583390
research-article2015
CRE0010.1177/0269215515583390Clinical Rehabilitation
CLINICAL REHABILITATION
Introductory paragraph
Rehabilitation research is, justifiably, often criticized for not describing accurately what actually occurs in treatment. We publish the Rehabilitation in Practice articles to overcome this, and this issue gives a ‘how to do it’ description of a balance training programme for the elderly; it has been shown to be effective. Another criticism is that people giving therapy do not follow the protocol or method used. A future paper may show that most interventions for improving memory are not even described, but in this issue the research team of a published study give data to show that the protocol was followed, and that adherence was maintained suggesting that it could be used more generally. Some specific treatments are, of course, reasonably easy to define and use. A study on a multi-axial shoulder abduction splint for use with people with burns in the shoulder area showed a definite benefit. Burns are usually accidental. People receiving rehabilitation after road accidents in Australia get specially supported rehabilitation and the providers are assessed using patient satisfaction surveys. A large study found that satisfaction with the service was worse in people who blamed another person for the accident. This, of course, is not unexpected when analysed within the biopsychosocial framework. A study from Canada investigating factors influencing mobility within the community also highlights the multitude of factors that influence it - as one would
Clinical Rehabilitation 2015, Vol. 29(5) 416 © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0269215515583390 cre.sagepub.com
expect. Many of the factors are unrelated to the traditional targets of ‘walking therapy’. A systematic review of studies of recovery after hip arthroplasty found, interestingly, that disease factors were most strongly associated with length of stay; this is not what I would have anticipated. However it is consistent with the findings of a second systematic review in this issue, which found that preoperative therapy to improve respiratory function benefited patients by reducing complications. The number of patients involved was small, and length of stay was shorter, but not statistically significantly so. Further research is needed! Increasing numbers of studies of post-operative rehabilitation show benefits, but a large study here failed to find any benefit from an additional exercise programme after shoulder surgery. Some interventions seem, at first sight unlikely to help especially given the evidence that to improve an activity one should practice it. Yet it seems that practicing walking backward improves balance and possibly forward walking - in this study in children, but similar results have been found in adults. Finally I am a great believer in shortening and simplifying measures (and everything else, including papers submitted to this journal!). A study on the Berg Balance scale suggests that on a group basis, shortening is satisfactory but in clinical practice with individual patients, the whole test is more sensitive.
Copyright of Clinical Rehabilitation is the property of Sage Publications, Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
research-article2015
CRE0010.1177/0269215515583390Clinical Rehabilitation
CLINICAL REHABILITATION
Introductory paragraph
Rehabilitation research is, justifiably, often criticized for not describing accurately what actually occurs in treatment. We publish the Rehabilitation in Practice articles to overcome this, and this issue gives a ‘how to do it’ description of a balance training programme for the elderly; it has been shown to be effective. Another criticism is that people giving therapy do not follow the protocol or method used. A future paper may show that most interventions for improving memory are not even described, but in this issue the research team of a published study give data to show that the protocol was followed, and that adherence was maintained suggesting that it could be used more generally. Some specific treatments are, of course, reasonably easy to define and use. A study on a multi-axial shoulder abduction splint for use with people with burns in the shoulder area showed a definite benefit. Burns are usually accidental. People receiving rehabilitation after road accidents in Australia get specially supported rehabilitation and the providers are assessed using patient satisfaction surveys. A large study found that satisfaction with the service was worse in people who blamed another person for the accident. This, of course, is not unexpected when analysed within the biopsychosocial framework. A study from Canada investigating factors influencing mobility within the community also highlights the multitude of factors that influence it - as one would
Clinical Rehabilitation 2015, Vol. 29(5) 416 © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0269215515583390 cre.sagepub.com
expect. Many of the factors are unrelated to the traditional targets of ‘walking therapy’. A systematic review of studies of recovery after hip arthroplasty found, interestingly, that disease factors were most strongly associated with length of stay; this is not what I would have anticipated. However it is consistent with the findings of a second systematic review in this issue, which found that preoperative therapy to improve respiratory function benefited patients by reducing complications. The number of patients involved was small, and length of stay was shorter, but not statistically significantly so. Further research is needed! Increasing numbers of studies of post-operative rehabilitation show benefits, but a large study here failed to find any benefit from an additional exercise programme after shoulder surgery. Some interventions seem, at first sight unlikely to help especially given the evidence that to improve an activity one should practice it. Yet it seems that practicing walking backward improves balance and possibly forward walking - in this study in children, but similar results have been found in adults. Finally I am a great believer in shortening and simplifying measures (and everything else, including papers submitted to this journal!). A study on the Berg Balance scale suggests that on a group basis, shortening is satisfactory but in clinical practice with individual patients, the whole test is more sensitive.
Copyright of Clinical Rehabilitation is the property of Sage Publications, Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
