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Selena Horner

I believe outcomes data is the new frontier - so many things to learn from this type of data: professionally, clinically and businessly!
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Jul 14, 2017 | Selena Horner

Yoga, Physical Therapy, or Education to Treat Individuals with Persistent Low Back Pain

Full text of the below study is really required in order to truly discuss the results.

I hope the full text version spends some time addressing the subjects ability to read. I also hope the investigators provide a rationale for 15 sessions of physical therapy. As with most comparative studies, I also expect a description of what "physical therapy" entailed. 

I tend to do better sharing my thoughts if I can review the findings within the full text.  I don't quite understand "noninferiority margins."  I'm not quite sure why the investigators didn't just use the minimal clinically important difference.

Below you will find a quick view of the abstract.

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Jul 12, 2017 | Selena Horner

Knee Dislocations and Outcomes

After most traumas, it isn't easy to know exactly what to expect.

I appreciate that this study shares the amount of knee motion and the typical complications after a traumatic knee dislocation. From a clinical perspective, this helps alert me as to what I need to also keep in the back of my mind when treating these individuals.

Below you will find a quick view of the abstract.

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Jul 10, 2017 | Selena Horner

Motivational Interviewing and Return to Work

The words we use matter. We've been learning this over the past few years, in particular in the pain science world.

 This study focused on individuals and return to work. We already know that a patient who is injured at work has a characteristic that is risk adjusted for fair comparison in outcomes. These individuals may not achieve functional outcomes as high or as fast compared to other patients. Motivational interviewing may be considered within the treatment strategy to improve outcomes.

Below you will find a quick view of the abstract.

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Jul 07, 2017 | Selena Horner

5 Questions Can Determine Degenerative Disc Disease

It's almost like the pendulum is swinging to value subjective history during the interview process.

This study just reached my radar. If we can implement these kinds of studies into our practice (and physicians also), we have an opportunity to reduce the cognitive changes and beliefs that happen after a patient learns and views radiographs and MRIs. 

Below you will find a quick view of the abstract.

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Jul 03, 2017 | Selena Horner

Transitioning to a Total Joint Arthroplasty Bundled Payment Program

More hospital systems will be involved in bundled payments for total joint arthroplasties.  Medicare currently has a bundled payment program for joint arthroplasties. Private payers will also be changing their payment models to potentially include an alternative payment model for joint arthroplasties.

This article focuses on how a private institution transitioned into a bundled payment model. Hopefully the full text provides details that will help you learn ways to negotiate and also be efficient in this type of payment model.

Below you will find a quick view of the abstract. 

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Jun 28, 2017 | Selena Horner

Patient Reported Outcomes in Electronic Health Record Can Inform Clinical and Policy Decisions

Historically, data mining used medical claims data. The problem with medical claims data is that it doesn't tell the whole story. Claims data answers the question of what services were provided. When thinking about rehabilitation services claims data only tells have the story. The patient isn't included in the story. 

When using FOTO, it is easy to incorporate patient reported outcomes into clinical decision making. What will be powerful: combining electronic health record with patient reported outcomes and claims data. 

Below you will find a quick view of the abstract. 

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Jun 26, 2017 | Selena Horner

Effects of Myofascial Release for Patients with Nonspecific Chronic Low Back Pain

This conclusion needs to be stated more strongly than it is.

When it comes to outcomes, a result will have meaning to the patient if the difference in scores falls outside of the minimal clinically important difference of the tool. Without reading the full text and seeing the actual scores and the data, it appears (based on the language in the conclusion) that myofasical release is no different than sham. Neither had clinical relevancy from the patient's perspective.

Below you will find a quick view of the abstract. 

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Jun 23, 2017 | Selena Horner

Physiotherapists Managing Patients with Musculoskeletal Complaints in Emergency Department

Physiotherapists managing patients with musculoskeletal conditions arriving by ambulance immediately had me thinking, "no way."

Here's another study done in Australia. Now the key for sucessful interpretation and implementation of physiotherapists in the emergency department... triage. Physiotherapists were not involved with every patient. Physiotherapists were involved in the care of patients in Categories 3-5. That makes sense and offsets my gut response. Australia has Advanced Musculoskeletal Physiotherapists practicing in their emergency departments.

Hospital systems may begin to shift emergency department personnel so that the skill level and knowledge level required to care for someone admitted into an emergency department matches the care required. Here in the States, the role of the physical therapist may be dependent upon state practice acts and scope of care.

Below you will find a quick view of the abstract. 

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