Is someone changed by their illness? Lily Gryspeerdt considers this question in a clinical and philosophical article. It should help you understand and help your patients.
"I Am Not My Self: Reconceiving Identity in Rehabilitation Medicine"
doi.org/10.1177/0269...
DW. An article discussing the Islamic view on starting, stopping, and refusing life-sustaining treatments. Interesting because it offers no easy answers, the situation that applies to all people of any faith and none. link.springer.com/article/10.1...
DW. This page expands on two Clinical Rehabilitation articles: doi.org/10.1177/0269... and doi.org/10.1177/0269..., which are on Rehabilitation Thinking and a General Theory of Rehabilitation.
DW. Intermittent hypoxia seems a counterintuitive treatment for incomplete spinal cord injury; some advocate hyperbaric oxygen. Yet a small trial provided data that certainly justifies further research.
doi.org/10.1177/0269...
DW. A new editorial argues that Rehabilitation Thinking is the crucial unifying factor seen in all types of rehabilitation and the primary factor responsible for its effectiveness. doi.org/10.1177/0269...
DW. Papers from a large trial of Acceptance and Commitment Therapy in people with Motor Neuron Disease (ALS in the US) are summarised in this paper; the therapy helped and should be targeted (see synopsis). njl-admin.nihr.ac.uk/document/dow... #neurorehabilitation
DW. A trial of a method to increase the use and effectiveness of group physiotherapy education, support, and exercise for people with osteoarthritis of the knee failed to alter outcomes. Implementing rehabilitation approaches remains a challenge. doi.org/10.1001/jama...
DW. Clinical Rehabilitation has made easily accessible collections of published papers on selected topics. The most recent covers health economic studies in rehabilitation. I was surprised how many we had published. journals.sagepub.com/topic/collec... #neurorehbiitation
DW. Healthcare is a competitive environment, and rehabilitation often struggles to compete for resources. An editorial suggests we are now showing health economic benefits, and we should use health economic outcomes much more. doi.org/10.1177/0269...
DW. Rehabilitation is a complex multifactorial process and many people and organisations are involved. Planning and coordination are integral to rehabilitation. A qualitative study asked, βIf I do not coordinate it, who else will?β. Surely, you should. doi.org/10.1080/0963... #neurorehabilitation
DW. A recent study found a difference in glutamate-type synaptic transmitter levels between people with long COVID cognitive impairment and healthy controls. This may be causal or a result of altered cognitive function. Not a readily available test! doi.org/10.1093/brai...
DW. Jeanne Hoffman et al undertook a huge randomised trial in 925 people with moderate/severe traumatic brain injury investigating added support for 6 months after discharge. Amazing follow-up success. Disappointing that no effect was detected. www.liebertpub.com/doi/pdf/10.1... #neurorehabilitation
DW. A useful study on predicting which individuals are likely to experience prolonged problems after a mild head injury. Unfortunately, statistically significant but not sufficiently specific to triage patients. bmjopen.bmj.com/content/15/9...
DW. Two vital aspects of rehabilitation are the professional-patient relationship and teaching self-management; a recent study investigated both, highlighting practical challenges. We must train therapists/nurses/doctors how to develop therapeutic relationships. doi.org/10.1177/0269... #neurorehab
DW. Are we too afraid to recommend more activity after stroke (and in most other conditions)? Gert Kwakkel thinks so; I agree. He has commented on a recent trial of increased walking exercise after stroke. A short, easy read: doi.org/10.1016/S147... #neurorehabilitation
DW. Practice improves function; this is a central tenet of rehabilitation. A recent trial demonstrates that a protocol to increase walking practice after stroke is effective. We must help patients practice independently without professional supervision. doi.org/10.1016/S147... #neurorehabilitation
DW. An updated Cochrane systematic review of virtual reality in stroke rehabilitation identified 190 trials; however, the evidence only allowed for weak conclusions. www.cochranelibrary.com/cdsr/doi/10..... Why was this? My editorial discusses reasons www.cochranelibrary.com/cdsr/doi/10.....
DW. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Ten years after publication, this article is 'trending' on Altimetric. Why such a delay? 2
doi.org/10.1177/0269...
DW. A new paper exploring the concept of financial capability in people with cognitive impairment, a significant issue in #neurorehabilitation. There are many ideas about what it is and how to assess it. doi.org/10.1177/0269... A Rehabilitation in Theory paper journals.sagepub.com/topic/collec...
When offered weekend speech therapy, patients valued the different, more social environment. We should pay more attention to a rehabilitation environment that facilitates adaptation and practice rather than direct therapy. pmc.ncbi.nlm.nih.gov/articles/PMC... #neurorehabilitation
DW. Technological aids in rehabilitation need as much research and evaluation for effectiveness and harm as drugs and other interventions. A study has evaluated an iPad programme to aid goal setting; this is the second evaluation, showing improvement from the first. st
doi.org/10.1177/0269...
DW. Self-rehabilitation is practising and adapting without a professional present; it typically follows advice from a professional. A systematic review finds individual practice as effective as practising with a therapist. doi.org/10.1177/1545... This is part of adaptation doi.org/10.1177/0269...
DW. We fail to identify most people who are unable to make sound healthcare decisions. Routine screening might be helpful if it is simple and short. The Mental Capacity Screening Assessment Tool (MCScreen) should be considered. doi.org/10.1016/j.cl... #neurorehabilitation
DW. This randomised trial of exoskeletons for people with spinal cord injury is impressive, with two weaknesses: unequal allocation (68v47) despite block allocation, and selective loss from the control arm. However, there was no difference between the groups. doi.org/10.1016/j.ap... #neurorehab
DW. Does 'cognitive retraining' after stroke have an impact on functional activities? Probably not. The evidence is suggestive, not conclusive. doi.org/10.1177/0269... Task-specific training is likely more effective. #neurorehabilitation
DW. Non-pharmacological treatment for depression after stroke would avoid the cognitive side effects of drugs, if it helps. A systematic review identifies many techniques tried, but the evidence base is too small to enable any recommendation.
doi.org/10.1177/0269...
DW. An observational study in Canada suggests that delays in providing wheelchairs to patients who need them may increase length of stay. The delays were between 1 and 9 days. The UK would have a bigger delay and should replicate this. doi.org/10.1016/j.ap... #neurorehabilitation
DW. The classification of traumatic brain injury severity has been based on the initial Glasgow Coma Scale score for decades. It was simple and applied widely, A new system has been developed. I suspect it is too complex for general use. It focuses only on pathology. doi.org/10.1016/S147...
DW. A significant study on somatic symptoms following concussive head injury. Suggests that psychological factors are a significant contributing factor. doi.org/10.1097/HTR....
DW. People with a prolonged disorder of consciousness have lost extensive networks that underlie consciousness. Surprisingly, repetitive transcranial magnetic stimulation (rTMS) may increase recovery; a randomised trial in 48 people suggests it may. doi.org/10.1016/j.ni... It may simply speed change
