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Biomedical subjects

N B Lincoln

Publications and source records attributed to N B Lincoln.

At least 19 recordsLinked to original sources
PubMed1996

SORT: a validation study with stroke patients. Salford Objective Recognition Test.

The Salford Objective Recognition Test (SORT) was developed as a measure of recognition memory suitable for use with elderly people as it requires a shorter administration time than Warrington's Recognition Memory Test. Normative data for the SORT were collected from 50 normal elderly people living in the community. Fifty stroke patients were assessed on the SORT and other tests of psychological functioning. The words and faces subtests were found to correlate well with other measures of memory. The SORT was found to be uninfluenced by the effects of sex and time since onset of stroke, but was affected by language difficulties and perception problems. The split-half reliability of the test was found to be good as alternative versions of the subtests correlated well with each other.

Aged↗
PubMed1996

Comparison of rehabilitation practice on hospital wards for stroke patients.

BACKGROUND AND PURPOSE: The aim of the study was to observe patients on a stroke unit and to compare their activity with that of patients on conventional hospital wards to identify aspects of rehabilitation practice that might account for differences in outcome. METHODS: Stroke patients admitted to the hospital were observed on three 8-hour shifts over 3 consecutive days. An observer recorded, at 10-minute intervals, where patients were, what they were doing, and whether their positioning was as recommended by rehabilitation therapists. Patients on a stroke unit were compared with those on conventional wards. RESULTS: Stroke unit patients spent less time by their beds and more time in other locations on the ward (P < .001). There were significant differences in the frequency of behaviors observed in the two types of ward (P < .001). Stroke unit patients had significantly more interaction with nurses and therapists (P < .001). They were also more often in the recommended position (P < .001). CONCLUSIONS: The proportion of time in therapeutic activity was low in all locations, with patients spending many hours sitting and doing nothing. Despite this, stroke unit patients had more therapeutic contact with staff and were more often in the recommended position. These two features may account for some of the differences in outcome.

Activities of Daily Living↗
PubMed1996

Effect of long-term glycemic control on cognitive function.

OBJECTIVE: To investigate the relationship between recurrent hypoglycemia and cognitive impairment in insulin-dependent diabetic patients. RESEARCH DESIGN AND METHODS: Seventy patients who were diagnosed as diabetic at age 18 years or older, were under 55 years old, and had no condition likely to affect cognitive abilities were recruited from a diabetic register. Patients were interviewed to obtain information on the frequency of major and minor hypoglycemia. Their cognitive abilities were assessed on tests of premorbid intelligence, current intelligence, reaction time, concentration, memory, and information processing. RESULTS: There was a significant correlation between the apparent decline in intelligence, expressed as the discrepancy between the estimated premorbid and the actual performance intelligence quotient, and the frequency of major hypoglycemic attacks (rs = -0.30; P < 0.01). Comparison of patients with and without recurrent hypoglycemia showed few significant differences in cognitive ability. CONCLUSIONS: Results support previous work that suggests that major hypoglycemic attacks have a significant effect on some aspects of cognitive function, but the clinical importance of this finding remains to be determined.

Adult↗
PubMed1994

Follow-up of a controlled trial of domiciliary stroke rehabilitation (DOMINO Study).

The DOMINO study compared domiciliary and hospital-based rehabilitation services for stroke patients after discharge from hospital, stratified by the hospital ward at discharge. No difference between the services had been found at 6 months, but home therapy was better than outpatient department therapy at improving household ability and leisure activity in the patients discharged from the Stroke Unit (SU), and attendance at a day hospital may have been better than a domiciliary service at preventing death or institutionalization for patients discharged from Health Care of the Elderly (HCE) wards. We report the follow-up of the patients between 6 months and 1 year after discharge, during which time few patients received further treatment and little change in health or function occurred. Over this period the benefits of domiciliary rehabilitation in the SU group were lost, largely because the patients who had been treated in outpatient departments continued to improve. Between 6 months and 1 year the numbers of HCE patients in the two treatment groups who died or were institutionalized were similar, but the advantage of day hospital attendance was still evident at 1 year.

Activities of Daily Living↗
PubMed1993

Use of the extended ADL scale with stroke patients.

The Extended ADL scale is a postal measure of Instrumental ADL ability, comprising sub-scales for mobility, household ability and leisure activity. Its validity was examined in 303 stroke patients who had participated in a rehabilitation study. Adequate Guttman scales were found in the mobility scale, an adjusted household scale and, in women, the leisure scale. Extended ADL scores at 6 months after discharge from hospital were independently predicted by the Barthel ADL score at discharge from hospital, the age of the patient, previous mobility, time spent in hospital for the stroke, the abbreviated mental test score at discharge and whether the patient was living alone or not. Extended ADL scores discriminated between patients in institutions and at home. In patients at home, the Extended ADL scores were lower in those who received social and nursing services than in those who did not. Death or institutionalization over the 6 months was uncommon in patients with high Extended ADL scores. These data support the validity of the Extended ADL scale and confirm it to be a useful measure of outcome in stroke research.

Activities of Daily Living↗
PubMed1993

A randomised controlled trial of domiciliary and hospital-based rehabilitation for stroke patients after discharge from hospital.

This study compared the functional ability and perceived health status of stroke patients treated by a domiciliary rehabilitation team or by routine hospital-based services after discharge from hospital. Patients discharged from two acute and three rehabilitation hospitals in Nottingham were randomly allocated in three strata (Health Care of the Elderly, General Medical and Stroke Unit) to receive domiciliary or hospital-based care after discharge. Functional recovery was assessed by the Extended Activities of Daily Living (ADL) scale three and six months after discharge and perceived health at six months was measured by the Nottingham Health Profile. A total of 327 eligible patients of 1119 on a register of acute stroke admissions were recruited over 16 months. Overall there were no differences between the groups in their Extended ADL scores at three or six months, or their Nottingham Health Profile scores at six months. In the Stroke Unit stratum, patients treated by the domiciliary team had higher household (p = 0.02) and leisure activity (p = 0.04) scores at six months than those receiving routine care. In the Health Care of the Elderly stratum, death or a move into long-term institutional care at six months occurred less frequently in patients allocated to the routine service, about half of whom attended a geriatric day hospital. Overall there was no difference in the effectiveness of the domiciliary and hospital-based services, although younger stroke unit patients appeared to do better with home therapy while some frail elderly patients might have benefited from day hospital attendance.

Activities of Daily Living↗
PubMed1992

Stroke rehabilitation.

Stroke produces impairments, disabilities and handicap. At each level attention may be directed at methods of assessment, monitoring or predicting outcome, and evaluating effects of treatment. There has been a change in emphasis from impairment to disability and handicap. The most informative research has been directed at evaluating rehabilitation effectiveness.

Activities of Daily Living↗
PubMed1991

Use of the Indented Paragraph test with right hemisphere-damaged stroke patients.

The Indented Paragraph reading test has been presented as a useful screening test for identifying hemispatial neglect, as it has been reported to be more sensitive to mild neglect than text with a predictable format (Caplan, 1987). The number of errors made by 42 right hemisphere-damaged stroke subjects on this test was compared with their performance on text with straight margins and unpredictable text, where both right and left margins were irregularly indented. The inter-rater reliability of the paragraphs was checked for 23 subjects. The scores from the three paragraphs were significantly correlated, and all were able to detect mild neglect. Inter-rater reliability was higher when identifying moderate and severe levels of neglect than mild neglect. Performance on the Indented Paragraph was also compared with that on the Star Cancellation and Article Reading subtests of the Behavioural Inattention Test in a separate group of 56 right hemisphere stroke subjects and found to classify patients differently.

Aged↗
PubMed1991

Factors influencing dressing performance after stroke.

Sixty consecutive patients with a diagnosis of stroke were assessed using the Nottingham stroke dressing assessment as well as a series of physical and cognitive assessments. Generally the items of clothing worn on the lower half of the body were significantly correlated with the physical assessments and the items of clothing worn on the upper half were significantly correlated with the cognitive assessments. These results support other studies which suggest that motor recovery and perceptual abilities are important determinants of dressing ability.

Activities of Daily Living↗
PubMed1990

A re-validation of the Rivermead ADL scale for elderly patients with stroke.

The Rivermead ADL scale was developed for assessing activities of daily living in stroke patients but was not validated for elderly subjects. This study was designed to validate the scale for patients aged over 64 years. A series of 150 stroke patients was assessed on the scale, of whom 103 were aged over 64 years. The coefficients of reproducibility and 'scalability' were within acceptable limits both for patients aged under 65 and over 64 years. A revised order of assessment is suggested based on the order of difficulty of items. The two original household scales were combined to give an overall household scale which was validated as a unidimensional Guttman scale.

Activities of Daily Living↗
PubMed1990

The accuracy of predictions about progress of patients on a stroke unit.

The aim of the study was to check the accuracy of predictions about the factors which affect the progress, in physical abilities and activities of daily living, of patients admitted to a stroke unit. A series of 60 patients admitted consecutively to a stroke unit were assessed on tests of motor, functional and cognitive abilities at admission. On the basis of these assessments predictions were made about the abilities of the patients at discharge. Patients were assessed for level of motor abilities and activities of daily living at discharge and the accuracy of the predictions checked. Predictions were found to be significantly correlated with outcome but the relationships were not so close as to be useful for the clinical management of individual patients.

Activities of Daily Living↗
PubMed1989

The relation between subjective and objective memory impairment after stroke.

The aim of this study was to examine the relationship between subjective memory and objective assessment using a test designed to reflect daily life memory skills, the Rivermead Behavioural Memory Test (RBMT). A total of 78 patients was assessed seven months after a stroke. Each patient completed a questionnaire about memory problems experienced in daily life. A relative or close friend completed the same questionnaire about the patient. Each patient was assessed on the RBMT and some conventional memory tests. Questionnaire responses were more highly correlated with the RBMT than with conventional tests of memory.

Adult↗
PubMed1989

An investigation of factors affecting progress of patients on a stroke unit.

The aim of the study was to identify factors affecting the progress in physical abilities and activities of daily living of patients admitted to a stroke unit. A series of 70 patients admitted consecutively were assessed on a series of tests of motor, functional and cognitive abilities at admission. They were assessed for level of motor abilities and activities of daily living at discharge and 9 months after stroke. Predictive equations were developed which account for between 61% and 33% of the variance in motor abilities and activities of daily living at discharge and at 9 months after stroke. The most important factor influencing outcome was the degree of motor loss.

Activities of Daily Living↗
PubMed1989

Service provision and functional independence in depressed stroke patients and the effect of social work intervention on these.

OBJECTIVE To compare the provision of health and social services between a social work intervention and non-intervention group. DESIGN Depressed stroke patients were randomly assigned to either an intervention or non-intervention group. Over a 4 month period both groups were visited three times by an independent assessor who rated them on service provision and functional independence. SETTING Patients' homes. PATIENTS 44 depressed stroke patients. INTERVENTION Both groups were given an information booklet and the intervention group were then visited regularly by a research social worker over a period of 4 months. The social worker adopted a pragmatic approach which included providing counselling and information on services and benefits. MAIN RESULTS The study groups did not differ in level of social independence (p greater than 0.05) or total number of financial benefits (p greater than 0.05), services (p greater than 0.05) or aids (p greater than 0.05) received either before or after intervention. When the results from the two groups were combined, home help and meals-on-wheels were the most frequently provided services (25% of patients). Walking aids (72% of patients) and bath aids (59% of patients) were the most frequently provided aids to daily living. CONCLUSION Social work assistance had little effect on service provision or level of functional independence.

Activities of Daily Living↗
PubMed1988

Inter-rater reliability of the Rey figure copying test.

To determine the inter-rater reliability of scoring the Rey figure copying test, two raters independently scored copies of version B of the Rey figure completed by 17 non-brain damaged general medical patients and 23 stroke patients. There was very high agreement between the total scores for each patient (rs = 0.99, P less than 0.001) and there was agreement for all patients as to whether these scores were within the normal range. It is concluded that, though subjective, the standard system for scoring the Rey figure copying test can be reliable between raters.

Adult↗