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https://www.readbyqxmd.com/read/28438453/effect-of-bundled-payments-and-health-care-reform-as-alternative-payment-models-in-total-joint-arthroplasty-a-clinical-review
#1
REVIEW
Ahmed Siddiqi, Peter B White, Jaydev B Mistry, Chukwuweike U Gwam, James Nace, Michael A Mont, Ronald E Delanois
BACKGROUND: In an effort to control rising healthcare costs, healthcare reforms have developed initiatives to evaluate the efficacy of alternative payment models (APMs) for Medicare reimbursements. The Center for Medicare and Medicaid Services Innovation Center (CMMSIC) introduced the voluntary Bundled Payments for Care Improvement (BPCI) model experiment as a means to curtail Medicare cost by allotting a fixed payment for an episode of care. The purpose of this review is to (1) summarize the preliminary clinical results of the BPCI and (2) discuss how it has led to other healthcare reforms and alternative payment models...
March 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28436878/biofeedback-for-gait-retraining-based-on-real-time-estimation-of-tibiofemoral-joint-contact-forces
#2
Claudio Pizzolato, Monica Reggiani, David J Saxby, Elena Ceseracciu, Luca Modenese, David G Lloyd
Biofeedback assisted rehabilitation and intervention technologies have the potential to modify clinically relevant biomechanics. Gait retraining has been used to reduce the knee adduction moment, a surrogate of medial tibiofemoral joint loading often used in knee osteoarthritis research. In this study we present an electromyogram-driven neuromusculoskeletal model of the lower-limb to estimate, in real-time, the tibiofemoral joint loads. The model included 34 musculotendon units spanning the hip, knee, and ankle joints...
April 18, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28433815/patterns-and-predictors-of-persistent-opioid-use-following-hip-or-knee-arthroplasty
#3
Seoyoung C Kim, Niteesh Choudhry, Jessica M Franklin, Katsiaryna Bykov, Matthias Eikermann, Joyce Lii, Michael A Fischer, Brian T Bateman
OBJECTIVE: The relationship between arthroplasty and long-term opioid use in patients with knee or hip osteoarthritis is not well studied. We examined the prevalence, patterns and predictors of persistent opioid use after hip or knee arthroplasty. METHOD: Using claims data (2004-2013) from a U.S. commercial health plan, we identified adults who underwent hip or knee arthroplasty and filled ≥1 opioid prescription within 30 days after the surgery. We defined persistent opioid users as patients who filled ≥1 opioid prescription every month during the 1-year postoperative period based on group-based trajectory models...
April 19, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28427333/the-experiences-of-physiotherapists-treating-people-with-dementia-who-fracture-their-hip
#4
A J Hall, R Watkins, I A Lang, R Endacott, V A Goodwin
BACKGROUND: It is estimated that people with dementia are approximately three times more likely to fracture their hip than sex and age matched controls. A report by the Chartered Society of Physiotherapy found that this population have poor access to rehabilitation as inpatients and in the community. A recent scoping review found a paucity of research in this area, indeed there has been no qualitative research undertaken with physiotherapists. In order to address this evidence gap, the aim of this current study was to explore the experiences of physiotherapists treating this population...
April 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28424026/walking-ability-following-hybrid-assistive-limb-treatment-for-a-patient-with-chronic-myelopathy-after-surgery-for-cervical-ossification-of-the-posterior-longitudinal-ligament
#5
Shigeki Kubota, Tetsuya Abe, Hideki Kadone, Kengo Fujii, Yukiyo Shimizu, Aiki Marushima, Tomoyuki Ueno, Hiroaki Kawamoto, Yasushi Hada, Akira Matsumura, Yoshiyuki Sankai, Masashi Yamazaki
CONTEXT: The hybrid assistive limb (HAL) (the wearable robot) can assist kinesis during voluntary control of hip and knee joint motion by detecting the wearer's bioelectric signals on the surface of their skin. The purpose of this study was to report on walking ability following the wearable robot treatment in a patient with chronic myelopathy after surgery for cervical ossification of the posterior longitudinal ligament (OPLL). FINDINGS: The patient was a 66-year-old woman with cervical OPLL who was able to ambulate independently with the aid of bilateral crutches...
April 20, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28423812/designing-an-e-learning-platform-for-postoperative-arthroplasty-adverse-events
#6
Ole Andreas Krumsvik, Ankica Babic
This paper presents a mobile software application development for e-learning based on the adverse events data within the field of arthroplasty. The application aims at providing a learning platform for physicians, patients, and medical students. Design of user interface aims to meet requirements of several user groups concerned with the adverse events of the knee and hip implants. Besides the clinical patient data, the platform wants to include even electronic patient data as a result of self-monitoring. Two different modules were created, one for medical staff and one for patients, both divided into the knee and hip areas...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28422563/effects-of-anterior-knee-displacement-during-squatting-on-patellofemoral-joint-stress
#7
Thomas W Kernozek, Naghmeh Gheidi, Matthew Zellmer, Jordan Hove, Becky L Heinert, Michael R Torry
CONTEXT: Squatting is a common rehabilitation training exercise for Patellofemoral pain syndrome (PFPS). Patellofemoral joint stress (PFJS) during squatting with more anterior knee displacement has not been systematically investigated. OBJECTIVE: The aim was to compare PFJS during squatting using two techniques: Squat while keeping the knees before the toes (SBT) and squat while allowing the knees to go past the toes (SPT). SETTING: University research laboratory...
April 19, 2017: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/28415885/fatigue-and-pain-limit-independent-mobility-and-physiotherapy-after-hip-fracture-surgery
#8
Kristine H Münter, Christopher G Clemmesen, Nicolai B Foss, Henrik Palm, Morten T Kristensen
PURPOSE: The patient's ability to complete their planned physiotherapy session after hip fracture surgery has been proposed as an independent predictor for achieving basic mobility independency upon hospital discharge. However, knowledge of factors limiting mobility is sparse. We therefore examined patient reported factors limiting ability to complete planned physiotherapy sessions as well as limitations for not achieving independency in basic mobility early after hip fracture surgery...
April 17, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28415881/hip-and-pelvic-fracture-patients-with-fear-of-falling-development-and-description-of-the-step-by-step-treatment-protocol
#9
Karin Kampe, Michaela Kohler, Diana Albrecht, Clemens Becker, Martin Hautzinger, Ulrich Lindemann, Klaus Pfeiffer
OBJECTIVE: Based on a theoretical framework and sound evidence, this article describes a rehabilitation programme for patients with fear of falling after hip and pelvic fracture. RATIONALE: Based on exercise science principles, current knowledge from fall prevention, emotion regulation, and the Health Action Process Approach we developed a theoretical framework, from which the components of the intervention were derived. Description of the intervention: The intervention consists of 6 components: (1) relaxation, (2) meaningful activities and mobility-based goals, (3) falls related cognitions and emotions, coping with high risk tasks and situations, (4) individual exercise programme, (5) planning and implementing exercises and activities, and (6) fall risks and hazards...
May 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28409031/patient-perspectives-on-engagement-in-recovery-after-hip-fracture-a-qualitative-study
#10
Joanie Sims-Gould, Sarah Stott-Eveneshen, Lena Fleig, Megan McAllister, Maureen C Ashe
Purpose. To understand older adults' engagement in their recovery experience and rehabilitation after a fall-related hip fracture. Method. 50 community-dwelling older adults recovering from a recent (3-12 months) hip fracture (32 women, 18 men) participated in telephone interviews using a semistructured format at 6 and 12 months after recruitment into the study. Interviews were conducted as part of a mixed-methods study designed to test the effect of a postoperative hip fracture management program (B4 Clinic)...
2017: Journal of Aging Research
https://www.readbyqxmd.com/read/28407505/a-randomized-controlled-trial-on-providing-ankle-foot-orthoses-in-patients-with-sub-acute-stroke-short-term-kinematic-and-spatiotemporal-effects-and-effects-of-timing
#11
Corien D M Nikamp, Marte S H Hobbelink, Job van der Palen, Hermie J Hermens, Johan S Rietman, Jaap H Buurke
Initial walking function is often limited after stroke, and regaining walking ability is an important goal in rehabilitation. Various compensatory movement strategies to ensure sufficient foot-clearance are reported. Ankle-foot orthoses (AFOs) are often prescribed to improve foot-clearance and may influence these strategies. However, research studying effects of actual AFO-provision early after stroke is limited. We conducted an explorative randomized controlled trial and aimed to study the short-term effects of AFO-provision on kinematic and spatiotemporal parameters in patients early after stroke...
March 30, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28399777/post-stroke-hemiparesis-does-chronicity-etiology-and-lesion-side-are-associated-with-gait-pattern
#12
Gabriela Lopes Gama, Coutinho de Lucena Larissa, Ana Carolina de Azevedo Lima Brasileiro, Emília Márcia Gomes de Souza Silva, Élida Rayanne Viana Pinheiro Galvão, Álvaro Cavalcanti Maciel, Ana Raquel Rodrigues Lindquist
BACKGROUND: Studies that evaluate gait rehabilitation programs for individuals with stroke often consider time since stroke of more than six months. In addition, most of these studies do not use lesion etiology or affected cerebral hemisphere as study factors. However, it is unknown whether these factors are associated with post-stroke motor performance after the spontaneous recovery period. OBJECTIVE: To investigate whether time since stroke onset, etiology, and lesion side is associated with spatiotemporal and angular gait parameters of individuals with chronic stroke...
April 12, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28399722/safety-and-function-of-a-prototype-microprocessor-controlled-knee-prosthesis-for-low-active-transfemoral-amputees-switching-from-a-mechanic-knee-prosthesis-a-pilot-study
#13
Timothy Hasenoehrl, Thomas Schmalz, Reinhard Windhager, Stephan Domayer, Sara Dana, Clemens Ambrozy, Stefano Palma, Richard Crevenna
PURPOSE: Aim of this pilot study was to assess safety and functioning of a microprocessor-controlled knee prosthesis (MPK) after a short familiarization time and no structured physical therapy. MATERIALS AND METHODS: Five elderly, low-active transfemoral amputees who were fitted with a standard non-microprocessor controlled knee prosthesis (NMPK) performed a baseline measurement consisting of a 3 D gait analysis, functional tests and questionnaires. The first follow-up consisted of the same test procedure and was performed with the MPK after 4 to 6 weeks of familiarization...
April 11, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28392324/the-reliability-and-validity-of-the-timed-up-and-go-motor-test-for-people-with-chronic-stroke
#14
Peggy P K Chan, Joyce I F Si Tou, Mimi M Y Tse, Shamay S M Ng
OBJECTIVES: To examine: (1) the intra-rater, inter-rater and test-retest reliabilities of the timed up and go (motor) test (TUGmotor) in terms of the number of steps taken and completion time with a chronic stroke population; (2) the relationship between stroke-specific impairments and the number of steps taken in the test and the completion time; (3) the minimal detectable change in TUGmotor times; and (4) the cut-off time which best discriminates the performance of people with stroke from that of healthy older adults...
April 6, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28388232/increasing-and-decreasing-pain-causes-acute-responses-of-strength-and-running-mechanics-in-patellofemoral-pain
#15
David M Bazett-Jones, Wendy Huddleston, Stephen Cobb, Kristian O'Connor, Jennifer E Earl-Boehm
CONTEXT:   Patellofemoral pain (PFP) is typically exacerbated by repetitive activities that load the patellofemoral joint, such as running. Understanding the mediating effects of changes in pain in individuals with PFP might inform injury progression, rehabilitation, or both. OBJECTIVE:   To investigate the effects of changing pain on muscular strength and running biomechanics in those with PFP. DESIGN:   Crossover study. SETTING:   University research laboratory...
April 7, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28385169/improved-functional-outcome-after-hip-fracture-is-associated-with-duration-of-rehabilitation-but-not-with-waiting-time-for-rehabilitation
#16
Tonny Jaeger Pedersen, Louise Nicole Bie Bogh, Jens Martin Lauritsen
INTRODUCTION: The aim of this study was to explore the relationship between "waiting time to onset of municipal rehabilitation", "length of municipal rehabilitation" and the attained level of function four months after the hip fracture. METHODS: Among a consecutive series of 156 patients, the 116 patients who were recommended a municipal rehabilitation sequence after discharge were included. The expos-ures were waiting time in days and duration in hours of the municipal rehabilitation...
April 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28378137/hip-external-rotation-strength-predicts-hop-performance-after-anterior-cruciate-ligament-reconstruction
#17
Paul W Kline, Jeremy Burnham, Michael Yonz, Darren Johnson, Mary Lloyd Ireland, Brian Noehren
PURPOSE: Quadriceps strength and single-leg hop performance are commonly evaluated prior to return to sport after anterior cruciate ligament reconstruction (ACLR). However, few studies have documented potential hip strength deficits after ACLR, or ascertained the relative contribution of quadriceps and hip strength to hop performance. METHODS: Patients cleared for return to sports drills after ACLR were compared to a control group. Participants' peak isometric knee extension, hip abduction, hip extension, and hip external rotation (HER) strength were measured...
April 4, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28378007/do-shorter-lengths-of-stay-increase-readmissions-after-total-joint-replacements
#18
Udai S Sibia, Kip A Waite, Maura A Callanan, Adrian E Park, Paul J King, James H MacDonald
BACKGROUND: Enhanced recovery after surgery protocols for total joint replacements (TJRs) emphasize early discharge, yet the impact on readmissions is not well documented. We evaluate the impact of a one-day length of stay (LOS) discharge protocol on readmissions. METHODS: We conducted a retrospective review of all primary TJRs (hip and knee) from April 2014 to March 2015. Patients who had adequate support to be discharged home were categorized into 2 groups, 1-day (n = 174) vs 2-day (n = 285) LOS groups...
March 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28375966/simultaneous-bilateral-hip-arthroscopy-in-adolescent-athletes-with-symptomatic-femoroacetabular-impingement
#19
Mark O McConkey, Vivek Chadayammuri, Tigran Garabekyan, Stephanie W Mayer, Matthew J Kraeutler, Omer Mei-Dan
BACKGROUND: Femoroacetabular impingement represents a common cause of hip pain in adolescents. The purpose of the present study was to evaluate the safety and efficacy of simultaneous bilateral hip arthroscopy for bilateral symptomatic femoroacetabular impingement in adolescent athletes. METHODS: Clinical data were collected in a prospective database on patients who underwent unilateral or simultaneous bilateral hip arthroscopy and included complications, reoperation rate, and return to play time...
April 3, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28367180/effects-of-supervised-structured-aerobic-exercise-training-program-on-high-and-low-density-lipoprotein-in-patients-with-type-ii-diabetes-mellitus
#20
Syed Shakil-Ur-Rehman, Hossein Karimi, Syed Amir Gillani
BACKGROUND AND OBJECTIVE: Hyperlipidemia and dyslipidemia are very common conditions among patients with Type-2 diabetes mellitus (T2DM) and associated with increased risk of coronary heart diseases. Physical activity and exercises along with medical management and dietary plan are common strategies to use for the management of deranged lipid profile in patients with T2DM. We aimed to determine the effects of supervised structured aerobic exercise training (SSAET) program on high and low density lipoprotein in patients with T2DM...
January 2017: Pakistan Journal of Medical Sciences Quarterly
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