Abstract
Communication is a central skill in rehabilitation. Really? A study of notes relating to patient communication show serious weaknesses in our communication. The ‘writing disabled people writing about the disabled’? We need to identify ineffective (and harmful) treatments as quickly as possible. Mirror therapy has been a popular research topic (along with imagery) and treatment over the last 10 years. Larger trials (still not very big; n = 40) raise questions about effectiveness. Laser therapy sounds good to patients. But also seems ineffective for subacromial impingement syndrome pain (n = 46). An interesting controlled trial in people with liver transplants (n = 45 – seems a large number to me) showed that neuromuscular stimulation of quadriceps reduced loss of muscle mass; no functional benefit detected, but numbers were quite small . A very large study (n = 197) of pre-operative inspiratory muscle training before cardiac surgery showed that it reduced later pulmonary complications and probably reduced length of stay. Another new treatment (to me; it is not available in the United Kingdom) for persistent hand oedema seemed successful in a trial of 60 people. Systematic reviews can reduce some risks associated with small trials – but not publication bias – and one in this issue investigated kinesiotaping (another popular treatment) for myofascial pain syndrome (seems effective). A second review of 42 trials (1168 patients) of repetitive transcranial magnetic stimulation after stroke found evidence of benefit. And a third systematic review, also of a treatment for stroke patients, found sensory retraining may improve sensory function (but insufficient numbers to know if hand function benefitted). Accelerometers are used to quantify activity; a study investigated whether bodily placement matters and suggests, as one might expect, that an ankle gives better data. Studies on rehabilitation after trauma are becoming more common, and bigger, and much trauma is musculoskeletal. A Short Musculoskeletal Function Assessment (in Dutch in this case) was found to be reliable and sensitive to change. Good. Last, another paper in our Rehabilitation in Practice series, describing a treatment for people with impaired social cognition after traumatic brain injury, is published here, and a letter comments on manual therapy for carpal tunnel syndrome.