Rehabilitation Matters

Posts in this category are not easily categorised! They will cover any aspect of rehabilitation and a range of topics peripheral to rehabilitation, matters that should be discussed and considered but may not be – yet.

Community Rehabilitation

In 1980 I started a three-year project, a large (n = 700+) controlled clinical trial investigating whether a community stroke rehabilitation team would reduce the use of hospital resources. My results found no effect. Twenty years later, I was still interested in community rehabilitation and, with Pam Enderby, published the results of a survey she …

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Frailty and rehabilitation

Is frailty a helpful concept within the rehabilitation context? I asked myself this question after seeing a recent paper on people with multiple sclerosis that concluded that there was “a significant relationship between frailty and history of falls in multiple sclerosis, independent of age, sex, and disease severity.” Frailty is widely used but without a …

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Rehabilitation potential

What is a person’s ‘Rehabilitation Potential’? Often this question is asked by one clinician of another about a patient. Still, there is a second interpretation, “What do we mean by Rehabilitation Potential when we ask that question?” I will discuss these questions, but before doing so, I will consider two further crucial questions, “Can we, …

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Consciousness – cause and effect

Thinking about prolonged disorders of consciousness Consciousness implies awareness: subjective, phenomenal experience of internal and external worlds. Consciousness also implies a sense of self, feelings, choice, control of voluntary behaviour, memory, thought, language, and (e.g. when we close our eyes or meditate) internally-generated images and geometric patterns. But what consciousness actually is remains unknown. Our …

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A model of person-centred rehabilitation

This blog post is based on an extensive systematic review that generated a sound, theoretically-based model of person-centred rehabilitation. I can only develop some central themes and messages here. For more details, read the article. (here) The authors conclude that person-centred rehabilitation “is a way of thinking about and providing rehabilitation services “with” the person.” …

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Prolonged disorders of consciousness (PDOC); history and update.

The diagnosis and management of patients with prolonged disorders of consciousness is an area of expertise acquired by rehabilitation specialists starting in 1992 with the Bland case. There were few developments until 2010. Change accelerated, culminating in 2018 with a Supreme Court ruling that removed the requirement to involve the Court of Protection in every …

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Chronic non-malignant pain

A recent article stated, “It has long been established that phantom limb pain is a real physiological condition.” (here) This statement begs the question, “What limb pain is not real?” Yet many patients and many healthcare professionals still refer to a patient’s pain as being real, with a strong implication that to be real, there …

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Ready for discharge?

Is this patient ready for discharge? This question must be asked endlessly by care staff, managers, and sometimes the patient themselves. In this blog post, I will argue that it is the wrong question and that, by asking the wrong question without thought, we are failing to provide the best care to our patients. Moreover, …

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