Selections From This Month in the Archives

Article Outline

• Rehabilitation of Traumatic Brain Injury in Active Duty Military Personnel and Veterans: Defense and Veterans Brain Injury Center Randomized Controlled Trial of Two Rehabilitation Approaches
• A Randomized Controlled Trial of Holistic Neuropsychologic Rehabilitation After Traumatic Brain Injury
• Assessment of the Effects of Aquatic Therapy on Global Symptomatology in Patients With Fibromyalgia Syndrome: A Randomized Controlled Trial
• Effect of Magnetic Knee Wrap on Quadriceps Strength in Patients With Symptomatic Knee Osteoarthritis

Rodney D. Vanderploeg, PhD

Karen Schwab, PhD

William C. Walker, MD

Jamie A. Fraser, MPH

Barbara J. Sigford, MD, PhD

Elaine S. Date, MD

Steven G. Scott, DO

Glenn Curtiss, PhD

Andres M. Salazar, MD

Deborah L. Warden, MD,

for the Defense and Veterans Brain Injury Center Study Group

Back to Article Outline

Rehabilitation of Traumatic Brain Injury in Active Duty Military Personnel and Veterans: Defense and Veterans Brain Injury Center Randomized Controlled Trial of Two Rehabilitation Approaches 

Although the benefits of traumatic brain injury (TBI) rehabilitation are established, there is little information about the optimal approach. Vanderploeg and colleagues addressed this lack in a randomized controlled trial (RCT) involving 360 adults with moderate to severe TBI undergoing acute rehabilitation at 4 Veterans Administration centers. All subjects participated in a conventional inpatient rehabilitation program with half also receiving a component that emphasized explicit learning and half one that featured procedural learning. The groups improved in a similar manner in terms of the study's primary outcome goals but the authors found suggestions that those receiving the cognitive treatment displayed improved cognitive performance at the end of treatment. Similarly, younger subjects in the cognitive arm appeared to have better vocational and academic outcomes relative to their functionally trained counterparts, while those in the functionally trained group who were somewhat older or better educated had higher rates of independent living. • SEE PAGE 2227

Keith D. Cicerone, PhD

Tasha Mott, PhD

Joanne Azulay, PhD

Mary A. Sharlow-Galella LCSW

Wendy J. Ellmo, MS, CCC-SLP

Susan Paradise, MEd

John C. Friel, PhD

Back to Article Outline

A Randomized Controlled Trial of Holistic Neuropsychologic Rehabilitation After Traumatic Brain Injury 

Cicerone and colleagues performed a single center RCT that compared the relative benefits of a post acute TBI intensive cognitive rehabilitation program (ICRP) emphasizing the integration of cognitive, interpersonal and functional interventions with that of a standard program that featured discipline specific treatment. Sixty-eight subjects with primarily mild to moderate TBI of greater than 3 month's duration were randomized into 2 groups. The investigators found that neuropsychologic functioning improved in both groups but that those receiving ICRP displayed, both at the end of treatment and 6 months later larger improvements on the Community Integration Questionnaire and Perceived Quality of Life scale as well as improved self-efficacy for the management of symptoms. • SEE PAGE 2239

Diego Munguía-Izquierdo, PhD

Alejandro Legaz-Arrese, PhD

Back to Article Outline

Assessment of the Effects of Aquatic Therapy on Global Symptomatology in Patients With Fibromyalgia Syndrome: A Randomized Controlled Trial 

Exercise may lessen pain as well as improve the quality of life and cognitive function of people with fibromyalgia (FM). Munguía-Izquierdo and Legaz-Arrese extend this work to the lesser known issues of its effects on sleep quality and overall FM symptomatology. Sixty women with FM were randomized into 2 groups. The first group took part in a 16-week aquatic aerobic, strength and relaxation exercise training program, while the second continued their normal activities. Efficacy as well as intention-to-treat analysis revealed that the exercise program was effective in decreasing the tender point count as well as improving sleep quality, cognitive function, and physical function. There were no significant changes in the control group and anxiety remained unchanged. More than two thirds of the exercise groups continued exercising a year later. • SEE PAGE 2250

Chung-Yao Chen, MD

Chia-Ling Chen, MD, PhD

Steele Chih-Chin Hsu, MD, PhD

Shih-Wei Chou, MD, PhD

Kun-Chung Wang, MD

Back to Article Outline

Effect of Magnetic Knee Wrap on Quadriceps Strength in Patients With Symptomatic Knee Osteoarthritis 

The therapeutic benefits of magnetic fields, whether static or dynamic, remain controversial but there are suggestions that static fields may lessen osteoarthritic (OA) pain. Chen and colleagues extend this work in an RCT that used changes in strength rather than the more commonly assessed pain as its primary outcome. Fifty subjects with mild to moderate knee OA were randomized to wear either an active (35mT) or placebo magnetic knee wrap for 12 weeks. An intention-to-treat analysis found statistically significant increases in peak isokinetic quadriceps strength in the active relative to the control group both at 4 weeks into the trial (.05Nm/kg vs –.09Nm/kg at 60°/s, P=.038) and at its 12-week conclusion (30°/s, .09Nm/kg vs .04Nm/kg, P=.044; 60°/s, .17Nm/kg vs .02Nm/kg, P=.031) The authors conclude that generalization of their study of more severe OA or different testing conditions is difficult but that further research is warranted. • SEE PAGE 2258