COVID-19 has rightfully become the focus of much of the discussion around health care, but interesting findings in other areas continued to emerge during the pandemic. Here's a roundup of some notable research released over the past few months.

1.TKA Is the Subject of APTA's First-Ever CPG
In addition to evaluating some of the most common interventions for rehabilitation after total knee arthroplasty, APTA's new CPG also makes recommendations around the factors PTs should take into account when determining a patient's prognosis, group versus individual therapy, timing of PT management, and discharge planning. Among the results: Preoperative exercise, cryotherapy, and motor function training are among the interventions with the strongest support, while use of a continuous passive motion device for mobilization is the approach to avoid. (PTJ, June 2020)

2. Physical Therapy Beats Steroid Injections for Treatment of Knee OA
A study of beneficiaries in the military health system concludes that patients with knee osteoarthritis treated through physical therapy experienced lower pain and higher physical function after one year than did patients who received steroid injections. In addition to challenging assumptions about the effectiveness of the widely used injections, the results also hint at the possibility that benefits of physical therapy for knee OA may be more long-lasting than earlier believed. (New England Journal of Medicine, April 9, 2020)

3. A New PT-Focused Lymphedema Guideline Follows "Care Trajectory"
APTA Oncology has published its first major treatment-related clinical practice guideline — a resource on treatment of lymphedema related to breast cancer targeted specifically at the PT's role. The new CPG structures its recommendations around what authors call "the care trajectory" and cites particularly strong evidence supporting exercise for those at risk for or in early stages of breast cancer-related lymphedema and careful, patient-focused compression interventions when appropriate. (PTJ, June 2020)

4. More Work Needs to be Done to Pinpoint Sports Physical Therapy Content in PT Education
Researchers analyzed responses to a questionnaire distributed to members of the American Academy of Sports Physical Therapy and found that 60% of respondents did not take a specific sports physical therapy course during their PT education. Just about the same percentage agreed that sports physical therapy education should be required by the Commission on Accreditation of Physical Therapy Education. Authors of the study hope the findings help educators identify "the necessity, structures, and implementation of education content needed to prepare new graduates." (Journal of Allied Health, Summer 2020)

5. Utilization Review Finds High Costs, Opioid Use Patterns Among Patients With Chronic Refractory LBP
A review of multiple patient databases from 2009 to 2016 revealed that among patients with chronic refractory low back pain, average costs rose sharply in the first year, from $2,710 in the first quarter to $13,922 by Q3, and were even higher for patients with Medicare Supplemental insurance. Just over 60% of patients used physical therapy, and 65.7% used prescription pain medications, mostly opioids (56.5%) followed by muscle relaxants (38%). (Spine, May 21, 2020)

6. American Academy of Pediatrics Releases Clinical Report on Resistance Training for Children and Adolescents
In a revision of a 2008 AAP policy statement, the pediatrician's group restates its support for resistance training in the pediatric population and provides guidance on assessment, risk avoidance, appropriate training age, and other topics. The report also includes a "resistance training roadmap" and recommendations on developing a resistance training program. (Pediatrics, June 2020)

7. Report Documents How PTs and OTs Use Safe Patient Handling and Mobility Equipment
OTs and PTs employed at the U.S. Veterans Administration were asked to write narratives and supply photos of their use of safe patient handling and mobility equipment during the course of their work. Researchers analyzed the submissions and found that the most common category of use was "changing and maintaining basic body position," followed by "walking and moving." Authors believe their findings could be useful for therapists looking to expand their use of this equipment. (Work, June 4, 2020)

8. Parents Need To Be Careful When Encouraging Their Kids' Physical Activity
A study of 7- 10-year-old children's perception of "physical activity parenting," or PAP, found that parents who exhibit "high responsiveness and high demandingness" of their children’s physical activities might not be effectively instilling an appreciation for PA.  Instead, researchers found that high responsiveness — attention to the child's interests — and  low demandingness — lower pressure on performance — tends to be the combination that nurtures a more positive attitude about PA. "Even though participation in organized PA or sports were primarily associated with positive [children's] perceptions of PAP, a significant amount of the perceived coercive, forceful, and disruptive parental behaviors is related to sports participation, as manifested in involuntariness, shame, embarrassment, and even humiliation," authors write. "Additionally, some children perceived coercive control in relation to co-participation in PA or sports with family members." (Environmental Research and Public Health, March 30, 2020)