Spasticity: a common symptom of multiple sclerosis

Spasticity is a common symptom in people with multiple sclerosis. The nurse plays a vital role in the assessment and ongoing management of spasticity.     

Towards better research: a discussion of some common mistakes in statistical analyses

Statistical errors are common in clinical research. This paper presents a set of hypothetical but realistic scenarios in complementary medicine research. Each scenario contains at least one mistake typical of those made in analyses. These are discussed. The general principles are that charts and summary statistics can be misleading or even meaningless if not chosen carefully; objectives of the research need to be clearly defined and related to statistical hypotheses; assumptions of tests need to be checked; discussing the practical implications of observed effects is better than merely quoting P-values and data trawling should be avoided.     

Spasticity

Spasticity affects people with a variety of conditions, including stroke, spinal cord injury and multiple sclerosis. Assessment, physical therapies and pharmacological and invasive treatments are discussed in this Update.     

Reflection demystified: answering some common questions

There is a growing body of literature related to reflection. However, few authors address how to reflect at a practical level. This article aims to answer some of the more common questions about reflection: What is reflection about? What is its value for nursing practice? What skills are needed to be a reflective practitioner? Where to start? There are doubts concerning the effectiveness of reflection and there is little research evidence regarding its benefits. Despite this, it is argued that reflection has the potential to raise nurses' awareness of practice.     

Nursing research: some guidelines for practitioners

In a state of rapid change, nursing over the last few years has become almost unrecognizable. And the profession, says Cushla Beckingham, has perhaps never been more divided. Some nurses (particularly those too senior to gain entry to tertiary courses) see a great chasm between tertiary-educated nurses and those who give "old-style" nursing care based on intuition. Indeed, the profession does consist of three separate groups--the educators and the practitioners (between which is a large gap) plus nurse managers. For Beckingham, research based on area of practice could be the uniting factor, particularly in the search for cost-cutting programmes, as government funds for medical care diminish with each new budget.     

Stroke rehabilitation: a reconsideration of some common attitudes.

Some common, yet erroneous, attitudes and perceptions about stroke still persist. These warrant reconsideration: (1) benefits of stroke rehabilitation (including validity of its basis, life expectancy, adequacy in nursing homes, outcome prediction, cost benefits, and vocational outcome); (2) gait training (including evaluation methods, gait patterns, hand supports, sensory deficits, and types of braces); (3) effects of training on regaining balance; (4) spasticity (as a negative factor, enhancement by spring-action brace, benefit of inhibition training, and importance of antispasmotic drugs); (5) danger of early activity; (6) depression; (7) effects on patients' sexuality; (8) effects of communication impairments on learning abilities as well as effectiveness of speech therapy; (9) application of neurphysiological principles (regarding decreasing synaptic resistance, applications of principles from cerebral palsy training, and benefits of training for percept-concept-motor function deficits); and (10) research including reliability of past reports and paucity of facilities for new research.     

Spasticity in multiple sclerosis

Already in 1860, the great neurologist Charcot described the symptom spasticity in patients affected by "sclerose en plaque". Spasticity is one of the most common symptoms of multiple sclerosis MS). The consequences of spasticity are very disadvantages because it hinders the functional mobility and overburden disability. Moreover, in the later stages of MS spasticity may be complicated by seating problems, pressure sores, fibrous contractures and poor perineal hygiene. In this article, the therapeutical management of MS spasticity, in all its components (pharmacological, rehabilitative, surgical) is reviewed.