Valenzeuala et al, Adherence to technology-based exercise programs in older adults: A systematic review. JGPT 41(1):49-61.
Trudelle-Jackson et al, Do older adults who meet 2008 physical activity guidelines…. JGPT(3):180-185.
To: Editorial at Readers Digest and Ms Sharon Feiereisen
September 27, 2018
RE: 14 Exercises to Never Do After Age 50 | Reader’s Digest | 25 September 2018
We are writing on behalf of the American Physical Therapy Association and the Academy of Geriatric Physical Therapy in response to the recent article, 14 Exercises to Never Do After Age 50. As representatives of a profession designed to optimize health through movement, we want your readers to know that exercise is appropriate throughout ones’ life span. Thus, we feel it is crucial to correct some misconceptions discussed in this article.
First, Readers Digest does a disservice to its readers to advise them “never” do an exercise. It’s always a good idea to check with a health care provider before starting a new exercise regimen. A physician or physical therapist can provide a medical assessment to older adults who are looking to begin a safe and effective exercise program.
It is true that, with age, people do need to “manage issues like past injuries, joint pain, and chronic muscle aches.” We concur with the article’s theme of caution, but we want to encourage people to be engaged in physical activity, and too many adults are inactive. According to the CDC, 46% of adults aged 45 to 64 years do not meet physical activity guidelines for either strength training or aerobic fitness. That number rises significantly in the aged 65+ years population.
However, there is clear scientific evidence that many of the exercises you suggested avoiding actually are indeed appropriate for individuals over the age of 50. For example, Bikram yoga offers benefits for many people, including older adults. A critical review by Hewett et al (1) found several studies, which included older people that showed benefits in glucose tolerance, cholesterol levels, and flexibility. Another article by Cramer et al (2) reviewed adverse events and did not list any that were specifically related to age.
Similarly, push-ups work the musculature around the shoulder and also the core, which are critical for posture and balance. In 2016, Harvard Men’s Health Watch (3) used the example of number of push-ups for men over 50 as a baseline for physical fitness. This exercise requires no equipment or gym membership. Thus, describing these and most of the others listed as a “never” for people over the age of 50 is inaccurate and may discourage a person from initiating or continuing a program, which could have very serious consequences to her or his health.
Data suggests that having more positive self-perceptions of aging is associated with higher levels of physical activity and longevity (4). Your readers can find more information about healthy aging on APTA’s patient information website, MoveForwardPT.com. We also would be happy to craft an article for an upcoming edition of Readers Digest to help your adult readers be more active.
Thank you for your time and consideration to publish this letter.
Sharon L. Dunn, PT, PhD
American Physical Therapy Association
Greg Hartley, PT, DPT
Academy of Geriatric Physical Therapy
The Oncology Section is sharing a recent article from their Journal with all AGPT members. "A New Perspective! Behavioral Change Strategies to Improve Physical Activity After Cancer Treatment" can be accessed at:
A new CDC publication, “The Potential to Reduce Falls and Avert Costs by Clinically Managing Fall Risk,” has been published in the American Journal of Preventive Medicine. This report is the first to show that evidence-based fall prevention interventions delivered by U.S. healthcare providers have the ability to prevent thousands of falls, thereby improving the health and well-being of older Americans. In addition, these interventions could substantially lower healthcare costs currently estimated at $50 billion annually.
Using a two-step process, the authors calculated the population-level impact of 7 evidence-based interventions on reducing falls and lowering direct medical costs. In step one, they used the prevalence of seven fall risk factors among American’s age 65 and older to calculate the number of older adults who would be eligible for and willing to reduce their risk by adopting an evidence-based fall prevention intervention. The interventions included 1) Tai Chi exercise program, (2) Otago Exercise Program, (3) medication management, (4) vitamin D supplementation, (5) expedited first eye cataract surgery, (6) single-vision distance lenses for outdoor activities, and (7) home modifications led by occupational therapist. In step two, the authors estimated the expected number of falls that would occur if the intervention had not been implemented and the medical costs of these falls. Lastly, the direct medical costs averted were calculated based on the known effectiveness of the intervention.
The study found that implementing single interventions could prevent between 9,563 and 45,164 medically treated falls and avert between $94 and $442 million in direct medical costs annually.
Preventing falls can benefit older adults significantly by improving their health, independence, and quality of life. Healthcare providers are in a unique position to educate and empower their older patients on how to reduce fall risk. The CDC’s Stopping Elderly Accidents, Deaths, and Injuries initiative (STEADI) includes resources and tools to help members of the healthcare team (e.g., physicians, nurses, pharmacists, and physical therapists) integrate fall prevention into their clinical practice.
2018 House of Delegates Update
Ellen R. Strunk, PT, MS
The 2018 session of the House of Delegates was held June 25-27, 2018 in Orlando, FL. This year’s agenda was quite busy! A total of 58 main motions were on the agenda for these 3 days. As the AGPT’s elected Delegate, I am reporting to the membership the actions taken in this year’s House of Delegates. Please be aware, however, that the “official” results of this year’s business will not be available until September 7, 2018. Therefore, this report is considered “unofficial” but in the interest of getting the information out to the membership timely, it is provided.
The governance of the Association is a year-round process. As an elected Delegate, I read hundreds of emails which served as an important part of crafting motions, and provided a means for informative deliberations about the merits of motions. As delegate, I participate in virtual town halls, meetings of the Southern Caucus (determined by my home state) and collaborated with other State and Section delegates. Although the Sections do not have a vote in the House of Delegates, we do participate in both debate and discussions. As AGPT’s delegate, we spoke in favor of RC-44-18 and RC-46-18.
In 2018, motions were proposed by The Special Committee to Review House Documents, The Board of Directors, and several components. The Special Committee to Review House Documents brought forward 34 motions of the 58 motions. This Committee was formed as a result of a motion passed at the 2017 House of Delegates. Its charge was to review documents previously adopted by the House, and forward motions to amend, consolidate or rescind documents as needed. There were many House Documents rescinded. These were documents that were felt to be outdated, duplicative and/or no longer necessary (Table 1). Other House documents were brought up to date through amendments (Table 2). There were also several motions (Table 3) brought forward by the Special Committee, the Board, and components. The Special Committee to Review House Documents will continue their work this year and bring forward additional motions to the 2019 House of Delegates. Tables 1, 2 and 3 can be found at http://geriatricspt.org/?k962jo
Three persons were elected to Honorary Membership in the American Physical Therapy Association: James H. Rimmer, PhD, Daniel M. Corcos, PhD, and Bonnie Polvinale. You can read more about them at http://www.apta.org/PTinMotion/News/2018/07/09/2018HonoraryMembers/. Unfortunately, RC-56-18, a motion to amend the bylaws to allow the Sections a vote at the House of Delegates was not considered due to limited time. However, the sections remain committed to continue pursuit of the vote.
As stated earlier, the official minutes of the House of Delegate’s proceedings will be posted on the APTA’s website by September 1, 2017. The 2018 House of Delegates is scheduled for June 27-30, 2018 in Orlando, FL. As your state begins to develop concepts for new motions in 2019, please feel free to share those issues with me, so the Academy can continue to engage all members.
To order your electronic copy, please see:
On July 31, 2018 CMS finalized three 2019 Medicare payment rules for the Skilled Nursing Facility PPS, Inpatient Rehabilitation Facility PPS, and Inpatient Psychiatric Facility PPS. Individually and collectively, the final rules issued today put patients over paperwork, ease provider burden, and make significant strides in modernizing Medicare
Rania Karim, PT, DPT, AGPT Membership Chair and Practice Committee member, was recently recognized as an APTA Emerging Leader. Rania was nominated by the Academy for her significant contributions to the advancement of the physical therapy profession, specifically in the area of geriatrics and we are proud of her many accomplishments!
The Emerging Leader Award was established to annually honor individuals who have demonstrated extraordinary service to the profession and APTA early in their careers. Watch for the announcement in the October issue of PT in Motion Magazine. Congratulations Rania!
The global population is currently undergoing the greatest demographic shift in the history of humankind. A direct consequence of this “longevity miracle” – if left unchecked – will be an explosion in the incidence of chronic diseases afflicting older people. In the absence of systematic and system-wide interventions, this tsunami of need is poised to engulf health and social care systems throughout the world. Osteoporosis, falls and the fragility fractures that follow will be at the vanguard of this battle which is set to rage between quantity and quality of life.
By 2010, the global incidence of one of the most common and debilitating fragility fractures, hip fracture, was estimated to be 2.7 million cases per year. Conservative projections suggest that this will increase to 4.5 million cases per year by 2050. While all countries will be impacted, in absolute terms, Asia will bear the brunt of this growing burden of disease, with around half of hip fractures occurring in this region by the middle of the century. And the associated costs are staggering: in Europe in 2010, osteoporosis cost Euro 37 billion, while in the United States estimates for fracture costs for 2020 are US$22 billion.
If our health and social care systems are to withstand this assault, a robust strategy must be devised, and an army of health professionals amassed to deliver it. This strategy must transform how we currently treat and rehabilitate people who have sustained fragility fractures, in combination with preventing as many fractures from occurring as possible. The latter can be achieved in part by ensuring that health systems always respond to the first fracture to prevent second and subsequent fractures. In short, let the first fracture be the last.
A major step towards making this aspiration a reality has occurred today with publication of a Global Call to Action to improve the care of people with fragility fractures. Endorsed by 81 leading organizations from around the world, covering the fields of medicine and nursing for older people, orthopaedic surgery, osteoporosis and metabolic bone disease, physiotherapy, rehabilitation medicine and rheumatology, the case for transformation of the following aspects of care has been made:
The Call to Action was conceived at an annual congress of the Fragility Fracture Network (FFN), when six leading organisations came together to determine how they could most effectively collaborate to improve fracture care globally. Lead author of the publication, Professor Karsten E. Dreinhöfer said “Fragility fractures can devastate the quality of life of people who suffer them and are pushing our already overstretched health systems to breaking point”. Dreinhöfer added “As the first of the baby boomers are now into their seventies, we must take control of this problem immediately before it is too late”.
The Global Call to Action illustrates that for the first time, all the leading organisations in the world have recognized the need for collaboration on an entirely new scale. “The Academy of Geriatric Physical Therapy has a long history of promoting bone health to improve population health and we are proud to be among the charter group of global endorsers. The publication of this CtA along with the unprecedented level of consensus shared by societies across the world provides an opportunity to drive widespread implementation of best practice in the United States and globally,” Dr. Greg Hartley, President of the Academy of Geriatric Physical Therapy.
The Global Call to Action proposes specific priorities for people with fragility fractures and their advocacy organisations, individual health workers, healthcare professional organisations, governmental organisations and nations as such, insurers, health systems and healthcare practices, and the life sciences industry. The World Health Organisation (WHO) has declared the years 2020-2030 to be the “Decade of Healthy Aging” and later this year the United Nations (UN) will hold its Third High-level Meeting on Non-Communicable Diseases. The authors highlight the opportunity for WHO and UN to consider the recommendations made in the Global Call to Action as an enabler for their global initiatives.
Read more at http://fragilityfracturenetwork.org/cta/
Fragility Fracture Network Central Office
c/o MCI Schweiz AG
Kate Mangione, PT, PhD, FAPTA
Member, Physio Special Interest Group
The Cognitive and Mental Health SIG would like to share with you a youtube video link that speaks to how we can all clinically assess and address feelings of job burnout. It speaks to physicians, but we can change the script ourselves from MDs to physical therapists, physical therapist assistants, students, residents, and physical therapy doctors.
The video is < 5.5 minutes long and describes a straight-forward 3-step process to clinicially assessing job burnout and real action steps to correct it. It is hoped you think it is worth your time and worth sharing/discussing with your colleagues in team conferences and in local chapter meetings. We always love to hear from you! Please keep sending your comments on content and project development ideas to Lise McCarthy, CMHSIG Chair at [email protected]. Last, if you like and appreciate the content posted on the CMHSIG webpage so far, please do sign up to be a member at https://geriatricspt.org/special-interest-groups/ as this is the only way to really let the Board of Directors and the CMHSIG leadership know we are on the right track in developing content that supports and represents your needs.
The video can be accessed at:
The Residency/Fellowship SIG proundly supports geriatric residencies and is excited to announce the recipients of scholarships to assist with offsetting costs associated with geriatric residency work. Congratulations to the following Academy members: Sarah Evans/University of Minnesota; Lashia Hicks/Brooks IHL Geriatric Residency; Ashley Kinsey/Durham VA Medical Center; Matthew Mucha/Louis Stokes Cleveland VA and Alexandra Piersanti/Creighton University.
The Academy of Geriatric Physical Therapy is pleased to announce Management of Falls and Fall Prevention in Older Adults written by Mariana Wingood, DPT, PT, GCS, CEEAA and edited by Barbara Billek-Sawhney, PT, EdD, DPT, GCS is now available in the APTA Learning Center.
Falls are major concern for older adults! Physical therapists play a key role in fall prevention, as well as treating falls and fall related injuries. With evidence-based practice the functional mobility and quality of life of older adults may be improved, while decreasing the national fall related statistics. This information will provide clinicians with the appropriate multi-factorial assessment and interventions to set their patient up for success!
APTA has a new mission, and it's all about bringing people together.
"Building a community that advances the profession of physical therapy to improve the health of society" is now the official mission statement for APTA. Developed by the APTA Board of Directors after the 2017 House of Delegates entrusted the Board to update and maintain the association's mission, the statement is strongly integrated with APTA's vision statement for the profession of physical therapy: "Transforming society by optimizing movement to improve the human experience."
"The vision statement APTA adopted in 2013 positions the association as an outward-facing organization committed to positive change," said APTA President Sharon L. Dunn, PT, PhD. "Our new mission statement articulates the association's role in that change—by being a place of engagement, where multiple perspectives can be brought together in support of advancing physical therapist practice to create pathways toward a healthier society."
According to Dunn, as the APTA Board of Directors explored the creation of a new mission statement, members realized that in many ways the association already is living out its mission.
"Our emphasis on being better together, our recommitment to diversity and inclusiveness, and our energized and connected members pointed the way toward this new mission statement," Dunn said. "We believe it's a forward-looking mission, but it's also a mission firmly rooted in our profession's values and its history of compassion, concern for society, and willingness to make bold moves.