Biomedical subjects
K Challen
Publications and source records attributed to K Challen.
Confidential inquiries should be funded in clinical genetics.
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Existence and quality of written antenatal screening policies in the United Kingdom: postal survey.
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Functional recovery of community stroke patients.
PURPOSE: The aims were to describe the functional abilities of and services provided to stroke patients not admitted to hospital a year after stroke and to investigate factors associated with receiving rehabilitation services. METHOD: A cohort of stroke patients who had not been admitted to hospital were notified by general practitioners. Patients were assessed at a month and a year after stroke on measures of impairment and disability. The rehabilitation received was recorded. There were 124 stroke patients notified by GP's who had not been admitted to hospital. Of these 70 were assessed at both one month and one year after stroke. RESULTS: Patients showed persistent impaired levels of disability one year after stroke, as measured by the Extended Activities of Daily Living (EADL) scale. There was no significant improvement in Barthel scores and only a slight improvement on the EADL from one month to one year after stroke. There were no patients with severe mobility or severe arm impairment. Most patients had some cognitive impairment but there was no significant change between a month and a year. The provision of rehabilitation services increased between a month and a year after stroke. Rehabilitation was provided to those patients with impaired motor function. CONCLUSIONS: Stroke patients not admitted to hospital have significant levels of disability which does not change substantially in the year after stroke. Rehabilitation was provided on the basis of physical function, rather than cognitive function.
Rehabilitation needs of community stroke patients.
PURPOSE: The aim was to identify stroke patients not admitted to hospital, to assess their disabilities and the rehabilitation provided. METHOD: Stroke patients were notified by General Practitioners, assessed a month after stroke on measures of impairment and disability and the rehabilitation received was recorded. There were 124 patients notified and 93 assessed. RESULTS: Patients showed an average decline of 1.7 on the Barthel Index and 3.6 on the Extended Activities of Daily Living scale from before to after stroke. There were 27% with severe mobility problems and 47% with clinically relevant arm impairment. Many patients had cognitive impairment with only 9% having no deficit. Mood problems were less common with 26% anxious and 13% depressed. Significant stress occurred in 15% of carers. The provision of rehabilitation was low and there was poor correspondence between impairments and services provided. CONCLUSION: There is an unmet potential for rehabilitation in stroke patients not admitted to hospital.