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Case management has long been advocated for people with acquired brain injury despite two small RCTs failing to support it. A third large good study (n=219) has failed to find any detectable benefit. We must reconsider how we improve outcomes. doi.org/10.1080/026990…

Pain in people who are unconscious is a contentious matter (see Court of Appeal assets.caselaw.nationalarchives.gov.uk/ewca/civ/2024/…). Pain appreciation is personal, and therefore one should measure pain experienced with a known pain-inducing stimulus, usually muscle stretching. doi.org/10.3390/jcm131…

Virtual reality in rehabilitation is increasingly popular, researched, & reviewed. But what is it, & are systematic reviews potentially flawed because the treatments vary so much? I conclude that computer-assisted treatment would be a better term. rehabilitationmatters.com/virtual-realit…

Multi-item rehabilitation assessment questionnaires are ubiquitous, increasing patient burden and reducing treatment time. A simple question is considered OK (for fear after head injury). Diagnosis is a process, not the result of a questionnaire. bmcneurol.biomedcentral.com/articles/10.11…

Hope is the key to person-centred rehabilitation, is my latest blog post. Having an early discussion on 'What do you hope to be like in a year?' may elucidate goals, beliefs, and treatment expectations. I have made some practical suggestions. rehabilitationmatters.com/hope-is-the-ke…

I have posted a reflection on how I approach challenging cases when asked to give a second opinion. The basic message is to think and look more broadly; the team and patient become stuck on a minor issue (in the context of the patient's life). rehabilitationmatters.com/resolving-comp…

Over the last seven weeks I have added four posts to my website. You can read a brief introduction to recent changes and additions here: rehabilitationmatters.com/#new-stuff

Recovery, recuperation, and rehabilitation sound like three separate concepts. In a post, I show that their common feature is the adaptive response to illness. I suggest that recovery refers to a state & needs to be replaced by a process. rehabilitationmatters.com/recuperation-r…

How to ... provide a second opinion on someone's best interests on continuing medical treatment (e.g. gastrostomy) when they have a prolonged disorder of consciousness. My recent article emphasises that the report is educational and written for the family. pn.bmj.com/content/early/…

I am movingto BlueSky and will soon stop tweets here; in the interval I may tweet the same post in both. My bluesky handle is the same (Derick Wade) so it is easy

My latest blog post considers whether acquired brain injury is a helpful category in rehabilitation (or anywhere else); the answer is no. rehabilitationmatters.com/acquired-brain…

I now post on Bluesky using the same handle Derick Wade

Being an expert in prolonged disorders of consciousness leads to appearing in Court. I have written a blog post discussing the challenges. One must acknowledge uncertainty. Comments are welcome, as I will talk about it in 5 weeks. rehabilitationmatters.com/being-a-prolon…

A reminder: I am now mainly posting on BlueSky - same name. My latest blog post is here: rehabilitationmatters.com/prolonged-diso… I review how to improve services for people with a prolonged disorder of consciousness

I have seen 1500 or more people with prolonged disorders of consciousness (PDOC) since 1980; what have I learned?! That we have overlooked intrinsic variability within and between patients. We must improve our understanding of PDOC. rehabilitationmatters.com/pdoc-clinical-…

A further reminder; most of my posts are now on Bluesky; same name (Derick Wade)

A new page on service design for patients with a prolonged disorder of consciousness, with a suggested key first step to achieving an comprehensive service. rehabilitationmatters.com/clinical-rehab… I am now mainly posting on Bluessky with the same name

Giving a prognosis for someone with a prolonged disorder of consciousness is complex, and I have discussed why and what is needed: rehabilitationmatters.com/clinical-rehab…

What is rehabilitation? I have been asking myself for 40 years. I have just published an update of my 2022 answer and the page includes a table of other relevant pages. rehabilitationmatters.com/what-is-rehabi…

I have just added a table to my website, giving links to all the pages and posts discussing in significant detail aspects of the biopsychosocial model of illness. rehabilitationmatters.com/what-is-rehabi… Don't forget, most of my posts are now on Bluesky