Abstract:
OBJECTIVE:To determine whether the intervention of a physiotherapist improved mobility in patients seen more than one year after stroke. DESIGN:Randomised crossover trial comparing two groups offered intervention by a physiotherapist, one immediately after entry into the trial and the other after a delay of three months. The intervention consisted of identifying problems and offering advice and help to solve the problems. SETTING:Patients' homes in Oxfordshire. SUBJECTS:Patients who had reduced mobility due to a stroke more than one year before entry; 60 were recruited from a community stroke register and 34 in other ways. MAIN OUTCOME MEASURES:Standard measures of mobility including gait speed, functional ambulation categories, the Nottingham extended activities of daily living index, and individual items from the Barthel activities of daily living index and the Frenchay activities index. Measures of manual dexterity, depression, and anxiety were used as controls. RESULTS:94 patients entered the trial and 49 were randomised to immediate and 45 to delayed physiotherapy; 89 were compared at the crossover point. At randomisation the two groups were comparable. At three months the group given early therapy showed an improvement in gait speed whereas the untreated group had declined (differences of -3.9 v 6.4 s to walk 10 m; p less than 0.01); between three and six months the group given delayed therapy showed improvement and the previously treated group declined (differences of 6.5 v -3.9 s to walk 10 m; p less than 0.01). A 9% (95% confidence interval 0% to 18%) decrease in time taken to walk 10 m was associated with treatment and a 12% (2% to 19%) increase when patients were untreated. Other measures did not change significantly. CONCLUSION:Intervention of an experienced physiotherapist late after stroke specifically improves mobility, albeit by a small amount, but the effects do not seem to be maintained, perhaps because there is an underlying decline in mobility in these patients. Gait speed offers a simple and sensitive measure of outcome.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Wade DT,Collen FM,Robb GF,Warlow CPdoi
10.1136/bmj.304.6827.609keywords:
subject
Has Abstractpub_date
1992-03-07 00:00:00pages
609-13issue
6827eissn
0959-8138issn
1756-1833journal_volume
304pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVE:To examine the extent to which changes in diagnostic methods and classification are responsible for the striking increase in incidence of primary liver cancer in Denmark since 1943. DESIGN:Analysis of the time trends in sex specific, age standardised incidence of primary liver cancer and unspecified liver ca...
journal_title:BMJ (Clinical research ed.)
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abstract:OBJECTIVE:To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. DESIGN:Longitudinal analysis. SETTING:35 medical facilities of Kaiser Permanente Northern California, 1997-2007. PARTICIPANTS:...
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abstract:OBJECTIVE:To assess the efficacy of arthroscopic subacromial decompression (ASD) by comparing it with diagnostic arthroscopy, a placebo surgical intervention, and with a non-operative alternative, exercise therapy, in a more pragmatic setting. DESIGN:Multicentre, three group, randomised, double blind, sham controlled ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.k2860
更新日期:2018-07-19 00:00:00
abstract:OBJECTIVE:To determine the effect of four monthly vitamin D supplementation on the rate of fractures in men and women aged 65 years and over living in the community. DESIGN:Randomised double blind controlled trial of 100 000 IU oral vitamin D3 (cholecalciferol) supplementation or matching placebo every four months ove...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.326.7387.469
更新日期:2003-03-01 00:00:00
abstract::One hundred and two patients returned structured questionnaires sent to clinics for sickle cell disease in the United Kingdom in order to gain greater insight into the patients' perception of painful crises. Most patients who suffer pain crises experience a prodromal stage that should be investigated further to find o...
journal_title:BMJ (Clinical research ed.)
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doi:10.1136/bmj.297.6646.452
更新日期:1988-08-13 00:00:00
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abstract:OBJECTIVE:To investigate whether residence before and after birth near 50 Hz high voltage installations increases a child's risk of cancer and whether risk correlates with the strength of the magnetic field. DESIGN:A population based case-control study. SETTING:Denmark. SUBJECTS:1707 children under the age of 15 wit...
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doi:10.1136/bmj.307.6909.891
更新日期:1993-10-09 00:00:00
abstract:OBJECTIVE:To evaluate an experimental heroin maintenance programme. DESIGN:Randomised trial. SETTING:Outpatient clinic in Geneva, Switzerland. SUBJECTS:Heroin addicts recruited from the community who were socially marginalised and in poor health and had failed in at least two previous drug treatments. INTERVENTION:...
journal_title:BMJ (Clinical research ed.)
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abstract:OBJECTIVE:To investigate whether work related stress, measured and defined as job strain, is associated with the overall risk of cancer and the risk of colorectal, lung, breast, or prostate cancers. DESIGN:Meta-analysis of pooled prospective individual participant data from 12 European cohort studies including 116,056...
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更新日期:2013-02-07 00:00:00
abstract:OBJECTIVES:To evaluate the effect of daily zinc supplementation in children on the incidence of acute lower respiratory tract infections and pneumonia. DESIGN:Double masked, randomised placebo controlled trial. SETTING:A slum community in New Delhi, India. PARTICIPANTS:2482 children aged 6 to 30 months. INTERVENTIO...
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pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.324.7350.1358
更新日期:2002-06-08 00:00:00
abstract:OBJECTIVE:To determine whether the more intensive screening and treatment for prostate cancer in the Seattle-Puget Sound area in 1987-90 led to lower mortality from prostate cancer than in Connecticut. DESIGN:Natural experiment comparing two fixed cohorts from 1987 to 1997. SETTING:Seattle-Puget Sound and Connecticut...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.325.7367.740
更新日期:2002-10-05 00:00:00
abstract:OBJECTIVES:To develop prediction models that better estimate the pretest probability of coronary artery disease in low prevalence populations. DESIGN:Retrospective pooled analysis of individual patient data. SETTING:18 hospitals in Europe and the United States. PARTICIPANTS:Patients with stable chest pain without ev...
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pub_type: 杂志文章,meta分析
doi:10.1136/bmj.e3485
更新日期:2012-06-12 00:00:00
abstract::To assess whether calcitonin is important in maintaining the integrity of bone the calcitonin gene of a young male patient with osteoporosis and no detectable plasma concentrations of calcitonin was studied. Genomic Southern blots with various restriction enzymes showed no large abnormalities in his calcitonin gene. G...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,收录出版
doi:10.1136/bmj.298.6682.1215
更新日期:1989-05-06 00:00:00
abstract:OBJECTIVE:To assess the role of rhinoviruses in elderly people living in the community. DESIGN:Prospective community based surveillance of elderly people, without intervention. Subjects were telephoned weekly to identify symptomatic upper respiratory tract infections. Symptoms and impact of illnesses were monitored, a...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7065.1119
更新日期:1996-11-02 00:00:00
abstract::The rapid aging of populations in developing countries as compared to those in the developed world has implications for medical training in these places. Moreover, the growing globalization of employment for many health professionals means that demographic shifts have implications for the training of health professio...
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pub_type: 杂志文章,评审
doi:10.1136/bmj.319.7221.1358
更新日期:1999-11-20 00:00:00
abstract::Eleven euthyroid patients with severe Graves' eye disease were treated with intravenous methylprednisolone and followed up for six months or more by ophthalmological assessment, orbital computed tomography (CT), photographs, and antibody measurements. Papilloedema resolved in the single patient in whom it was present;...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6663.1574
更新日期:1988-12-17 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of two mechanical methods of blood conservation in reducing the need for allogeneic red blood cells or coagulation products during cardiac surgery. DESIGN:Randomised controlled trial. SETTING:Regional cardiac centre in a teaching hospital in Southampton. PARTICIPANTS:263 adults ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.324.7349.1299
更新日期:2002-06-01 00:00:00
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doi:10.1136/bmj.307.6917.1465
更新日期:1993-12-04 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章
doi:10.1136/bmj.300.6735.1302
更新日期:1990-05-19 00:00:00
abstract:OBJECTIVE:To examine whether the risk of breast cancer is increased by a recent term pregnancy. DESIGN:Population based case-control study. SETTING:Eight areas in the United States. SUBJECTS:Cases were 2279 multiparous women residents of the eight areas aged 25-49 who were diagnosed as having breast cancer during 19...
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pub_type: 杂志文章
doi:10.1136/bmj.308.6945.1672
更新日期:1994-06-25 00:00:00
abstract::Monocycline is the most widely prescribed systemic antibiotic for acne largely because it needs to be given only once or twice a day and seems not to induce resistance. Up to April 1994 11 cases of minocycline induced systemic lupus erythematosus and 16 cases of hepatitis had been reported to the Committee on Safety o...
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pub_type: 杂志文章
doi:10.1136/bmj.312.7024.169
更新日期:1996-01-20 00:00:00
abstract:OBJECTIVE:To determine the value of short course, high dose albendazole chemotherapy in the treatment of persistent diarrhoea related to HIV in unselected patients in urban Zambia. DESIGN:A randomised double blind placebo controlled trial of albendazole 800 mg twice daily for two weeks. Patients were monitored intensi...
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1996-05-11 00:00:00
abstract:OBJECTIVE:To identify the nature and extent of any vocational training deficit within the London initiative zone and investigate the reasons. DESIGN:Collation of statistics and postal questionnaire surveys. SETTING:Thames regions inside and outside the London initiative zone. SUBJECTS:General practice registrars, tr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7023.97
更新日期:1996-01-13 00:00:00
abstract:OBJECTIVE:To evaluate the association between body mass index and mortality from overall cardiovascular disease and specific subtypes of cardiovascular disease in east and south Asians. DESIGN:Pooled analyses of 20 prospective cohorts in Asia, including data from 835,082 east Asians and 289,815 south Asians. Cohorts w...
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pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.f5446
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:To undertake a cost effectiveness analysis comparing first and second generation endometrial ablative techniques, hysterectomy, and the levonorgestrel releasing intrauterine system (Mirena) for treating heavy menstrual bleeding. DESIGN:Model based economic evaluation with data from an individual patient data...
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pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.d2202
更新日期:2011-04-26 00:00:00
abstract:OBJECTIVE:To investigate the impact of coexistent psychiatric morbidity on risk of suicide after a suicide attempt. DESIGN:Cohort study with follow-up for 21-31 years. SETTING:Swedish national register based study. PARTICIPANTS:39 685 people (53% women) admitted to hospital for attempted suicide during 1973-82. MAI...
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pub_type: 杂志文章
doi:10.1136/bmj.a2205
更新日期:2008-11-18 00:00:00
abstract:OBJECTIVE:To test the hypothesis that hydroxymethyl glutaryl coenzyme A reductase inhibitors (statins) may decrease the risk of community acquired pneumonia. DESIGN:Population based case-control study. SETTING:Group Health, a large integrated healthcare delivery system. Population Immunocompetent, community dwelling ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
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更新日期:2009-06-16 00:00:00
abstract:OBJECTIVE:To compare the clinical effectiveness of local corticosteroid injection, standard non-steroidal anti-inflammatory drugs, and simple analgesics for the early treatment of lateral epicondylitis in primary care. DESIGN:Multicentre pragmatic randomised controlled trial. SETTING:23 general practices in North Sta...
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:1999-10-09 00:00:00