What Doesn't Work II
PETE: Here’s one for you...acupuncture may not be helpful for improving functional ambulation, spasticity and activities of daily living for the lower extremity. Again we’re still talking about the lower extremity. Here’s one that may not surprise you...Neuro Aid may not be beneficial for improving stroke severity
DEB: Huh! That’s interesting. It made it in here, into the EBRSR
PETE: Yeah. How about this one? Stimulants may not be beneficial for improving motor function. Do you remember when stimulants were all the rage for people with brain injury because it was thought that they would somehow get better if they had...what’s the big one again?
DEB: oh Adderall yeah... Ritalin’s the one that I seem to remember somebody talking about a lot at the hospital
PETE: For brain injury recovery?
DEB: I think so because it was a stroke center
PETE: How about this one...have you ever heard of wholebody vibration?
PETE: Yeah? Wholebody vibration may not be beneficial for improving balance, functional ambulation, and muscle strength. How ‘bout them apples?
DEB: How ‘bout them apples?
DEB: Is that going to come up again in what does work?
PETE: That’s a good question because I know for acupuncture there are some things where it does work
DEB: Yeah...I do too.
PETE: You can have that. You can have stuff that doesn’t work for one thing but where it works for another. Yeah, absolutely
DEB: Maybe we should’ve done a comparison what does this intervention work for, what doesn’t it work for?
PETE: That is the third one...so we have what doesn’t work, what does work and what’s the comparison for things that do work and don’t work and when do they work and not work? This is a lot of work!
EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified, Pete and Deb talk about more of What Doesn’t Work. We discovered:
- There’s mixed evidence around bilateral training
- How clinical reasoning works and why it’s important in the rehab process
- The literature is mixed about music therapy, telerehabilitation, arm/shoulder robotics for arm recovery
- Neuro Aid engages in shady practices and it may not improve spasticity
- Research supports that recovery does NOT occur from proximal to distal – it is indeed a myth!
- Yet again the importance of bringing meaning into recovery
- Acupuncture, Botox, exoskeleton systems, whole body vibration and stimulants may not be effective for lower extremity recovery
- It’s important to look closely at evidence available for treating spatial neglect
- That hyperbaric oxygen therapy isn’t effective for stroke recovery
Pete and Deb infuse clinical reasoning and stories into this interesting conversation about stroke and brain injury interventions that don’t work. People who have experienced stroke or brain injury are smart. They are also in a vulnerable space and may be susceptible to being taken advantage of. This why all of us, survivors, caregivers and healthcare providers must do our research to ensure they receive high quality interventions that work.
As always, we want to hear your top takeaways!
LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:
- Bennet, M., Weibel, S., Wasiak, J., Schnabel, A., French, C., & Kranke, P. (2014). Hyperbaric oxygen therapy for acute ischemic stroke. Cochrane Review
- Bordoloi, K., & Deka, R. Scientific Reconciliation of the Concepts and Principles of Rood Approach. International Journal of Health Sciences and Research
- EBRSR Chapter 10: Upper Extremity Motor Interventions
- Stroke Engine:
- AOTA & Choosing Wisely
- Neuroaid: Partial Truth and Petty Theft
- Stroke and Hyperbaric Oxygen Therapy
- Stem Cell Treatment Available in China I
- Stem Cell Treatment Available in China II
Questions and Comments about the podcast: NogginsAndNeurons@gmail.com
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- Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT's Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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