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Biomedical subjects

P J Laycock

Publications and source records attributed to P J Laycock.

10 recordsLinked to original sources
PubMed1985

Incidence and correlates of incontinence in stroke patients.

The incidence of incontinence in a series of 135 consecutive stroke patients was 51% (urine) and 23% (feces) within one year. In 75% the urinary incontinence started within the first two weeks, and in 41% it had cleared during that time. Incontinence at onset is associated with measures of severity of stroke (and of immobility for fecal incontinence). Among 92 survivors at one year, 15% were incontinent of urine, a proportion that rose in two- and three-year survivors to 23 to 24%, but by four years was again 14%, a level similar to that of the general elderly population. It is concluded that incontinence is more commonly a by-product of immobility and dependency than of involvement of the neurologic pathways, and most of it is transient.

Activities of Daily Living↗
PubMed1984

The influence of age on the clinical presentation and outcome of stroke.

Of 135 patients who survived the first 2 weeks following a stroke 25% were under the age of 65 years, 40% between 65 and 74 years and 35% were 75 years of age or older. Those under 65 years had a lower incidence of a previous history of lower limb arthritis, balance problems, and limited mobility but a greater incidence of ischaemic heart disease than those 65 years and over. This younger age group had a lower mortality and were more likely to progress beyond severe degrees of disability. However, if only those who survived the first year are included, then there was no difference in outcome between the age groups. In none of the parameters studied was there any difference between those 65 to 74 years of age and those 75 years and over. It was, however, those over the age of 74 years who were more likely to require long-term institutional care. These findings suggest that, although elderly 1-year survivors had a similar level of functional recovery to younger patients, other factors, probably social, affected the eventual placement of stroke patients.

Activities of Daily Living↗
PubMed1982

Stroke: does side matter?

Of 135 patients seen two weeks following a stroke and followed up for one year, 69 had a right hemiplegia and 66 left-sided weakness. Disturbance of the level of consciousness at the onset and confusion following the stroke were more common in those with right hemiplegia. Confusion, when present, improved more often in those with right hemiplegia. Neither severity nor functional outcome was associated with laterality. Elderly patients with right hemiplegia were more likely to be admitted to hospital, and of those admitted there were significantly more patients with a right hemiplegia admitted to general wards and of those with left hemiplegia to geriatric units. Radios, but not television, were more often used by those patients with left hemiplegia. Most bedside containers were placed on the patients right side irrespective of the side of the lesion.

Adult↗
PubMed1982

The recovery of the severely disable stroke patient.

Fifty-three stroke patients with severe functional loss at two weeks, following the stroke were followed up for one year. No improvement occurred in 47% during this time and this was associated with abnormalities of muscle tone, incontinence of urine or faeces, perceptual disorders and previous disabilities affecting locomotion. Remedial therapy continued for long periods especially in the group who did not improve. It is suggested that rehabilitation resources could have been used more appropriately. Further research is required to determine whether intensive therapy is of value in the severely disabled stroke patient especially those with perceptual and cognitive dysfunction.

Activities of Daily Living↗
PubMed1981

The rate of recovery from stroke - and its measurement.

A battery of tests to measure improvement over time in physical recovery of stroke patients - and to compare this with varying levels of disability at onset, is described. Recovery in a series of 135 patients with fresh stroke treated by traditional methods of rehabilitation is principally in the first 3 months - but also continues in the second 3 months, except for muscle power. Recovery after 6 months is least in muscle power and is limited mainly to walking and mobility (e.g. getting out of the house) which in some cases may be due to altered environmental factors. At onset only 62 per cent showed moderate or severe impairment of muscle power compared to 88 per cent with similar impairment in mobility and dependency. By 1 year 30 per cent of survivors remained dependent.

Activities of Daily Living↗
PubMed1978

How much physical therapy for patients with stroke?

The use of physiotherapy, occupational therapy, and speech therapy for patients with stroke was investigated, and the three treatments were compared. Out of 135 patients with stroke surviving at two weeks, 107 received physiotherapy, but only 35 received occupational therapy and 19 speech therapy. Those who received most physiotherapy were the most severely disabled and had the worst prognosis, and, although almost no recovery occurred after six months, 30 patients continued with treatment beyond this time. Stiff and painful shoulders were present in 21 of the patients by two weeks and had developed in a further 37 by one year. Physiotherapy did not prevent this. The objectives of physiotherapy for patients with stroke need careful definition, with emphasis on treatment in the early months. Alternative treatment, possibly carried out by volunteers or more simply trained personnel, merits further consideration.

Aged↗