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People with stroke living in the community: an investigation into the relationship between attention, functional ability and falls (abstract of paper in Proceedings of SSR)
No full textBackground: Information about the attention deficits of people with stroke living in the community is limited. The aims of this study were, to describe levels of attention and to explore the relationships between attention deficits, functional ability and fall events.
Method: Subjects living in the community were identified through GPs and therapy records. Assessments of balance, ADL function, attention and history of falls were completed in participants' homes for this cross-sectional study. Results: Forty-eight participants (30 men, 18 women mean age 68.4, SD 11.2) were recruited, 17 were repeat fallers, 7 single fallers, 12 were nonfallers with near falls and 12 were nonfallers with no near falls. One subject had a brainstem lesion, 26 had right and 21 left hemisphere infarctions. Mean time since onset of stroke was 46 months (range 5-204). Five (10.4%) participants presented with visual inattention, 15 (31%) had sustained attention deficits, 9 (19%) had auditory selective attention deficits, 17 (35%) had visual selective attention deficits and 21 (43%) presented with divided attention deficits. Sustained and divided attention scores were found to correlate with the scores for balance and ADL ability (p < 0.01). The balance and functional abilities of those subjects with normal attention scores were significantly better than those with abnormal scores (p < 0.01). Analysis of variance revealed significant differences between the fall groups for balance, ADL ability and divided attention; the greatest differences (p < 0.01) were between repeat fallers and nonfallers with no near falls.Conclusions: Attention deficits were common among community-dwelling people with stroke. Repeat fallers had significantly more problems dividing attention than nonfallers with no near falls. Those with impaired attention and those who had fallen repeatedly had significantly greater functional deficits
Fall events among people with stroke living in the community: Attention deficits, balance and falls (Proceedings of SRR)
No full textPURPOSE: To describe levels of attention deficits among people with stroke living in the community and explore relationships between attention, balance, function and falls. METHOD: Forty-eight mobile community-dwelling people with stroke (30 men, 18 women, mean age 68.4 +/- 11.2) were recruited to this cross-sectional investigation through General Practitioners. Twenty-six participants had a right, 21 a left hemisphere infarction and one had a brain stem lesion; mean time since stroke was 46 months (range five to 204). Participants' were interviewed about fall-events; attention, balance and function were assessed using standardised tests. RESULTS: Visual inattention was identified in five participants (10%), deficits of sustained attention in 15 (31%), auditory selective attention in nine (19%), visual selective attention in 17 (35%) and divided attention deficits in 21 participants (43%). Sustained and divided attention scores correlated with balance, ADL ability and fall-status (p < 0.01). The balance and function of subjects with normal attention were better than those with abnormal scores (p < 0.01). Analysis of variance revealed differences between repeat-fallers and non-fallers with no near-falls for divided attention, balance and ADL ability (p < 0.01). CONCLUSIONS: Attention deficits were common among this sample; sustained and divided attention deficits correlated with functional impairments and falls, highlighting that attention deficits might contribute to accident prone behaviour and falling
"Stops walking when talking" as a predictor of falls in people with stroke living in the community
No full textOBJECTIVE: To test "Stops walking when talking" (SWWT) as a predictor of falls among people with stroke living in the community. METHODS: People with stroke were identified through hospital records. Mobility, ADL (activities of daily living) ability, mental state, mood, and SWWT were assessed in a single session. Participants were followed prospectively for six months, using falls diaries and regular telephone calls. RESULTS: Sixty three participants (36 men, 27 women mean (SD) age 68.4 (10.6)) were recruited. Four subjects had a brainstem lesion, 30 had right hemisphere, and 29 left hemisphere infarctions. Mean time since onset of stroke was 20 months (range 2-72). Twenty six subjects stopped walking when a conversation was started and 16 of them fell during the six month follow up period (11 experienced repeated falls). For all fallers (>or=1) the positive predictive value of SWWT was 62% (16/26), the negative predictive value 62% (23/37), specificity 70% (23/33) and sensitivity 53% (16/30). For repeat fallers (>or=2) the positive predictive value of SWWT was 42% (11/26), the negative predictive value 89% (33/37), specificity 69% (33/48) and sensitivity 73% (11/15). Those who stopped walking were significantly more disabled (p<0.001)-that is, they were more dependent in activities of daily living, had worse gross function as well as worse upper and lower limb function, and had depression (p = 0.012). CONCLUSIONS: The specificity of the SWWT test was lower but sensitivity was higher than previously reported. Although the SWWT test was easy to use, its clinical usefulness as a single indicator of fall risk in identifying those community dwelling people with stroke most at risk of falls and in need of therapeutic intervention is questionable
The influence of attention deficits on functional recovery post stroke during the first 12 months after discharge from hospital
No full textBackground: Attention deficits have been linked to poor recovery after stroke and may predict outcome. We explored the influence of attention on functional recovery post stroke in the first 12 months after discharge from hospital.Methods: People with stroke completed measures of attention, balance, mobility and activities of daily living (ADL) ability at the point of discharge from hospital, and 6 and 12 months later. We used correlational analysis and stepwise linear regression to explore potential predictors of outcome.Results: We recruited 122 men and women, mean age 70 years. At discharge, 56 (51%) had deficits of divided attention, 45 (37%) of sustained attention, 43 (36%) of auditory selective attention and 41 (37%) had visual selective attention deficits. Attention at discharge correlated with mobility, balance and ADL outcomes 12 months later. After controlling for the level of the outcome at discharge, correlations remained significant in only five of the 12 relationships. Stepwise linear regression revealed that the outcome measured at discharge, days until discharge and number of medications were better predictors of outcome: in no case was an attention variable at discharge selected as a predictor of outcome at 12 months.Conclusions: Although attention and function correlated significantly, this correlation was reduced after controlling for functional ability at discharge. Furthermore, side of lesion and the attention variables were not demonstrated as important predictors of outcome 12 months later.<br/
People with stroke living in the community: a study of falling (abstract of paper presented at Society for Research in Rehabilitation, Liverpool, July 2000)
No full textPsychometric properties of the lateral reach task of the Head Activity Test (HAT): inter-rater reliability, validity and discriminant ability
No full textGeophysics conquering new territories: The rise of “agrogeophysics”
Full text linkAgriculture is facing immense challenges. We have to produce enough food while safe-guarding the environment for future generations. This results in the need to use less water and fertilizer, and to harness soil quality. Key to achieving this goal is improving the understanding of processes and interactions governing the soil–plant–atmosphere continuum of agricultural ecosystems. Geophysical tools have great potential to better characterize and quantify these processes noninvasively from the plot to landscape scale. Nevertheless, a number of challenges remain for geophysical results to be better exploited by different scientific communities and by decision-makers. In this special section, we explore ongoing research in the relatively new field of agrogeophysics, and we provide an overview of potential applications and highlight future research needs
Psychometric properties of the sitting upright task of the Head Activity Test (HAT): inter-rater reliability, validity and discriminant ability
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