PTAG Blog

Newnan resident Joan Hope Latiolais was left nearly paralyzed when she fell from her horse and suffered a tragic spinal cord injury in late 2008.

Joan and her husband had been tracking foxes in Moreland, Ga., when her horse’s leg fell into a 2.5 foot deep hole. The sudden drop caused her horse to fall forward, throwing Joan to the ground face forward and hyper-extending the cervical vertebrae in her neck.

The resulting spinal cord injury left her 80 percent paralyzed, with little movement or sensation below her chest.

Four years later, she is on a steady path to recovery with the help of Karyn Staples, a local physical therapist who has been by her side the entire way.

Karyn first set up her physical therapy and Pilates studio, ProHealth, seven years ago to deliver a combination of therapy and Pilates exercises that support recovery.

She was first introduced to Joan in the fall of 2012.

Joan had been seeking methods to restore strength and flexibility to her body and, having previously done Pilates, decided to find a physical therapist who could incorporate similar exercises into her treatment.

Karyn began to meet with Joan two times a week, using intensive training methods and modified Pilates techniques to assist with her recovery.

Before starting treatment, Joan had hoped, over time, she would be able to independently transfer into and out of her wheelchair.

Now, Joan has met that goal and is able to sit up and move to and from her wheelchair with minimal assistance.

Karyn credits Joan’s drastic improvement to a variety of exercises that have helped stretch and strengthen core muscles in her body. Karyn uses a series of Pilates techniques to work Joan’s legs and upper extremities, making her body stronger.

For patients recovering from serious injuries, exercise is fundamental to recovery. But Karyn emphasizes it is also important to know how to correctly use your body.

And in Joan’s case, it was about re-learning the basic movements of her body.

“We had to find ways to incorporate exercise techniques that motivated and excited her,” says Karyn, “and remind her what her body can do, helping her become more aware and in control of her movements.”

Karyn says working alongside Joan and witnessing her recovery has been an inspiration.

“That’s my whole reason for being a PT,” says Karyn, “Watching Joan’s demeanor change as well as her ability to feel better about herself, that’s why I got into this profession. It is about the gift they are giving me.”

Karyn reminds patients who are facing long recoveries and physical hardships that while exercise can make a huge difference, it is also a mental battle.

And that hard work, determination, courage and of course a little hope can go a long way.

By 2020, 16.3 percent of the U.S. population will be 65 or older, double the current number, according to the American Orthopaedic Association, in response, physical therapists are preparing for a surge in older patients.

And while its true physical therapy helps the elderly reduce the risk of injury, enhance balance and increase long-term mobilization, physical therapists are also focused on an equally important patient demographic – youth.

About 17 percent of U.S. children ages 18 and younger have a developmental disability, according to the CDC. Physical therapy can help children learn the appropriate skills to function independently and ease every day challenges.

Pediatric physical therapists focus on newborns to 21-year-olds with developmental disabilities or who have or are at risk for movement dysfunction. Working with children and their families, physical therapists help set goals and strategies aimed at enhancing the lives of their younger patients.

Unlike other health care providers, physical therapists may work with their patients from infancy through adolescence to promote health and wellness, while providing support in a number of different roles throughout all stages of development.

They are not just responsible for providing exercise and rehabilitation guidelines – they must also apply clinical expertise by examining and diagnosing their younger patients.

And while children are the primary focus of pediatric physical therapists, collaboration with parents and families is essential.

Families are responsible for implementing the individualized intervention programs designed for their children. And pediatric physical therapists work with families to ensure children are helped at home, which according to the American Physical Therapy Association includes:

• Positioning children during their daily routines and activities;
• Using equipment effectively;
• Adapting toys for play; and
• Expanding mobility options.

When working with children, physical therapists are the source of knowledge for patients and their families – leading the team effort in recovery and development.

With advances in healthcare and childhood development, pediatric physical therapy is a growing field. And with physical therapy job growth expected to increase 39 percent by 2020, according to the Bureau of Labor Statistics, the demand for specialized practices, such as pediatric physical therapy, is expected to increase as well.

Additional information on pediatric physical therapy including resources, tips and information for patients and physical therapists can be found at www.pediatricapta.org.

On January 1, 2013, Congress passed the American Taxpayer Relief Act of 2012.  The Act extends the Medicare therapy cap exceptions process through December 31, 2013.  The automatic exceptions process will apply when patients reach the $1,900 threshold and the manual medical review process will continue at the $3,700 threshold.  Hospital outpatient settings will continue to be included under the therapy cap with the exceptions process in 2013.  Additionally, the Act averts the 26.5 percent payment cut caused by the sustainable growth rate formula and extends the geographic practice cost index for one year.  The Act also delays sequestration cuts until March 1, 2013, avoiding a 2 percent cut in reimbursement rates for Medicare providers.

Despite the passage of the above critical provisions, Congress included an increased multiple procedure payment reduction (MPPR) to therapy services provided on the same day.  The Act increases MPPR from 20 percent in private practice and 25 percent in facilities, to 50 percent for all settings.  This provision will not begin until April 1, 2013 and APTA will advocate aggressively to prevent implementation of this flawed policy.  For more information on MPPR, review the attached Congressional summary of the Medicare extender offsets.

In addition to this legislation, several policies took effect today, including:

• In 2013, Physical therapists must submit information regarding a patient’s functional limitation for Medicare Part B services.  For more information visit APTA’s Functional Limitation Reporting webpage.
• The Physician Quality Reporting System (PQRS) changes from an incentive-based program to a penalty program in 2013.  In order to avoid penalties of 1.5 percent in 2015 physical therapists can report a variety of measures.  See APTA’s PQRS webpage for more information.
• A 4 percent increase in payments went into effect on January 1 due to the final year of a practice expense survey conducted by APTA.  Members will see a 4 percent increase in Medicare payments.

The American Taxpayer Relief Act of 2012 will now be sent to the President’s desk for signature.