193 of 195 people found the following review helpful
Approach with caution,
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This review is from: The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science (Paperback)
This is an interesting and readable book, and it clearly has created a lot of interest in the subject. It covers a range of topics relating to neural plasticity, which is not quite such a new topic as the author would have us believe. The strength of the book is the writing style and how accessible it is.
However, I would urge readers to approach this book with a degree of caution, or dare I say take it with a pinch of salt. What the author fails to do is apply any real level of critical appraisal to the material he covers. Some of the material covered has a substantial evidence base, some of it has a shaky evidence base, some has no evidence base whatsoever and is pure conjecture. If I take the example of constraint-induced therapy, originating from a psychologist called Taub, which I went away and read up on quite extensively following the claims made in this book. This is a treament for hemiplegia following stroke, whereby the good arm is constrained for several hours each day, thus forcing the person to use their bad arm. The logic behind this is that this will prevent learned non-use and also facilitate some cortical remapping, so that that control of that arm is taken over by in-tact brain areas. When you look at the evidence, a lot of which is pretty good quality research, this is not anything like the panacea that Doidge presents it to be. There are only a proportion of patients this works for, it is still unclear what the best protocol for its use is, and there is a lack of evidence for it producing lasting, long-term gains. A recent Cochrane review concluded that there was not enough evidence to say clearly whether it was effective or not, so the jury is still out.
Some of the education-related material was based on one particular programme. When looking at the references, all the evidence seemed to come from one source, and was not published in peer-reviewed journals (i.e. had not been scrutinised by the scientific community). About the highest level of publication appeared to be a poster presented at a conference.
As another reviewer mentioned, the chapter on sexuality seemed to be pure conjecture.
Do I regret reading it? No, it entertained me, and annoyed me in equal measure, but consequently prompted me to do further reading. So I have to say I benefitted from reading it, and would probably recommend it to others. But please approach it with a critical mind.
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Showing 1-3 of 3 posts in this discussion
Initial post: 18 Jul 2011 09:30:24 BDT
A. Sunter says:
An excellent review. How refreshing to see an interesting and intelligent appraisal of a book on Amazon.
Posted on 20 Aug 2012 21:58:31 BDT
Mr. R. Patel says:
for me it offered hope when I thought there was none so for me I have to say it was priceless I found myself throewing myself into my excerses with a real hope and i did see some good results
btw contraint therapy is widely used now as its been shown to help a lot of people
any of youwith hemiplegia through stroke or rain injury would have heard you physio's mantra of 'use it or lose it' and so it follows imo that using an effected limb be it with the aid of stroke theapy devices such as those by seabo or even by constraint therapy can only be a good thing.the brain does have a capacity to rewire itself ( neuroplacticity) its for thsat very reason that deices have now been made which when attached to a blind persons tongue allows them to be able to have 'limited' sight be it only shapes and light and dark. those devices clearly show that the brain starts to imnterpret stimulations and signals sent from ones tongue and 'makes sense out of them so why shouldnt the use of an effected limb which start sending signals to te brain be 'reinterpreted' by the brain?
Posted on 24 Feb 2013 19:40:48 GMT
J. G. says:
1. The reviewer said "A recent Cochrane review concluded that there was not enough evidence to say clearly whether it was effective or not, so the jury is still out".
The only Cochrane review regarding CIMT I found actually says:
"At the end of the treatment period, compared with exercise without constraint, CIMT improved the patient's ability to manage activities of daily living, but there was no evidence that this improvement was maintained over the next six months. Further larger trials to assess whether CIMT provides lasting benefit are justified"
This review indeed agrees that CIMT does improve the patient's mobility but its long term success after the treatment is not clear.
The link is: (subsitute dot with . and slash with /)
summaries dot cochrane dot slash CD004433 slash constraint-induced-movement-therapy-for-u
2. The reviewer also says "the chapter on sexuality seemed to be pure conjecture". It's not conjecture, at least not pure conjecture because it provides some background studies, although I agree that the author's case study seems out of place in this book.
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