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Biomedical subjects

C E Skilbeck

Publications and source records attributed to C E Skilbeck.

12 recordsLinked to original sources
PubMed1985

Controlled trial of a home-care service for acute stroke patients.

In a controlled trial of a home-care service available for the first 6 months after acute stroke, 440 patients received the new service and 417 patients were in the control group. The trial group used more hospital bed days, had a slightly higher admission rate, and did not show better emotional adjustment to stroke than the control group. There was no difference between the 2 groups in stress on relatives. Functional recovery was equal in the 2 groups. A quarter of patients managed at home in each group were severely disabled. Providing a new service does not necessarily alter clinical decisions in the short term, and care should be taken before expanding domiciliary services to reduce hospital use.

Acute Disease↗
PubMed1984

Raven IQ and language recovery following stroke.

The relationship between IQ and language recovery in aphasic patients was investigated using Raven's Coloured Progressive Matrices, Functional Communication Profile, and Schuell scores. The study involved 148 stroke patients who were part of a controlled trial of speech therapy. Although initial IQ correlated with severity of aphasia, no evidence was found for a relationship between IQ and subsequent language recovery. Nevertheless, initial IQ level was found to relate to some measures of physical status and to death soon after testing.

Aged↗
PubMed1984

Long-term survival after stroke.

A total of 162 patients referred for rehabilitation were followed-up for two years. Using the t test and the chi-square test, 15 variables distinguishing the 107 survivors from the 55 who died were identified. Multiple regression analysis identified three factors that gave a predictive equation which correctly identified 92% of the two-year survivors and 48% of those dying in that time. These factors were the severity of the stroke (represented by the patient's walking ability), the presence of pre-existing cardiovascular disease (indicated by a history of myocardial infarction), and the patient's age. Pre-stroke motivation or fitness may also influence long-term survival. The technique of using multiple regression analysis allows a clearer separation of the important prognostic factors than the more usual comparative statistical methods.

Age Factors↗
PubMed1984

Therapy after stroke: amounts, determinants and effects.

This report investigates the amounts of physiotherapy and occupational therapy given to acute stroke patients over the first 6 months, the factors that determine how much therapy a patient receives, and the effects of therapy upon outcome. The study is based on 162 acute stroke patients referred to a stroke rehabilitation unit. In this group the average daily rate of treatment during active rehabilitation, for both therapies combined, was 46 minutes, with a maximum of 42 minutes a day for physiotherapy and 48 minutes a day for occupational therapy. The major factors associated with the amount of therapy given related to the severity of the stroke: more therapy was given to those with lower initial functional ability, worse sitting balance, or greater loss of use of arm or leg. This association with severity probably accounts for the association between therapy and shoulder disease. A minor factor governing the amount of therapy given was the patient's degree of recovery: those who recovered less well received more therapy. It was not possible to demonstrate a specific beneficial effect of therapy.

Activities of Daily Living↗
PubMed1983

An activities index for use with stroke patients.

Scales of 'Activities of Daily Living' measure only a patient's ability for self-care. There is no brief scale to measure lifestyle, although this would be useful in determining rehabilitation goals. This paper describes such a scale, developed for use with stroke patients. The data obtained relate to pre-morbid and post-stroke levels of activities. Factor analysis indicates three major factors (domestic chores, leisure/work, outdoor activities). Two of these factors are sex-linked, as predicted. Some evidence is noted of the sensitivity of the index to severity of stroke.

Activities of Daily Living↗
PubMed1983

Recovery after stroke.

One hundred and sixty-two patients were referred to a rehabilitation unit after an acute stroke. The patterns of recovery of overall functional ability, arm function, walking and speech in 92 of 101 survivors have been analysed. In all modalities the majority of recovery occurs within 3 months; although improvement is seen thereafter it does not reach statistical significance. Possible reasons for the apparent lack of late recovery are discussed.

Activities of Daily Living↗
PubMed1983

The hemiplegic arm after stroke: measurement and recovery.

Seven clinical tests have been used to study the recovery of arm function in 92 patients over 2 years following their stroke. These tests are simple and quick, and can be used by any interested observer. They form a hierarchical scale that measures recovery. Statistically significant improvement is only seen in the first 3 months. Fifty-six patients initially had non-functional arms; eight made a "complete recovery" and 14 a partial recovery. The tests described are inadequate on their own because they are not sufficiently sensitive at the upper range of ability. While recovery of lost function does relate to the degree of initial neurological loss in the arm, it seems to be largely independent of the overall severity of the stroke.

Aged↗
PubMed1983

Predicting Barthel ADL score at 6 months after an acute stroke.

In 83 patients with stroke, multiple regression analysis was used to identify 5 variables, measured at the 1st assessment shortly after stroke, that related to the Barthel ADL score at 6 months. The variables were age, the presence of hemianopia or visual inattention, the presence of urinary incontinence, the motor deficit in the affected arm, and the patient's sitting balance. A 2nd equation, based upon the initial Barthel score with age and hemianopia added, was also developed. The success of the 1st equation in predicting the final Barthel score was about 55%, a rate better than that yielded by the 2nd equation, and also better than that produced by adding the average improvement score to the patient's initial score.

Activities of Daily Living↗
PubMed1976

A method for decreasing patients' medication errors.

Eighty anxious and eighty depressed patients were assigned randomly to receiving one of three versions of an information leaflet about their medication, or to receiving no leaflet at all. Mean medication errors were reduced from 15 to 4% by provision of suitably constructed leaflets. The results show the practical importance of informing patients about their medication and of paying attention to the difficulty level of any leaflets issued.

Antidepressive Agents↗