Historically, the institution has focused on neurology and the outcome measures included in this website reflect the expertise and experience of its creators, with a heavy weighting towards neurological conditions. For example, there is information about more than 70 instruments for use with stroke patients. Spinal cord
injury and traumatic brain injury instruments are being added currently. The website creators plan to expand the database substantially to include other conditions over the next few years. There are some idiosyncratic kinks to work out. For example, I couldn’t get the audio to work on any of the computers I used to access the ‘tour’ feature of the TGF-beta pathway website. Overall, however, the creators should be proud of their clinical contribution with this electronic resource. There are a number of reasons that there are no good, modern textbooks on outcome INCB018424 price measures: first, the information is fluid and the change outpaces a static information source such as a textbook; and second, the work involved in creating the outcomes depository is daunting. I recommend that clinicians investigate the site and evaluate its possible contribution to this critical aspect of clinical practice. “
“Lisa Harvey and colleagues have made a major contribution to the rehabilitation of spinal cord injuries so it is a pleasure to have a chance to engage with them in a discussion
of some aspects of their paper (Harvey et al 2011). The aim of this study was to investigate whether people with recently acquired paraplegia benefit from an intensive motor training program aimed at improving unsupported sitting.
All subjects undertook standard much inpatient rehabilitation that included physiotherapy and occupational therapy training for transfers, wheelchair skills, dressing, and showering. Experimental subjects received three additional 30 min sessions per week for 6 weeks, of exercises directed at improving the ability to sit unsupported. At the end of the study both experimental and control participants had improved. However, there were no significant differences between the groups rendering, in the authors’ opinion, the additional training redundant. The results of this study raise some interesting questions about the specificity of exercises and training in motor learning and in the acquisition of skill; in particular, can one expect exercises aimed at improving specific movements (eg, Fig 1, Harvey et al 2011) to generalise into improved performance of complex functional tasks such as dressing, showering, brushing teeth, and wheelchair skills? The history of specificity studies tells us this may not occur unless the action being trained has similar biomechanical characteristics to the activity to be learned. This issue is of some importance for physiotherapists in many fields of neurorehabilitation.