Archives of PMR, October 2014
1810 Does home therapy with telerehabilitation improve shoulder pain related symptoms in wheelchair users with SCI? Do NOT read this paper to know the answer because they’ve done only a ‘before-after’ study, from which nothing useful can be inferred. Such (and many) interventions need an RCT design to prove usefulness. Should a placebo controlled RCT be done for Ebola vaccine too, in these crisis times? Yes but No. If keen to know how, read this
1838 Can MRI findings in acute brain injury predict which patients would later progress to a level of high functional walking? “No” was the inference from this longitudinal followup study of 65 persons with brain injury in Norway.
1903 I’m not a fan of using questionnaires as key outcome measures in clinical conditions. And I’m glad with the findings of this Spanish study. The authors evaluated whether questionnaires filled by persons with fibromyalgia to report their activity levels corroborated with actual activity recorded on the accelerometer carried by them for a week. “The (questionnaires) and the accelerometer differ greatly when assessing physical activity… Therefore, the self-administered (questionnaires) show questionable usefulness…to assess physical activity in fibromyalgia.”
Experitemental Eye Research, November 2014
Never believe a health news from any non-scientific media, my resolve is stronger now. “Viagra linked to blindness” cried out a prominently placed Google news item. Along with a tell-tale photo of a man who is apparently blind.
Since we routinely prescribe Sildenafil in SCI rehabilitation, I was intrigued and chased the link to the source journal article.
1. It was a report of an animal study,not humans.
2. Rats with mutations in Retinitis Pigmentosa gene,when given Sildenafil, showed reversible impairments in electroretinograms. They didn’t become blind.
Lesson: Never believe a health news from any non-scientific media.
Cell transplantation, October 2014
Lots of noise made by a BBC feature about a research that claims near miraculous improvement in one patient with spinal cord injury after receiving olfactory ensheathing cells treatment. The cells were taken directory from the olfactory bulb in the brain (contrast from cells derived from the nose reported in previous studies) and supplemented with a nerve graft across the injured spinal cord. Points to note: authors themselves indicate this is just a proof of concept study, and say “The results …are very encouraging, but have to be
confirmed in a larger group of patients…”. Lesson: Promising- yes. Euphoria- no. Let’s wait.
If in doubt, please read the original article (not media reports) Functional regeneration of supraspinal connections in a patient with transected spinal cord following transplantation of bulbar olfactory ensheathing cells with peripheral nerve bridging. It’s open access.
Practice tidbits
Are heparin-flushes worth the money? Cochrane review December 2013: “We found no conclusive evidence of important differences when heparin intermittent flushing was compared with 0.9% normal saline flushing for central venous catheter maintenance in terms of efficacy or safety. As heparin is more expensive than normal saline, our findings challenge its continued use in CVC flushing outside the context of clinical trials.”
Are electrical modalities useful in shoulder adhesive capsulitis? Cochrane Review May 2014: Low level laser has low level evidence that it could reduce pain for upto 1 month and improve functions for upto 4 months. No other modality has any reliable evidence.
If you’re having removal of lower wisdom tooth, should you take paracetamol or Ibuprofen for pain relief? Cochrane Review December 2013: “There is high quality evidence that ibuprofen is superior to paracetamol at doses of 200 mg to 512mg…The novel combination drug is showing encouraging results when compared to the single drugs.”
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Liked on twitter: “Integrity in research is like virginity- you can only lose it once” (Source: Twitter)
Rehab Journal Review 