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DW. A paper confirming considerable behavioural variability in people with a prolonged disorder of consciousness. It is more common if aroused, and mostly affects the motor function of Coma Recovery Scale - Revised. Consciousness fluctuates. doi.org/10.1016/j.apmr…

DW. Trials on the development and implementation of complex rehabilitation interventions are challenging. This trial concerned psychological therapy for people who had had a stroke. I hope a larger trial is funded, because psychological input may help. mdpi.com/2227-9032/13/7…

DW. We published some data from the RETAKE vocational rehabilitation trial. doi.org/10.1177/026921… A detailed analysis of some case studies highlights aspects of the intervention worth further study. ncbi.nlm.nih.gov/books/NBK61314… An opportunity for a new trial?!

DW. A large trial of vocational rehabilitation after stroke found no difference compared to standard UK practice. Disappointing, but failure allows learning (see previous tweets). The response must be to develop and evaluate better interventions. 4 doi.org/10.1177/174749…

DW I advocate short, simple measures, especially for audit and research, because they facilitate the collection of data from all participants. The AMPSIMM-4 paper on a simple mobility measure after amputation illustrates how to improve a good measure. doi.org/10.1177/026921…

DW. We fail to use meals as an active rehabilitation intervention combining many skills with social benefits. This qualitative study of breakfast clubs in a nursing home exposes several avenues for all residential or day units including lunch to explore. doi.org/10.1177/026921…

DW. A meta-analysis comparing group and individual therapy for the affected arm after stroke found no difference (currently a weak conclusion). But we should also investigate broader psychological and social effects, and cost-effectiveness. doi.org/10.1177/026921…

DW A paper on whether people with a prolonged disorder of consciousness (PDOC) feel pain supports a 1991 paper in saying, 'yes, probably'. journals.sagepub.com/doi/10.1177/02…

DW. Enablement theory (doi.org/10.1016/j.apmr…) underlies the analysis of clinical rehabilitation data within the holistic biopsychosocial model of illness. (doi.org/10.1177/026921…) Treatment theory is sometimes separated, but the two are completely interwoven.

DW. A novel, non-surgical non-pharmacological treatment for chronic pain: EEG entrapment. A well-designed study was conducted on 24 people with fibromyalgia. It is feasible; further trials are essential. doi.org/10.1016/j.jpai…

DW. Patient education may improve outcomes if (a) education succeeds and (b) the learned knowledge leads to action that helps. A trial of education about osteoarthritis gave information but had no clinical effect. Maybe surgery is needed to reduce pain. doi.org/10.1016/j.pec.…

DW. A significant study on somatic symptoms following concussive head injury. Suggests that psychological factors are a significant contributing factor. doi.org/10.1097/HTR.00…

DW. The classification of traumatic brain injury severity has been based on the initial Glasgow Coma Scale score for decades. It was simple and applied widely, A new system has been developed. It is too complex for general use. It only considers pathology. doi.org/10.1016/S1474-…

DW. An observational study in Canada suggests that delays in providing wheelchairs to patients who need them may increase length of stay. The delays were between 1 and 9 days. The UK would have a bigger delay and should replicate this. doi.org/10.1016/j.apmr…

DW. Non-pharmacological treatment for depression after stroke would avoid the cognitive side effects of drugs, if it helps. A systematic review identifies many techniques tried, but the evidence base is too small to enable any recommendation. doi.org/10.1177/026921…

DW. Does 'cognitive retraining' after stroke have an impact on functional activities? Probably not. The evidence is suggestive, not conclusive. doi.org/10.1177/026921… Task-specific training is likely more effective.

DW. This randomised trial of exoskeletons for people with spinal cord injury is impressive, with 2 weaknesses: unequal allocation (68v47) despite block allocation, & selective loss from the control arm. However, there was no difference between the groups. doi.org/10.1016/j.apmr…

DW. We fail to identify most people unable to make sound healthcare decisions. Routine screening might help if simple and short. The Mental Capacity Screening Assessment Tool (MCScreen) should be considered. doi.org/10.1016/j.clin…

DW. Self-rehabilitation is practising and adapting without a professional present; it typically follows advice from a professional. A systematic review finds individual practice as effective as practising with a therapist. doi.org/10.1177/154596…

DW. Technological aids in rehabilitation need as much research & evaluation for effectiveness & harm as drugs & other interventions. A study evaluated an iPad programme to aid goal setting; this is the second evaluation, showing improvement from the first doi.org/10.1177/026921…