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Measurement in rehabilitation - Rehabilitation Matters

Derick Wade @derickwaderehab.bsky.social · 24d

I talk about measurement in rehabilitation, and use a non-psychometric approach that explains what validity and reliability (repeatability) are and why they are needed. I also discuss the vital importance of knowing what you want to know and why. rehabilitationmatters.com/academic-reh... #neurorehab

Measurement in rehabilitation is crucial clinically, in service improvement, & in research. The data collection tool defines validity & influences repeatability

The prognostic value of a screening tool for psychological risk factors after mild traumatic brain injury: prospective studies in Canada and New Zealand

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Derick Wade @derickwaderehab.bsky.social · 24d

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... #neurorehabilitation

Objective To investigate the prognostic value of the Subgroups for Targeted Treatment (STarT) Screening Tool adapted for concussion (STarT-C) on persistent symptoms and disability at 6–9 months follow...

bmjopen.bmj.com

Derick Wade @derickwaderehab.bsky.social · Aug 24

Biomedical healthcare dominates all health discussions. Rehabilitation uses a biopsychosocial model,. We should refer to biopsychosocial healthcare, joining with psychiatry, palliative care, geriatrics etc. The MindMap compares them. Comments? #neurorehabilitation

Biomedical and biopsychosocial healthcare compared.

Derick Wade @derickwaderehab.bsky.social · Jul 21

Therapeutic relationships are crucial in rehabilitation yet are understudied and scarcely taught or trained. Look at this study. #neurorehabilitation

Clinical Rehabilitation @clinicalrehab.bsky.social · Jul 21

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

Sage Journals: Discover world-class research

Subscription and open access journals from Sage, the world's leading independent academic publisher.

Derick Wade @derickwaderehab.bsky.social · Jul 21

Professional rehabilitation should be less cautious about exercise after stroke and should encourage patients to be active++

Clinical Rehabilitation @clinicalrehab.bsky.social · Jul 21

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

Virtual reality for stroke rehabilitation - Laver, KE - 2025 | Cochrane Library

Derick Wade @derickwaderehab.bsky.social · Jul 15

Virtual reality appears to be a promising approach for rehabilitation. But a new Cochrane systematic review of 190 trials only found weak evidence. www.cochranelibrary.com/cdsr/doi/10..... I have discussed some reasons for this in an editorial. www.cochranelibrary.com/cdsr/doi/10..... #neuroreab

Select your preferred language for Cochrane reviews and other content. Sections without translation will be in English.

www.cochranelibrary.com

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Derick Wade @derickwaderehab.bsky.social · Jul 7

Should speech therapists attend inpatient rehabilitation services at weekends? Patients are equivocal, with a greater interest in increasing social interaction and support. This emphasises the crucial role of a rehabilitation environment, in contrast to therapy. pmc.ncbi.nlm.nih.gov/articles/PMC...

Speech and Language Therapy Weekend Service in Inpatient Rehabilitation: A Qualitative Study Exploring Perspectives of People With Stroke

An allied health weekend service in subacute inpatient stroke rehabilitation can improve patient and organisational outcomes. However, there is insufficient evidence to justify the role of a speech an...

pmc.ncbi.nlm.nih.gov

Derick Wade @derickwaderehab.bsky.social · Jun 6

I am interested in rehabilitation expertise and what ALL professionals should know to be an expert; only doctors have validated training as an addition to medical training. I have a section on my site. I have just updated the entry page. rehabilitationmatters.com/academic-reh... #neurorehabilitation

Rehabilitation expertise - Rehabilitation Matters

Defining rehabilitation expertise is best achieved using high-level training outcomes, capabilities in practice, covering professional behaviours and expertise.

Capability 5: complexity and uncertainty - Rehabilitation Matters

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Derick Wade @derickwaderehab.bsky.social · Jun 3

I have started revising the capabilities needed by a rehabilitation expert, managing complexity and uncertainty is the first. rehabilitationmatters.com/academic-reh... It includes behaviours, attitudes, knowledge and skills with practical suggestions. #neurorehabilitation

Managing complexity and uncertainty is crucial because both are central features of rehabilitation and the expert will freely acknowledge both to the patient.

UKROC database - Rehabilitation Matters

Derick Wade @derickwaderehab.bsky.social · May 30

The UKROC (UK Rehabilitation Outcomes Collaborative) database has collected data on thousands of inpatients and is as a goldmine. I wrote the first version of my page about it in 2021; I have updated it regularly, including today (30 May); visit rehabilitationmatters.com/rehabilitati... to see it.

The UKROC database collected data using FIM+FAM from most specialist rehabilitation inpatient units from 2011. Analysis of data has altered clinical practice.

Rehabilitation and education; a useful analogy? - Rehabilitation Matters

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Derick Wade @derickwaderehab.bsky.social · May 30

Rehabilitation is essentially an educational service? This page on my website explores the analogy and suggests that adopting this perspective could enhance our approach. rehabilitationmatters.com/patient-publ... #neurorehabilitation

Comparing rehabilitation with education helps understanding; both should be available whenever people need help. Rehabilitation has more person-centred goals.

PDOC: an introduction and history. - Rehabilitation Matters

Derick Wade @derickwaderehab.bsky.social · May 30

Prolonged disorders of consciousness (PDOC) arise rarely in most medical services, and no one knows much about them. There is guidance. For an alternative, giving background history and covering areas of interest, start here: rehabilitationmatters.com/clinical-reh... #neurorehabilitation

PDOC, an introduction and history introduces Prolonged Disorders of Consciousness (PDOC) apges. History explains why many terms exist, such as vegetative state

British Society of Physical and Rehabilitation Medicine - Rehabilitation Matters

Derick Wade @derickwaderehab.bsky.social · May 30

The British Society of Physical and Rehabilitation Medicine is the UK's specialist rehabilitation medical society with other professions represented in it. You may read about it here rehabilitationmatters.com/rehabilitati... The page covers its history and lists all its publications

British Society of Physical and Rehabilitation Medicine (BSPRM) represents UK doctors involved in rehabilitation, and includes The Clinical Post-COVID Society.

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Reposted by Derick Wade

Clinical Rehabilitation @clinicalrehab.bsky.social · May 27

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

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Home Page - Rehabilitation Matters

Derick Wade @derickwaderehab.bsky.social · May 26

I have just summarised the one new page, two new posts, and a page revision on my website over the last six weeks. rehabilitationmatters.com#new-stuff #neurorehabilitation

Rehabilitation Matters is an evangelical, informative site covering all aspects of rehabilitation including patient experience, training, and stimulating ideas.

PDOC: emergence - Rehabilitation Matters

Reposted by Derick Wade

Derick Wade @derickwaderehab.bsky.social · May 26

What distinguishes a prolonged disorder of consciousness (PDOC) from having emerged out of that state, where is the boundary on the consciousness spectrum? Following a command is, surprisingly, within PDOC. Read more here rehabilitationmatters.com/clinical-reh... #neurorehabilitation

Emergence from PDOC (a prolonged disorder of consciousness) requires complex, purposeful behaviours that are consistent and repeated whenever the eyes are open

PDOC: emergence - Rehabilitation Matters

Derick Wade @derickwaderehab.bsky.social · May 26

What distinguishes a prolonged disorder of consciousness (PDOC) from having emerged out of that state, where is the boundary on the consciousness spectrum? Following a command is, surprisingly, within PDOC. Read more here rehabilitationmatters.com/clinical-reh... #neurorehabilitation

Emergence from PDOC (a prolonged disorder of consciousness) requires complex, purposeful behaviours that are consistent and repeated whenever the eyes are open

Derick Wade @derickwaderehab.bsky.social · May 24

This new TBI classification is driven by specialists working in well-resourced centres, interested mainly in brain damage. I cannot be applied widely. Classification of TBI after one week must consider symptoms (e.g. post-concussion) & disability as damage is of limited value. #neurorehabilitation

Clinical Rehabilitation @clinicalrehab.bsky.social · May 24

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...

Derick Wade @derickwaderehab.bsky.social · May 19

This study (below) of rTMS in unconscious people is small, started at 9 weeks after onset, in a population mainly with traumatic brain injury. It needs replication and long-term follow up to establish if it increases amount of recovery, or just is speed. #neurorehabilitation

Clinical Rehabilitation @clinicalrehab.bsky.social · May 19

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

Disease, illness, sickness, and disability - Rehabilitation Matters

Derick Wade @derickwaderehab.bsky.social · May 6

Malady could be a useful, non-specific, non-judgmental word for all types and combinations of disease, illness, disability, sickness, psychologically-based problems etc. See rehabilitationmatters.com/disease-illn... A Malady is when the person is not in equilibrium.

Disease, illness and sickness are three words often used interchangeably causing misunderstanding. Disease is 'objective', illness personal, and sickness social

Holistic rehabilitation thinking - 2 - Rehabilitation Matters

Derick Wade @derickwaderehab.bsky.social · May 5

Holistic rehabilitation thinking is my second post on rehabilitation thinking; I have just published it. rehabilitationmatters.com/holistic-reh... I hope it will help you reframe your approach, making it more interesting and individualised to your patient.

Holistic rehabilitation thinking is crucial for person-centred rehabilitation. It is based on the biopsychosocial model & the general theory of rehabilitation

Rehabilitation thinking - 1 - Rehabilitation Matters

Derick Wade @derickwaderehab.bsky.social · May 5

Rehabilitation thinking is our most powerful yet hidden and unacknowledged strength; it underlies our great success in spinal cord injury, stroke, and much else. My first (of two) posts on the topic has now been published. rehabilitationmatters.com/rehabilitati...

Rehabilitation thinking is holistic and its greatest unacknowledged strength, the basis of its unrecognised success with spinal cord injury, stroke, etc.

Derick Wade @derickwaderehab.bsky.social · May 4

A novel, non-surgical non-pharmacological treatment for chronic pain: EEG entrapment. A well-designed study was conducted on 24 people with fibromyalgia. It is feasible; pilot study data consistent with short-term benefit. Further trials are essential. doi.org/10.1016/j.jp... #neurorehabilitation

Disease, illness, sickness, and disability - Rehabilitation Matters

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Derick Wade @derickwaderehab.bsky.social · May 1

"Disease, disability, sickness and illness" is a popular page on my website; I have just updated it. rehabilitationmatters.com/disease-illn... #neurorehabilitation

Disease, illness and sickness are three words often used interchangeably causing misunderstanding. Disease is 'objective', illness personal, and sickness social