U.S. Healthcare Spending Highest Among Developed Countries
The United States, on a per capita basis, spends much more on healthcare than other developed countries; the chief reason is not greater healthcare utilization, but higher prices, according to a study from a team led by a Johns Hopkins Bloomberg School of Public Health (JHSPH) researcher. The researchers determined that the higher overall healthcare spending in the United States was due mainly to higher prices—including higher drug prices, higher salaries for doctors and nurses, higher hospital administration costs, and higher prices for many medical services. The paper finds that the United States remains an outlier in terms of per...
Amputee Coalition President, CEO Retiring
The Amputee Coalition and Jack Richmond, CPOA, CFo, announced his retirement from the role of president and CEO. Richmond, who has held the position since 2016, will stay on for the next several months and work with the board of directors in its search for a successor. “I feel fortunate that over the years I have been able to serve the organization as a volunteer, a board member, and CEO, and I look forward to writing my next chapter in helping others,” said Richmond.
Exercise May Help Fight Depression in Seniors
Kinesiologists at McMaster University have found that physical activity may help fight depression in seniors by stimulating muscle-generated mood boosters. The findings, published in the American Journal of Physiology—Cell Physiology, reveal that the underlying mechanisms that make us feel good when we exercise persist into old age and highlight the importance of staying active. “A previous study demonstrated these mechanisms in healthy young adults; however, it was unknown whether the muscle deterioration which accompanies aging would preclude older adults from achieving similar exercise-induced benefits,” explained David Allison, lead author on the study and a postdoctoral fellow in McMaster’s Department of...
Research Finds Individualized Diets Most Effective for Managing Blood Sugar
An individualized diet based on a person’s genetics, microbiome, and lifestyle is more effective in controlling blood glucose (sugar) levels than one that considers only nutritional composition of food, Mayo Clinic researchers have confirmed. The research published in JAMA Network Open demonstrates that each person’s body responds differently to similar foods, due to the unique composition of each person’s gut microbiome—the complex community of trillions of bacteria within the digestive tract. The goal of this research was to develop a model for predicting glycemic response to foods—how a person’s blood sugar level spikes or stays the same after eating. The study finds that...
Proteins Regenerate Residual Bone and Joints After Amputation
Researchers at Texas A&M University and Tulane University have found that treating amputation wounds in mice with two proteins encouraged growth of the residual bone and joint. Because the human skeletal structure is similar to a mouse, the researchers are optimistic that one day the discovery will help people with amputations regrow limbs. The research team studying methods to stimulate tissue regeneration after traumatic injury previously discovered that treating toe amputation wounds in neonatal mice with a protein called BMP2 stimulated endochondral ossification to regenerate the residual bone. The team’s latest research, published February 5 in Nature Communications,found that also...
Parental Support Needed for Children With Limb Differences
Rehabilitative care for children with limb differences often includes the provision and use of a prosthesis. However, there is little research about how parents experience and respond to their child’s limb difference and prosthesis use. A study published online February 2 in Disability and Rehabilitationjournal explored the experiences of parenting a child with limb difference who had been provided a prosthetic device. The study method included semi-structured interviews with seven parents. Interview data was recorded, transcribed, and analyzed using interpretative phenomenological analysis. Four themes were identified: managing the initial emotional experience through the development of coping resources; opportunities through prosthesis...
Judge Certifies Class Action in Prosthetics Suit
A California federal judge has certified a class of more than 1,000 UnitedHealth Group beneficiaries accusing the insurer of denying benefits for prosthetic limbs in violation of federal benefits law. Two previous certification bids failed. According to Law 360, U.S. District Judge John F. Walter ruled that the beneficiaries have shown there are “significant questions of fact and law” that are common to the entire class involving allegations that United didn’t offer alternative devices that met the customers’ needs in its notices of benefit denial and that if United determined that any of the components in a claim were not...
NAAOP Webcast: O&P Profession Planning Legislation to Protect Patients
The National Association for the Advancement of Orthotics & Prosthetics (NAAOP) has released its latest webcast in which general counsel Peter Thomas, JD, comments on the federal budget proposals for fiscal year 2020, which will be released late due to the federal government shutdown. When the proposals are made public, NAAOP will report on their potential impact on access to O&P care, Thomas said. In the interim, NAAOP will continue to work with the American Orthotic & Prosthetic Association and members of the O&P Alliance regarding off-the-shelf (OTS) orthotics and other priorities in the Medicare O&P Improvement Act, he said....
Clinical Practice Guideline Developed for Prosthetic Knee Selection
Phil Stevens, MEd, CPO, and Shane Wurdeman, PhD, MSPO, CP, have published a clinical practice guideline that was developed to present the evidence and provide clinical recommendations on prosthetic knee selection for people with unilateral amputations at the knee disarticulation or transfemoral level. The open-access article was published in the January issue of the Journal of Prosthetics and Orthotics. The guideline was based upon the best available evidence, and recommendations were drawn from systematic review, meta-analysis, and additional published practice guidelines. The results led to the following recommendations: 1. Fluid knee benefits and indications: Knees with hydraulic or pneumatic swing...
Reinforcement Learning Expedites Tuning of Robotic Prostheses
Researchers from North Carolina State University (NC State), the University of North Carolina (UNC), and Arizona State University (ASU) have developed an intelligent system for tuning powered prosthetic knees, allowing patients to walk comfortably with the device in about ten minutes. The system is the first to rely solely on reinforcement learning to tune the robotic prosthesis, according to the research team. The new tuning system adjusts 12 different control parameters to address prosthesis dynamics, such as joint stiffness, throughout the gait cycle. A paper about the development, “Online Reinforcement Learning Control for the Personalization of a Robotic Knee Prosthesis,”...
Our Bodies May Cure Themselves of Diabetes in the Future
Diabetes is caused by damaged or non-existing insulin cells’ inability to produce insulin, a hormone that is necessary in regulating blood sugar levels. Many diabetes patients take insulin supplements to regulate these levels. In collaboration with other international researchers, researchers at the University of Bergen (UiB) have discovered that glucagon-producing cells in the pancreas can change identity and adapt so that they do the job for their neighboring damaged or missing insulin cells. “We are possibly facing the start of a totally new form of treatment for diabetes, where the body can produce its own insulin, with some start-up help,”...
Experimental Stem Cell Therapy Speeds Up Wound Healing
The healing of wounded skin in people with diabetes can be sped up by more than 50 percent using injections of stem cells taken from bone marrow, a new study in mice shows. The research, led by scientists at the New York University (NYU) School of Medicine, focused on a chain of events in diabetes that makes skin sores more likely to form and less likely to heal. The body’s failure in diabetes to break down dietary sugar creates molecules called free radicals that can wreak havoc on cells and damage their DNA. These free radicals also trigger an inrush...
Prices Rising Even for Older Drugs
It’s no secret that drug prices are increasing, but to what extent are rising costs explained by the advent of newer, better drugs? A study from the University of Pittsburgh found that new drugs entering the market do drive up prices, but drug companies are also hiking prices on older drugs. The paper, published in the January issue of Health Affairs, shows that for specialty and generic drugs, new product entry accounted for most of the rising costs, whereas for brand-name drugs, existing products explained most of the cost increases. “It makes sense to pay more for new drugs because...
Three Tips for Sticking With Your New Year’s Resolutions
By February, nearly 80 percent of Americans will give up on their New Year’s resolutions, but Tomeka Flowers, a Houston Methodist behavioral development coordinator and certified lifestyle coach, says making a few simple changes can help people reach their goals. “The majority of New Year’s resolutions are about getting healthy—eating better, drinking more water, and exercising regularly,” said Flowers. “Unfortunately, most people have this idea of what getting healthy looks like, and they’ll give up on their goals when they don’t live up to that ideal.” To be successful in sticking with your resolutions, Flowers recommends: 1. Eliminate the all or...
Adjustable Sockets May Help Control Fluid Volume in Residual Limb
Existing prosthetic technologies’ adjustable sockets and locking pin tethers can be used in novel ways to help maintain residual limb fluid volume in active prosthesis users with transtibial amputations. Researchers examined if either of two accommodation strategies executed during resting—socket release with full socket size return and socket release with partial socket size return—enhanced limb fluid volume retention during subsequent activity. Two repeated-measures experiments were conducted to assess the effects of socket release on limb fluid volume retention. Limb fluid volume was monitored while participants wore a socket with a single adjustable panel. Participants performed eight activity cycles, each including...
Depression Often Follows Dysvascular Amputation
Individuals undergoing lower-limb amputations secondary to dysvascular disease were found to have depressive symptoms during the first year after the procedure, according to a study published online December 31, 2018, in the Archives of Physical Medicine and Rehabilitation. Patients were surveyed four times (perioperative period and six weeks, four months, and 12 months post-amputation) at four U.S. Department of Veterans Affairs (VA) medical centers, a university hospital, and a Level I trauma center. Multilevel modeling was used to describe and predict trajectories, and patients completed a health questionnaire. A total of 141 participants (74 percent retention) were a consecutive sample,...
Amputation Level Affects Child’s Physical, Sports Function
Sports and physical functioning of children with amputations were significantly worse after amputations near the knee when compared with ankle-level amputations, according to a study published in the January issue of the Journal of Pediatric Orthopaedics. Researchers considered whether children with amputations have differences in subjective function based on amputationlevel and whether children with more proximal amputations would report poorer function and quality of life. An Institutional Review Board (IRB)-approved, retrospective chart review of patients age 0 to 21 years old with lower-limb amputations was performed. Demographic information, type of amputation, type of prosthesis, and the Pediatric Outcomes Data Collection...
TMR on Transtibial Amputees Reduces Initial Phantom Limb Pain
Physicians at The Ohio State University Wexner Medical Center and College of Medicine are pioneering the use of primary targeted muscle reinnervation (TMR) to prevent or reduce debilitating phantom limb and residual limb pain in individuals with transtibial amputations. Primary TMR has shown to reduce phantom limb and residual limb pain, as reported in recent publications by Ian Valerio, MD, division chief of Burn, Wound and Trauma in Ohio State’s department of Plastic and Reconstructive Surgery, and J. Byers Bowen, MD, a former resident now in private practice. Their latest work has been published in the January issue of Plastic...
Leaders Launch Global Campaign for Inclusive and Accessible Cities
On December 3, World Enabled andthe German Federal Ministry for Economic Cooperation and Development (BMZ) hosted a celebration of the International Day of Persons with Disabilities and the launch ofthe Cities For All global campaign and theGlobal Compact on Inclusive and Accessible Cities. This event gathered city leaders from New York City, São Paulo, Chicago, Curitiba, Brazil, and Laayoune, Morocco, for a signing ceremony signifying their commitment toward inclusive and accessible cities for people with disabilities and older people. World Enabled is leading the Cities For All campaign with the support of United Cities and Local Governments, with a membership...
Brief Film Highlights Benefits of Hiring People With Disabilities
Companies that do not employ people with disabilities are missing out. This is the message of the third Transforming Lives Makes Sense for Everyone film, a joint campaign between the International Paralympic Committee (IPC) and United Nations Human Rights Office to showcase the employment legacy of the London 2012 Paralympic Games. The film can be viewed at https://youtu.be/pAMBxEdn2BY. Although the London 2012 Paralympics contributed to shifts in attitudes and greater employment opportunities for people with disabilities, a gulf in the employment rates of those with and without impairments still exists. Latest statistics for Great Britain show that 51.3 percent of people with...
Second Edition of The Paralympian Now Available
The International Paralympic Committee (IPC) has released the final 2018 edition of its magazine The Paralympian, which reflects on a busy year of World Championships and looks ahead to a new Paralympic Winter Games cycle. Download an online copy at http://paralympics.uberflip.com/i/1059743-the-paralympian-dec-2018. Also, to watch videos and subscribe to ParalympicSport.TV, visit www.youtube.com/ParalympicSportTV.
Diabetic Foot Ulcers Heal Quickly With Nitric Oxide Technology
Diabetic foot ulcers can take up to 150 days to heal. A biomedical engineering team wants to reduce it to 21 days. To drop the healing time, they plan to amplify what the body already does naturally: build layers of new tissue pumped up by nitric oxide. In patients with diabetes, impaired nitric oxide production lessens the healing power of skin cells and the Centers for Disease Control and Prevention reports that 15 percent of Americans living with type 2 diabetes struggle with hard-to-heal foot ulcers. However, simply pumping up nitric oxide is not necessarily better. The long-term plan of...
AARP Releases Findings of Bipartisan Post-election Survey
AARP released the findings of a nationwide poll of general election voters, along with oversamples in 39 GOP-held seats that flipped to a Democrat and 37 GOP-held seats targeted as competitive by the Cook Political Report that held for the GOP. The bipartisan poll, fielded jointly by Fabrizio Ward and Benenson Strategy Group, found that, for voters over the age of 50, Social Security, Medicare, and healthcare were the top issues driving them to the ballot box. The 2,800-voter survey also indicated voters in this demographic across the board are concerned about gridlock in Washington and prefer candidates who will...
Retired Soldiers Benefit From Wheelchair Rugby
If you have never witnessed wheelchair rugby in person, you should make it a point to do so. The sound of the wheelchairs rushing up and down the court and the metal-on-metal collision of those same wheelchairs is an experience in and of itself. The athletes maneuver their chairs with grace, finesse, and ferocity all at once—an image unique to the sport commonly referred to as “murderball.” Retired Army Sgt. Ryan Major and retired Army Staff Sgt. Joel Rodriguez discovered the sport after suffering serious injuries. Major was injured after stepping on an improvised explosive device in Iraq in 2006,...
New Online Tool Displays Cost Differences for Surgical Procedures
The Centers for Medicare & Medicaid Services (CMS) has launched a new online tool that allows consumers to compare Medicare payments and copayments for certain procedures that are performed in hospital outpatient departments and ambulatory surgical centers. The Procedure Price Lookup tool displays national averages for the amount Medicare pays the hospital or ambulatory surgical center and the national average copayment amount a beneficiary with no Medicare supplemental insurance would pay the provider. The launch of the Procedure Price Lookup tool is required by Congress in the 21st Century Cures Act. Medicare’s statutes require that CMS maintain separate payment systems...
Insole Provides Oxygen to Heal Diabetic Foot Ulcers
Purdue University researchers have developed a shoe insole that could help make the healing process more portable for the 15 percent of Americans who develop ulcers as a result of diabetes. The researchers used lasers to shape silicone-based rubber into insoles, and then created reservoirs that release oxygen only at the part of the foot where the ulcer is located. “One of the ways to heal these wounds is by giving them oxygen,” said Babak Ziaie, PhD, a professor of electrical and computer engineering at the university. “We’ve created a system that gradually releases oxygen throughout the day so that...
Frogs Help Regeneration Science Leap Forward
Tufts University researchers led by biologists and engineers have found that delivering progesterone to an amputation injury site can induce the regeneration of limbs in otherwise non-regenerative adult frogs—a discovery that furthers understanding of regeneration and could help advance treatment of amputation injuries. The researchers created a wearable bioreactor attached to the wound site that delivered the progesterone locally for a 24-hour period. Results showed that it had a lasting beneficial effect on tissue regrowth, allowing the frogs to partially regenerate their hind-limbs. A day of exposure led to nine months of changes in gene expression, innervation, and patterned growth,...
OPAF Receives $3,600 Swim Grant
The Orthotics & Prosthetics Activities Foundation (OPAF) and the First Clinics along with the First Swim Training and Clinic program was recently awarded a $3,600 grant from U.S. Masters Swim and its Adult Learn To Swim program. The funds will come via the Swimming Saves Lives Foundation and will be used in 2019. OPAF plans to offer two pilot programs of adaptive swim instruction in Orlando, Florida, and Bay City, Michigan, said Robin Burton, OPAF executive director. “These grant dollars will help us to grow the first swim program in two specific cities where we have close ties with local...
Co-founder of LegWorks Named to Forbes 30 Under 30
Forbes Magazine has named Brandon Burke, co-founder and chief product officer of LegWorks, headquartered in Buffalo, New York, as one of its 30 Under 30 entrepreneurs and innovators. LegWorks produces and delivers high-functioning and affordable prosthetic technology globally. The awards are given to “bold risk-takers putting a new twist on the old tools of the trade,” according to Forbes. Burke was named in the social entrepreneurs category. LegWorks uses a multi-tiered pricing model that has allowed 30 percent of the company’s total volume to be sent to the developing world. Burke, who has a transfemoral amputation, uses the company’s prosthetic...
Less Exercise May Still Yield Benefits
A Beaumont Health study featured in Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine, found that middle-aged and older women who exercise moderately to vigorously, three times a week for at least 30 minutes, were able to significantly reduce cardiac risk factors in just six months. Specifically, participants in Beaumont’s Women Exercising to Live Longer (WELL) program achieved reductions in weight, cholesterol, and blood pressure, along with symptoms of depression and anxiety. While heart disease is the leading killer of women in the United States, many women still struggle to embrace...
Recognizing Capability and Ability, Not Disability
Charlene Liles, outpatient medical records technician, processes approximately 100 weekly requests for release of information at Naval Hospital Bremerton’s (NHB) Medical Records Department. The electronic mail, postal service, and fax machine requests are her obligation, and then some. She’s ready and responsible for any requirement. It’s that professional capability, as well as personal ability, that NHB underscored in recognizing October as National Disability Employment Awareness Month (NDEAM). “Charlene is our first line of defense at Medical Records. Huge contributor to the team! When she is out for any reason, it is quite noticeable. Her workload can be different every day,...
Female Double Amputee Plans to Complete NYC Full Marathon
Brazilian athlete and bilateral lower-limb amputee Adriele Silva, 31, looks forward to crossing the finish line at mile 26.2 of the 2018 TCS New York City (NYC) Marathon on Sunday, November 4. “I hope to inspire people when they see me run and challenge them to go after things that seem unachievable,” said Silva, who will be running her first full marathon. “Where I come from, people often look down on you for having a disability, but I don’t think about that. When I face a challenge, I look for ways to overcome it. I see the possibilities and that...
Neuroprosthetic Advance May Improve Prosthetic Touch and Phantom Limb Pain
Scientists at the École Polytechnique Fédérale de Lausanne (EPFL), Switzerland, have developed a miniaturized electronic platform for the stimulation and recording of peripheral nerve fibers on a chip. The platform paves the way for using chips to improve neuroprosthetic designs, which may lead to restoration of the sense of touch for people who use prosthetic devices, silence painful nerve activity, and help people with paralysis walk. The scientists used the platform to test a photothermic method for inhibiting neural activity to treat pain. “Neural inhibition could be a way to treat chronic pain like the phantom limb pain that appears...
New Research, Tools Center on Treating Phantom Limb Pain
Max Ortiz-Catalan, PhD, Chalmers University of Technology, Gothenburg, Sweden, who conducts research using augmented reality to reduce phantom limb pain (PLP) in people with amputations, has developed a new theory and treatment for PLP that could lead to more effective treatment. Also advancing treatment of PLP, a new virtual reality (VR) tool is having success in initial studies in Brazil. Ortiz-Catalan’s theory for the origin of PLP, called “stochastic entanglement,” builds upon his previous work that uses machine learning and augmented reality. He proposes that after an amputation, neural circuitry related to the missing limb loses its role and becomes...
AOPA Says BCBS Draft Policy Would Decrease Access to Prostheses
The American Orthotic & Prosthetic Association (AOPA) said on October 1 that a draft policy governing coverage of lower-limb prostheses would significantly reduce access to advanced prosthetic technology for Blue Cross Blue Shield (BCBS) subscribers in several states. The draft policy was issued by Health Care Services Corporation (HCSC), which operates BCBS of Illinois, Texas, Montana, New Mexico, and Oklahoma. AOPA’s first concern was that HCSC published the draft policy on September 15 with comments due by October 1. AOPA suggested a minimum 60-day comment period to allow stakeholders adequate time to review the draft and prepare comments. AOPA’s comments...