The Effect of Hypnotic Suggestion on Cognition, Sleep, Patient-Reported Outcomes, and Insight following Acquired Brain Injury

What is the downside of doing this before the additional RCT is never performed? 

The Effect of Hypnotic Suggestion on Cognition, Sleep, Patient-Reported Outcomes, and Insight following Acquired Brain Injury

The Effect of Hypnotic Suggestion on Cognition, Sleep, Patient-Reported Outcomes, and Insight following Acquired Brain Injury Hypnosis has been successfully applied in neurorehabilitation, including for motor disorders, aphasia, pain, and vertigo. However, cognitive rehabilitation using hypnosis has received little attention. Here, we report the data from two such studies on patients with chronic cognitive sequalae following acquired brain injury. Eight sessions of hypnotic suggestion yielded large effects on WAIS working memory (d = 1.65), progress on 87% of patient-reported outcomes, and four sessions reduced the need for sleep and rest with a median of 55 minutes per day. An exploratory factor analysis showed no relationship between objective improvements and perceived improvements, indicating large individual differences in the structure of the perceived improvements. This, in turn, indicate that subjective reports following hypnotic suggestion should be interpreted with caution. No adverse effects have been observed in these experiments or reported in the literature. Based on our findings and converging evidence from the literature, we conclude that hypnotic suggestion is a promising method in cognitive neurorehabilitation following acquired brain injury. However, the mechanism is currently unknown. We argue that it should be regarded as experimental until at least one further high-quality RCT is published. Data and analysis script are available at https://osf.io/sz6bw/ .

Effects of Robot-Assisted Therapy for the Upper Limb After Stroke A Systematic Review and Meta-analysis

And yet we still have no one writing up a stroke protocol on this. A great stroke association president would be making sure at the very least a draft protocol would be written up. It could then be critiqued and updated as necessary. But since we have fucking failures of stroke associations something as simple as this will never occur under current lack of leadership. We don't have stroke leaders because leaders actually tackle the difficult problems, they don't run away and just produce press releases. 

Effects of Robot-Assisted Therapy for the Upper Limb After Stroke A Systematic Review and Meta-analysis

1. Janne M. Veerbeek, PhD1,2,3⇑
2. Anneli C. Langbroek-Amersfoort, MSc4
3. Erwin E. H. van Wegen, PhD1,2,3
4. Carel G. M. Meskers, PhD, MD1,2,3,5
5. Gert Kwakkel, PhD1,2,3,5,6

1. ¹MOVE Research Institute Amsterdam, VU University Amsterdam, Amsterdam, the Netherlands
2. ²Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
3. ³VU University Medical Center, Amsterdam, the Netherlands
4. ⁴Centrum voor Fysiotherapie, Eerstelijns Centrum Beatrixpark, Ede, the Netherlands
5. ⁵Northwestern University, Evanston, IL, USA
6. ⁶Amsterdam Rehabilitation Research Center, Reade, Amsterdam, the Netherlands

1. Janne M. Veerbeek, Department of Rehabilitation Medicine, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands. Email: j.veerbeek@vumc.nl

Abstract

Background. Robot technology for poststroke rehabilitation is developing rapidly. A number of new randomized controlled trials (RCTs) have investigated the effects of robot-assisted therapy for the paretic upper limb (RT-UL).  

Objective. To systematically review the effects of poststroke RT-UL on measures of motor control of the paretic arm, muscle strength and tone, upper limb capacity, and basic activities of daily living (ADL) in comparison with nonrobotic treatment.  

Methods. Relevant RCTs were identified in electronic searches. Meta-analyses were performed for measures of motor control (eg, Fugl-Meyer Assessment of the arm; FMA arm), muscle strength and tone, upper limb capacity, and basic ADL. Subgroup analyses were applied for the number of joints involved, robot type, timing poststroke, and treatment contrast.  

Results. Forty-four RCTs (N = 1362) were included. No serious adverse events were reported. Meta-analyses of 38 trials (N = 1206) showed significant but small improvements in motor control (~2 points FMA arm) and muscle strength of the paretic arm and a negative effect on muscle tone. No effects were found for upper limb capacity and basic ADL. Shoulder/elbow robotics showed small but significant effects on motor control and muscle strength, while elbow/wrist robotics had small but significant effects on motor control.  

Conclusions. RT-UL allows patients to increase the number of repetitions and hence intensity of practice poststroke, and appears to be a safe therapy. Effects on motor control are small and specific to the joints targeted by RT-UL, whereas no generalization is found to improvements in upper limb capacity. The impact of RT-UL started in the first weeks poststroke remains unclear. These limited findings could mainly be related to poor understanding of robot-induced motor learning as well as inadequate designing of RT-UL trials, by not applying an appropriate selection of stroke patients with a potential to recovery at baseline as well as the lack of fixed timing of baseline assessments and using an insufficient treatment contrast early poststroke.

The Bobath Concept/NDT: Clarifications and Context

Wow, The Bobath concept  is an individualised response-based treatment approach. Because of that it results in difficulty in investigating the Bobath concept using traditional experimental designs such as the Randomised Controlled Trial. What a crock, if you can't create a RCT then you have no basis in even using it for therapy. Apologists in force in this posting. I guess it is unprofessional to criticize Bobath, well shit, I'm not a medical professional so if you can't prove your stuff works then you can shove it. 

Hopefully you aren't using it - NDT(Bobath) anymore  in stroke rehab when it should have been shitcanned since 2003? Physiotherapy Based on the Bobath Concept for Adults with Post-Stroke Hemiplegia: A Review of Effectiveness Studies 2003)

The Bobath Concept/NDT: Clarifications and Context 

Point by point refutation here:
Thoughts on the BBTA’s thoughts

Methodological Quality of Motor Intervention Randomized Controlled Trials in Stroke Rehabilitation

Did this research tell us anything useful at all? In understandable English; What the hell was the reason behind doing this and the results?
http://www.strokejournal.org/article/S1052-3057%2815%2900510-8/abstract

Amanda McIntyre, RN, and MSc

,

Nerissa Campbell, PhD

,

Julianne Vermeer, MPH

,

Rachel Mays, BSc

,

Shannon Janzen, MSc

,

Robert Teasell, MD, FRCPC

Received: July 27, 2015; Received in revised form: September 15, 2015; Accepted: September 21, 2015; Published Online: October 20, 2015

Publication stage: In Press Corrected Proof

DOI: http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2015.09.024

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Purpose

The objective of the study was to evaluate the methodological quality of motor intervention randomized controlled trials (RCTs) published in the stroke rehabilitation literature and to examine trends in quality over time.

Methods

A systematic literature search was conducted for all English articles (published up to December 2013) examining rehabilitation for motor recovery poststroke. All RCTs with a human sample, of which at least 50% had a stroke, were included in the analysis. A Physiotherapy Evidence Database (PEDro) score was assigned to assess methodological quality. A one-way analysis of variance was conducted to examine adherence to quality items overall and over time, with post hoc t-tests performed where appropriate.

Results

Six hundred seventy-six RCTs met inclusion criteria, of which 32.0% had excellent, 42.0% good, 23.1% fair, and 3.0% poor methodological qualities. The overall mean PEDro score was 6.6 ± 1.6; with scores improving significantly between 1979-1983 and 2009-2013 (5.0 ± 1.4 versus 7.0 ± 1.5; P = .0003); however, no significant improvements in individual items were found (P > .05).

Conclusions

This study showed improvements in the total methodological quality of motor intervention RCTs in stroke rehabilitation over time.??? However, no relationship was found between individual quality items and improvement over time.

randomized controlled trial (RCT) - Run your own

You know the complaints about nobody knowing a damn thing about stroke recovery. Well here's your answer. Run your own trial and show it off to your research challenged neurologist.
http://www.randomiseme.org/
The blogger who created it talks about it here;

RandomiseMe: our fun new website that lets anyone design and run a randomised controlled trial.