Recommendations around falls prevention, physical activity, and obesity prevention are among the topics covered in the latest edition of the US Preventive Services Task Force (USPSTF) Guide to Clinical Preventive Services, which grades preventive services based on the "net benefit" to the patient.
The new guide contains USPSTF recommendations released over the past 10 years on screenings for conditions such as breast cancer, cognitive impairments, osteoporosis, and carotid artery stenosis, but also includes recommendations around interventions and counseling on falls in community-dwelling older adults, diet and physical activity in adults and children, and obesity in all age groups. According to USPSTF, the recommendations are intended to be the result of evaluations "free from the influence of politics, special interests, and advocacy."
While none of the preventive services most strongly related to physical therapy received an A grade, falls prevention in community-dwelling older adults (65 and older) is most strongly supported, with the recommended intervention of "exercise or physical therapy and/or vitamin D supplementation" receiving a B, indicating "high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial."
Also receiving a B grade were screening and management of obesity in adults and children. The guide gave "healthful diet and physical activity" a C rating, but limited its discussion to the effectiveness of behavioral counseling interventions at the primary care level, and not through referral or linkages with community-based programs. The guide notes that "the correlation among healthful diet, physical activity, and the incidence of cardiovascular disease is strong."
According to USPSTF, the guide and grading system evolved "as it has become widely recognized that some 'preventive' services were not actually beneficial. Individual health care providers, professional organizations, [and other health care stakeholder groups] … have recognized the need to carefully balance potential benefits and harms using the highest quality evidence."
Prevention, wellness, and disease management figure heavily into APTA's priorities for physical therapy. As part of its effort to highlight the ways in which physical therapists (PTs) can have a positive impact on these issues, the APTA Board of Directors recently identified specific health priorities that are consistent with the United States National Prevention Strategy. These priorities include active living, injury prevention, and secondary prevention in chronic disease management. The association also provides extensive resources on these topics at its prevention, wellness, and disease management webpage, and has representatives on the board of the National Physical Activity Plan Alliance.
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