575361
research-article2015
CRE0010.1177/0269215515575361Clinical Rehabilitation
CLINICAL REHABILITATION
Introductory paragraph
The main difficulty in evaluating rehabilitation interventions is not design or subject variability, but it is knowing and describing the intervention in a way that allows it to be replicated, and considering what is a suitable control in that context. In this issue the experience of people using a Nintendo Wii sports game attempting to improve on function after stroke is analysed, and unsurprisingly it is found that participants become engaged and undertake much practice. Therapy must be meaningful and fun. The second paper describes the problems of training people in a new intervention. The reasonably large randomised study found that training caregivers after stroke seemed to be associated with benefits, but a very large multicentre study did not confirm this. The paper in this issue describes the training, and considers why it may not have been effective. Relaxation therapy is another illdefined intervention, and a systematic review of its effectiveness or otherwise in people with fibromyalgia highlights the different meanings covered by the term. Several other studies in this issue evaluate treatments that are not easily described such as the Alexander technique, and virtual reality. In a large study of 120 people with visual impairment, half of whom were treated with the Alexander technique, no easily detected benefit was seen in terms of mobility or balance. However in a much smaller study of only 20 patients seen after stroke, stepping
Clinical Rehabilitation 2015, Vol. 29(3) 210 © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0269215515575361 cre.sagepub.com
exercises incorporated within a virtual reality environment may have improved balance; this certainly needs replication before being taken further. Two other evaluative studies investigated much more easily defined interventions, progressive resistive exercise and treadmill training. Perhaps unsurprisingly, in a study of 61 people after stroke, it was found that increasing the speed of the treadmill was associated with a more effective treatment in terms of the speed of normal gait after training. In a study of 60 women with osteoarthritis of the knee, progressive resistive exercise was associated with improvements. Constraint induced therapy is popular as a research topic, although whether it is popular with patients is another matter. It probably increases practice. An explorative pilot study has investigated its use in people with peripheral nerve injuries in the arm, and provides some evidence that it might be effective. Prevention should also be a concern of rehabilitation, and this issue contains a systematic review of factors that predispose individuals who have fractured a hip in a fall towards having a second hip fracture on the other side. The risk factors identified are unsurprising and relate to frailty and the general likelihood of falling. Finally there are nine abstracts from a meeting of the Dutch Congress of Rehabilitation Medicine illustrating the range of rehabilitation research occurring in that country.
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
CRE0010.1177/0269215515575361Clinical Rehabilitation
CLINICAL REHABILITATION
Introductory paragraph
The main difficulty in evaluating rehabilitation interventions is not design or subject variability, but it is knowing and describing the intervention in a way that allows it to be replicated, and considering what is a suitable control in that context. In this issue the experience of people using a Nintendo Wii sports game attempting to improve on function after stroke is analysed, and unsurprisingly it is found that participants become engaged and undertake much practice. Therapy must be meaningful and fun. The second paper describes the problems of training people in a new intervention. The reasonably large randomised study found that training caregivers after stroke seemed to be associated with benefits, but a very large multicentre study did not confirm this. The paper in this issue describes the training, and considers why it may not have been effective. Relaxation therapy is another illdefined intervention, and a systematic review of its effectiveness or otherwise in people with fibromyalgia highlights the different meanings covered by the term. Several other studies in this issue evaluate treatments that are not easily described such as the Alexander technique, and virtual reality. In a large study of 120 people with visual impairment, half of whom were treated with the Alexander technique, no easily detected benefit was seen in terms of mobility or balance. However in a much smaller study of only 20 patients seen after stroke, stepping
Clinical Rehabilitation 2015, Vol. 29(3) 210 © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0269215515575361 cre.sagepub.com
exercises incorporated within a virtual reality environment may have improved balance; this certainly needs replication before being taken further. Two other evaluative studies investigated much more easily defined interventions, progressive resistive exercise and treadmill training. Perhaps unsurprisingly, in a study of 61 people after stroke, it was found that increasing the speed of the treadmill was associated with a more effective treatment in terms of the speed of normal gait after training. In a study of 60 women with osteoarthritis of the knee, progressive resistive exercise was associated with improvements. Constraint induced therapy is popular as a research topic, although whether it is popular with patients is another matter. It probably increases practice. An explorative pilot study has investigated its use in people with peripheral nerve injuries in the arm, and provides some evidence that it might be effective. Prevention should also be a concern of rehabilitation, and this issue contains a systematic review of factors that predispose individuals who have fractured a hip in a fall towards having a second hip fracture on the other side. The risk factors identified are unsurprising and relate to frailty and the general likelihood of falling. Finally there are nine abstracts from a meeting of the Dutch Congress of Rehabilitation Medicine illustrating the range of rehabilitation research occurring in that country.
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.
