Hello and welcome to The Mobility Brief. This is the monthly podcast from the Gray Centre for Mobility and Activity, part of St. Joseph's Health Care London. We're recording on Monday, January 5th, 2026. For our first episode of the new year, we have four updates from the centre to share.

First up, we're looking at a recent publication led by Janelle Unger that addresses the question: does training with electrical stimulation help people with an incomplete spinal cord injury walk faster or for longer? Her team conducted a systematic review and meta-analysis, looking at thirteen previous interventional studies. After combining the results from the randomized controlled trials, the analysis did not find evidence that this type of training improves walking speed or endurance for people with an incomplete spinal cord injury when compared to other locomotor training. The review found small, non-significant effects on both walking speed and endurance.

Our second update moves from a specific therapy to a question about the healthcare system itself: What are the known ways to improve patient handovers between acute and rehabilitation care? E. Ali Bateman contributed to a recent scoping review protocol that plans to map the existing evidence on this topic. The protocol outlines a search of several academic databases to find studies about physician-to-physician handovers between these two settings. The objective is to synthesize the literature and identify strategies for improving this transition, which the authors note can be complicated and is linked to patient safety.

Our third item for today is a case report that looks at the question: when a nerve block for knee replacement pain fails, could an injection in a different place offer relief? Eldon Loh contributed to this work, which describes the case of an 84-year-old female experiencing persistent pain after a total knee arthroplasty. The patient did not respond to a standard genicular nerve block. She subsequently received a modified block protocol with injections at different locations around the knee. The paper reports that following this modified procedure, the patient had 100% pain relief for five hours.

For our final update, we're shifting from individual treatments to a broader, system-level question: Why do accepted health guidelines fail in practice? A recent commentary led by Manuel Montero-Odasso addresses this by looking at lessons from Sweden’s implementation of the World Falls Guidelines. The piece discusses a study that used a participatory research design, bringing together researchers, practitioners, and individuals with lived experience to co-create a knowledge support tool. The authors suggest that guideline implementation often stalls at the organizational, or middle management, level. They identify barriers like fragmented documentation systems and communication silos, and propose that this co-creation model offers a way to better connect guidelines with frontline clinical work.

And that brings us to the end of our updates for January. We began with a systematic review that did not find evidence for electrical stimulation training to improve walking speed or endurance for people with an incomplete spinal cord injury. From there, we heard about a protocol to map existing strategies for patient handovers, and a case report describing pain relief for an 84-year-old female using a modified nerve block after knee replacement.

We finished with the commentary on implementing the World Falls Guidelines. That final piece on the challenges of putting guidelines into practice touches on a theme present in all of today's topics: the connection between generating new knowledge and applying it in the real world. Whether it's evaluating a therapy, improving a system process, or exploring a new procedure, there is always a path between the research and the person it is meant to help.

Thank you for listening to The Mobility Brief.