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Andrea Selley

Publications and source records attributed to Andrea Selley.

3 recordsLinked to original sources

Balance disability after stroke.

BACKGROUND AND PURPOSE: Balance disability is common after stroke, but there is little detailed information about it. The aims of this study were to investigate the frequency of balance disability; to characterize different levels of disability; and to identify demographics, stroke pathology factors, and impairments associated with balance disability. SUBJECTS: The subjects studied were 75 people with a first-time anterior circulation stroke; 37 subjects were men, the mean age was 71.5 years (SD=12.2), and 46 subjects (61%) had left hemiplegia. METHODS: Prospective hospital-based cross-sectional surveys were carried out in 2 British National Health Service trusts. The subjects' stroke pathology, demographics, balance disability, function, and neurologic impairments were recorded in a single testing session 2 to 4 weeks after stroke. RESULTS: A total of 83% of the subjects (n=62) had a balance disability; of these, 17 (27%) could sit but not stand, 25 (40%) could stand but not step, and 20 (33%) could step and walk but still had limited balance. Subjects with the most severe balance disability had more severe strokes, impairments, and disabilities. Weakness and sensation were associated with balance disability. Subject demographics, stroke pathology, and visuospatial neglect were not associated with balance disability. DISCUSSION AND CONCLUSION: Subjects with the most severe balance disability had the most severe strokes, impairments, and disabilities. Subject demographics, stroke pathology, and visuospatial neglect were not associated with balance disability.

Adult↗

The development of the Stroke Physiotherapy Intervention Recording Tool (SPIRIT).

PURPOSE: To develop a recording system that describes physiotherapy interventions for the rehabilitation of postural control post-stroke. METHODS DESIGN: A draft recording tool was developed using the method described by Edwards et al, involving literature searches and collaboration with senior clinicians. It was piloted with stroke physiotherapists using a cross-sectional survey design to assess validity, utility and completeness. Participants used the recording tool to record five treatment sessions. Feedback regarding the utility and completeness of the system was obtained via short semi-structured interviews. SETTING: 11 NHS Trusts. PARTICIPANTS: 35 stroke physiotherapists working in acute and rehabilitation settings recorded the treatment of 120 patients in 590 treatment sessions. RESULTS: A double-sided A4 form with a checklist of 79 physiotherapy interventions in 9 categories was produced: the Stroke Physiotherapy Intervention Recording Tool (SPIRIT). The participants found it quick and easy to use and reflective of clinical practice. There were a few missing interventions and some confusion regarding definition of terms. Revisions were to include the omitted interventions and to produce a user's booklet defining the categories and interventions. CONCLUSIONS: SPIRIT provides a system for recording physiotherapy treatment for stroke patients which reflects current clinical practice in acute and rehabilitation settings.

Adult↗

A content analysis of physiotherapy for postural control in people with stroke: an observational study.

PURPOSE: The lack of information about the content of therapy packages is a frequent criticism in stroke rehabilitation research. This study aimed to describe, in detail, the content of one aspect of physiotherapy; the rehabilitation of postural control. METHODS: The design was a cross-sectional survey and the setting was in 11 NHS Trusts. The participants were 35 stroke physiotherapists working in acute and rehabilitation settings who recorded the treatment of 132 patients in 644 treatment sessions using the Stroke Physiotherapy Intervention Recording Tool. Analysis was carried out by descriptive statistics, one-way ANOVAS and chi-squares which were used to describe content of interventions and effects of the aim of treatment. RESULTS AND CONCLUSIONS: Physiotherapists' clinical practice focused on therapist-led interventions, which aimed to normalize muscle tone and promote normal movement patterns. The most frequent interventions were 'preparation for treatment' (n = 1969, 43%), 'practising balance and walking activities' (n = 1583, 34%) and 'practising functional tasks' (n = 703, 15%). Interventions to encourage independence or activity outside the treatment session were rarely used. This pattern was seen regardless of the aim of treatment (the restoration of sitting balance, standing balance or stepping/walking).

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