body weight support systems and with the launch of Vector 2.2 software, continues to improve. New Force-based Active Body Control provides the ability to perform an extensive variety of exercises while actively preventing falls. Equally important, treadmill training has been integrated with the Biodex Trainer 3, allowing you to control the Vector Elite System and treadmill with one simple-to-use interface.
“With the new developments showcased at this year’s APTA-CSM we’ve strengthened our position as the technology leader in rehab by empowering therapists with new features that will drive meaningful outcomes for their patients,” saidTodd Cushman, President and CEO of Bioness. “Bioness continues its commitment to innovation by driving breakthroughs and developing the most effective technology for rehabilitation professionals in skilled, acute, inpatient and outpatient practices.”
Bioness will also feature the Company’s complete portfolio of innovative clinical solutions in Booth #719, including the following:
BITS® Bedside & Mobile Configurations
Most rehabilitation activities are designed to be performed from a standing position, however, many rehab patients are confined to their beds or restricted to seated activities for medical or safety reasons. To help tackle this challenge, Bioness has developed the BITS Bedside & Mobile configurations. The BITS Bedside configuration allows clinicians to engage rehab patients right at the bedside facilitating rehabilitative exercises for non-ambulatory patients. The BITS Mobile configuration is highly adaptable to challenging rehab environments where a full rehab gym is not available. With the BITS Bedside & Mobile configurations, clinicians can challenge and assess patients’ physical, visual, auditory, and cognitive abilities in virtually any treatment area. The BITS 2.0 software provides the ability to track and document progress with the goal of keeping patients engaged during this important phase of care.
H200® Wireless Hand Rehabilitation System
With more than 20 peer-reviewed and published clinical studies, the H200 System has been clinically shown to improve hand and upper extremity function during all stages of stroke rehabilitation. The System delivers non-invasive, functional electrical stimulation (FES) to improve hand function, reduce muscle spasms and prevent disuse atrophy. H200 Wireless is widely used in the Veterans Administration to promote functional hand use in spinal cord injury patients that lack the ability to perform daily activities including grasping and releasing hand movements.
StimRouter® Neuromodulation System for Chronic Peripheral Pain
With an estimated 100 million people suffering from chronic pain, contributing more than $280 billion in annual costs to the U.S. healthcare system, there’s never been a greater need for innovative pain management options.1 Specific to rehabilitation, shoulder pain is a common disability resulting from a central nervous system trauma (e.g. stroke). This pain traditionally originates at the axillary nerve, a peripheral nerve in the upper arm, and has been reported to occur in up to 85% of stroke survivors.2 The StimRouter is an implanted neuromodulation system designed to treat chronic pain of peripheral nerve origin (excluding the cranial facial region) by directly targeting pain at its point of origin, as an adjunct to other modes of therapy (e.g. medications). StimRouter helps minimize long-term healthcare costs and may provide pain relief compared to other treatments such as medications and injections which often have limited effect.3
About Bioness, Inc.
Bioness is the leading provider of innovative technologies helping people regain mobility and independence. Bioness solutions include implantable and external neuromodulation systems, robotic systems, and software-based therapy programs providing functional and therapeutic benefits for individuals affected by pain, central nervous system disorders, and orthopedic injuries. Currently, Bioness offers six medical devices within its commercial portfolio which are distributed and sold on five continents and in over 25 countries worldwide. Our technologies have been implemented in the most prestigious and well-respected institutions around the globe with approximately 90% of the top rehabilitation hospitals in the United States currently using one or more Bioness solutions. Bioness has a singular focus on aiding large, underserved customer groups with innovative, evidence-based solutions and we will continue to develop and make commercially available new products that address the growing and changing needs of our customers. Individual results vary. Consult with a qualified physician to determine if this product is right for you. Contraindications, adverse reactions and precautions are available online at www.bioness.com.
Media Relations Contact Information
Next Step Communications
Bioness®, BITS®, H200®, and StimRouter™ are trademarks of Bioness, Inc. | www.bioness.com | Rx Only for applicable products.
1 Institute of Medicine (US). Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research. 2011. The National Academies.
2 Van Ouwenaller, C. et al. 1986. Archives of Physical Medicine and Rehabilitation. 67, 23–26.
3 Deer T, et al. 2016. Neuromodulation. 19:91-100.
SOURCE Bioness, Inc.
Related Links http://www.bioness.com
More than 2,000 physical therapists from across the nation will soon gather for the APTA NEXT Conference and Exposition June 27-30 in Orlando, Fla. To help plan your conference itinerary, Rehab Management, the magazine devoted to comprehensive coverage about technologies and services for the physical therapy market, offers this exclusive preview of products you’ll want to take a closer look at. Don’t miss this opportunity to speak with manufacturer’s representatives on the exhibit hall floor and learn how these select offerings can benefit your practice; including gait and balance equipment, practice management software, and coordination training products and beyond.
Biodex Medical Systems, Inc
The Biodex Balance System ™ SD can expand your programs to the community. Widely used for Fall Risk programs serving older adults as well as athletes with concussion management, the system establishes baseline, determines risk. Select tests and training modes improve balance and agility, such as limits of stability, and percentage of weight shift.
Incorporate sensory feedback using the VibroTactile™ System to help detect changes in postural sway, especially suited for vestibular disorders.
Visit us at the APTA NEXT Booth #803
CrawlAhead™ by mobility research
Lightweight, portable crawler helps develop gross motor skills and left-right brain coordination. CrawlAhead properly positions infants during normal development of crawling and assists delayed infants to work on quadruped tasks. Therapeutic for clinic use – assistive for home use – cost-effective for both. Easy to don harness, rolls effortlessly, for children up to 35 lbs. or 35 inches. Turn little function to big advantage! Rentals available.
Visit us at the APTA NEXT Booth #606
GaitKeeper™ by mobility research
Designed with both therapists and patients in mind. They perform with great consistency & power at very low speeds of ambulation for patients of all functional levels. Our models feature high torque, accurate speed, adjustable inclines, MoveAble control panels or remote, a true zero Start and new AdjustaBars™ for ease of use. GaitKeeper treadmills are designed for rehabilitation and can be used effectively with or without LiteGait®.
Visit us at the APTA NEXT Booth #606
LiteGait® by mobility research
A gait training device that simultaneously controls weight bearing, posture, and balance over treadmill or ground, creating an ideal treatment environment for patients with a wide range of impairments and functional levels. Its unique harness permits unilateral and bilateral support allowing progression of weight bearing from non to full, while allowing access to lower extremities and pelvis to facilitate proper gait patterns. A safe, fall-free environment for patients and hands-free for the therapists.
Visit us at the APTA NEXT Booth #606
Q-pads™ by mobility research
An interactive balance and coordination training system which provides visual feedback via pressure sensitive surfaces and colorful lights. Multi-functional rehabilitation system that enables therapists to design training activities for all functional levels and training needs. Use on the floor for weight shifting, balance or stepping tasks or mounted on wall for upper extremity work. Both fun and challenging. Each pad measures between 10 and 330 pounds of force, is magnetic, has auto-turn-off and cleans easily.
Visit us at the APTA NEXT Booth #606
Raintree Systems develops Value Based Solutions for the Health Care Industry. Our products are built with the specific purpose of providing real value to the provider, practice and patient. Fully Integrated, custom configurable certified EHR designed for Adult and Pediatric rehab (PT, OT, SP) are designed to be powerful, intuitive and easy to use so that the individuals that use our products can be more effective and efficient at their jobs. Let us show you the Raintree Difference.
Visit us at the APTA NEXT Booth #902
TheraOffice is the only EMR and practice management software designed by physical therapists to be the most adaptable to your unique business. Our fully-integrated solution including scheduling, documentation, accounting, and reporting enables improvement in clinical workflow processes and overall business performance with a focus on striving to achieve compliance that exceeds today’s evolving billing requirements. Come visit us at booth #1006 to view a live demo of our brand-new, all-in-one application!
Visit us at the APTA NEXT Booth #1006
Therapy Mouse™ by mobility research
A wearable sensor that allows control of computer pointer using movement of any body segment. Snap the sensor in its bracket affixed to desired body segment, plug the receiver into any PC, Mac or Android computer, and Therapy Mouse will translate user movements to precise control of the mouse pointer. No setup. No cameras. No driver to install. Therapy Mouse can be used for Computer Access, Neuro-Gaming, and Dual Tasking Therapy in the clinic or home.
Visit us at the APTA NEXT Booth #606
[WEB SITE] Restorative Therapies to Showcase Xcite FES System at APTA Combined Sections Meeting in San Antonio, TX February.
Restorative Therapies, Inc, the leader in FES powered systems, announced today that it will be exhibiting the new Xcite FES system at APTA’s Combined Sections Meeting taking place at the Henry B. González Convention Center in San Antonio, TX over February 15 to 18, 2017.
BALTIMORE, MD (PRWEB) FEBRUARY 13, 2017
Restorative Therapies will be featuring live demonstrations of their new Xcite FES system, and experts will be on hand at booth number 442 to discuss the clinical applications.
Xcite FES Clinical Station is a portable, multi-channel FES therapy system. Easy to use pre-programmed activity libraries for upper extremity, lower extremity and general activities deliver sequenced stimulation enabling a patient’s weak or paralyzed muscles to move through dynamic movement patterns. Xcite assists patients to perform task specific, strengthening and gross motor activities using up to 12 channels of stimulation.
The on screen photo guide for electrode placement facilitates easy set up. An avatar demonstrates each activity and there are chimes to indicate transitions providing visual and auditory cues that assist your patient with timing and awareness of movements.
“Repetitive practice of task specific, strengthening and gross motor activities have long been a cornerstone of PT and OT programs for patients with neurological impairments or muscle weakness,” says Wendy Warfield, MSHA, OTR/L, Clinical Education Manager of Restorative Therapies. “Xcite is designed to be easily integrated into these traditional programs. Xcite enhances the impact of the traditional therapeutic activities that support neuromuscular reeducation.”
“There is nothing else on the market that compares to Xcite…It is great to finally have a device that allows you to work on precise motor control and dexterity while providing FES…Xcite’s ability to control each movement channel individually allows you to facilitate more accurate and functional movement patterns for greater recovery,” said Jenny Suggit, MS OTR/L, CLT, Occupational Therapist, Centre Manager, Neurokinex-Gatwick, UK.
Also on display will be RT300 supine. RT300 supine allows people to leg or arm cycle while in bed. Cycling from bed can be an important component in an Early Mobility program. Early Mobility programs are being adopted by a growing number of Intensive Care Units with the goal of enhancing patient outcomes and reducing lengths of stay.
About Restorative Therapies
Restorative Therapies mission is to help people with a neurological impairment or in critical care achieve their full recovery potential. Restorative Therapies is one of the first companies to target activity-based physical therapy and Functional Electrical Stimulation as a rehabilitation therapy for immobility associated with paralysis such as stroke, multiple sclerosis and spinal cord injury or for patients in critical care.
Restorative Therapies is a privately held company headquartered in Baltimore. To learn more about Restorative Therapies please visit us at http://www.restorative-therapies.com
There is nothing else on the market that compares to Xcite…It is great to finally have a device that allows you to work on precise motor control and dexterity while providing FES
There is now an iOS App for PT Journal. An iPhone, iPad, iPod Touch will allow for easy access and online reading of the journal. If you are looking to read the articles before print, then this is the app for you!
You will need to be an APTA member or institutional member to access the journal to get full access. With an individual membership, you will need to login using an APTA membership and password. If you are on a wireless network through your institution, the app will automatically recognize your institution’s membership. If you are not on their network, a institutional proxy can be requested.
After first opening the app, you will have the option of having it send you notifications. The next step allows you to download the entire article or change the settings regarding downloading the full issue. In the setting you change set the new issue to automatically download or turn it off. You can also set the storage limit at different levels or leave it unlimited.
The bottom of the app has the following tabs: issues, online first, podcast, archives, and more. The online first section is where you will find future articles which have yet to be published in the paper version of the journal. The podcasts section also includes the Craikcasts, various speeches from symposiums, or lectures. The archives allows for searching of back issues. There is a “more” section which allows you to select your favorites or check the history of articles you have accessed.
Have no fear though, if you are not an Apple user other great Android apps also exist and can be found below.
Other pod casts
- Physiopedia Podcasts
- IFOMPT 2016 Podcasts Keynote Speakers
- Clinically relevant apps
- Top 15 Health Care Apps for Android Users
Source: PT Journal Now Has an iOS App