Raymond Tallis

Raymond Tallis
The University of Manchester · Emeritus Medicine

About

92
Publications
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Introduction
Skills and Expertise

Publications

Publications (92)
Article
Raymond Tallis (doi:10.1136/bmj.d2355) argues that allowing terminally ill people to choose an assisted death is part of good care, but Kevin Fitzpatrick believes it will endanger the lives of disabled people
Article
Physical therapy doses may need to be higher than provided in current clinical practice, especially for patients with severe paresis. The authors aimed to find the most effective and feasible dose of Mobilisation and Tactile Stimulation (MTS), which includes joint and soft-tissue mobilization and passive or active-assisted movement to enhance volun...
Article
Full-text available
Exercise-based therapy is known to enhance motor recovery after stroke but the most appropriate amount, i.e. the dose, of therapy is unknown. To determine the strength of current evidence for provision of a higher dose of the same types of exercise-based therapy to enhance motor recovery after stroke. An electronic search of: MEDLINE, EMBASE, CINHA...
Article
After stroke, physiotherapy can promote brain reorganization and motor recovery. Combining muscle strength and functional training (functional strength training, FST) may be beneficial. The aim of the authors was to compare FST with conventional physiotherapy (CPT) while controlling for the potential confounder of therapy intensity in a multicenter...
Article
Inadequate description of treatment hampers progress in stroke rehabilitation. To develop a valid, reliable, standardised treatment schedule of conventional physical therapy provided for the paretic upper limb after stroke. Eleven neurophysiotherapists participated in the established methodology: semi-structured interviews, focus groups and pilotin...
Article
Functional training and muscle strength training may improve upper limb motor recovery after stroke. Combining these as functional strength training (FST) might enhance the benefit, but it is unclear whether this is better than conventional physical therapy (CPT). Comparing FST with CPT is not straightforward. This study aimed at assessing the feas...
Article
ObjectiveTo explore whether carbamazepine impairs postural control in older people with epilepsy.DesignMeasures at 0 hours, before ingesting carbamazepine (baseline), and 2, 4 and 6 hours thereafter.SettingRehabilitation laboratory.ParticipantsPatients, aged 55 years or more, taking carbamazepine for epilepsy (n = 4) and age-matched healthy volunte...
Article
Repetitive transcranial magnetic stimulation (rTMS) of the lesioned hemisphere might enhance motor recovery after stroke, but the appropriate dose (parameters of rTMS) remains uncertain. The present review collates evidence of the effect of rTMS on corticospinal pathway excitability and motor function in healthy adults and in people after stroke. T...
Article
To explore the efficacy of repetitive transcranial magnetic stimulation (rTMS) and voluntary muscle contraction (VMC) to improve corticospinal transmission, muscle function, and purposeful movement early after stroke. Factorial 2 x 2 randomized single-blind trial. n = 27, mean age 75 years, mean 27 days after middle cerebral artery infarct (24 subj...
Article
To develop a treatment schedule of physical therapy techniques used to improve movement control and functional use of the paretic lower limb after stroke in U.K. clinical centers to be involved in a subsequent clinical trial of experimental interventions given in addition to routine clinical practice. Ten physiotherapists experienced in stroke reha...
Article
Full-text available
Recovery of upper limb movement control after stroke might be enhanced by repetitive goal-directed functional activities. Providing such activity is challenging in the presence of severe paresis. A possible new approach is based on the discovery of mirror neurons in the monkey cortical area F5, which are active both in observing and executing a mov...
Article
BACKGROUND Cerebrovascular disease is thought to be a major cause of epilepsy in late life. We investigated the hypothesis that the onset of seizures after the age of 60 years in people with no history of overt stroke might be associated with an increased risk of subsequent stroke. Data were obtained from the UK General Practice Research Database o...
Article
The purpose of this study was to describe the patterns of phasic muscle during gait initiation in normal elderly people. Bilateral surface EMG recordings were made of tibialis anterior, medial gastrocnemius and gluteus medius activity throughout gait initiation in 21 subjects. A variable expression of the onset muscle pattern is shown, with a tende...
Article
Metaphor has an important role in the discussion of scientific discovery because it enables researchers to talk about things of which their understanding is incomplete. Alzheimer's disease (AD) can be seen as a journey down a path, which becomes steadily less pleasant and ends in a wholly undesirable destination. To further the metaphor, treatments...
Article
SummaryNeuro-rehabilitation is an emergent science and therefore the evidence base is not so well developed as in other areas of medical science. Nevertheless neuro-physiotherapists expect, and are expected, to deliver evidenced-based practice and seem to be changing practice on the basis of research findings. However, it is unclear whether current...
Article
Unilateral spatial neglect is a disabling disorder, or set of disorders, that commonly occurs after stroke. Previous research suggests that tactile stimulation may reduce neglect, albeit temporarily. This study evaluated the effectiveness of a therapy package combining stimulation of the affected hand and the behavioural technique of self‐instructi...
Article
cerebral multi-infarct states may lead to gait disorders in the absence of cognitive impairment. Where these gait disorders occur in the absence of neurological signs they have been termed gait apraxia or more recently higher-level gait disorders. In this paper we hypothesise three main types based on presumptive sites of anatomical damage: (a) Ign...
Article
BackgroundAlthough the number of physiotherapists with research training has increased this may not be enough to facilitate evidence-based practice. Research education may need to be combined with clinical practice and organisational support. We therefore instituted clinical research secondments to the Stroke Association's Therapy Research Unit for...
Article
Many doctors have the impression that elderly-onset epilepsy is uncommon. This has no basis in the recent literature. There is evidence from many countries e.g. USA, Denmark, that the incidence of seizures rises sharply in old age. The United Kingdom National General Practice Survey of Epilepsy and Epileptic Seizures (NGPSE), a prospective-based, c...
Article
Over the last few decades, there have been considerable improvements in the outcome of stroke patients both as regards mortality and disability. At least some of these improvements can be attributed to better organization of services and improved rehabilitation. Many patients, however, remain severely disabled and we will need to develop new strate...
Article
To determine the frequency of coprescription of antiepileptic drugs (AEDs) and drugs with proconvulsant potential and of coprescription of AEDs and low dose oral contraceptives. Using information from all 294 fully computerised general practices participating in the General Practice Research Database who entered complete data in 1995, persons were...
Article
Martin Heidegger is one of the most important as well as one of the most difficult thinkers of the last century. His masterpiece Being and Time has been described as the most profound turning point in German philosophy since Hegel. Raymond Tallis, who has been arguing with Heidegger for over thirty years, illuminates his fundamental ideas through a...
Article
There is strong evidence that all stroke patients should receive rehabilitation from a specialist multi-professional team but there is little research evidence to guide the treatment given. This is particularly important for physiotherapists, as many patients remain severely disabled after rehabilitation. Most physiotherapists in the UK probably us...
Article
Full-text available
Therapists and nurses often use verbal instruction in the rehabilitation of mobility following stroke. This study aimed to determine whether performing a verbal cognitive task while walking adversely affected patients' balance and velocity. There were two counterbalanced conditions: walking only and walking and concurrent cognitive activity. The co...
Article
To describe current nursing and therapy interventions for the prevention and treatment of post-stroke shoulder pain and to explore the extent of their reported use in England. Semi-structured, the med interviews followed by a postal questionnaire. Six nurses, five occupational therapists (OTs) and six physiotherapists (PTs) were interviewed. Twelve...
Article
Introduction Physical therapy forms a large part of the multi-professional package of stroke care which has been shown to save lives and reduce disability, effects which may be maintained in the longer term. More specifically, physical therapy may improve performance of movement and functional ability poststroke, especially in the form of exercise-...
Article
to compare the therapeutic effects of two approaches to gait re-training--a schedule of conventional physiotherapy and treadmill re-training--in patients with higher-level gait disorders associated with cerebral multiinfarct states. single-blind crossover study involving a 4-week baseline period, 4 weeks of treadmill re-training and 4 weeks of conv...
Article
Full-text available
the central tenet of the neurofacilitatory approach to stroke therapy is that muscle tone needs to be normal before normal movement can occur. A reliable clinical measure of the full spectrum of muscle tone is needed to test: (i) the purported relationship between muscle tone, other motor impairments and disability, and (ii) the effectiveness of st...
Article
Evidence suggests that respiratory function is impaired poststroke. Body position is known to influence respiratory function in normal subjects and those with respiratory pathologies. Its effect on respiratory function after stroke has received little attention. However, one study suggests that some positions used in clinical practice may adversely...
Article
The trial of a treatment device for Unilateral Spatial Neglect (USN) is reported. A patient who had suffered a right hemisphere stroke that resulted in left sided neglect was studied over a six month period. The study involved the use of a customized electrical device providing stimulation to the neglected hand, triggered by movement of the unaffec...
Article
To determine whether freezing episodes commonly occur in patients who have had a hemiparetic stroke. A postal questionnaire sent to 108 patients who had been admitted to our Stroke Unit with a hemiparesis due to an acute ischaemic stroke or a primary intracerebral haemorrhage. Ninety-three questionnaires were returned, of which 14 were unsuitable f...
Article
We sought to determine the frequency of occurrence of contralesional unilateral spatial neglect (USN) after stroke and to investigate the effect of side of lesion, nature of assessment tool used, and timing of assessment relative to stroke onset. We performed a systematic review of published reports, identified by a search of electronic databases (...
Article
To evaluate the efficacy of intermittent pneumatic compression in treating oedema in the hemiplegic hand of stroke patients. Single-blind randomized control trial. acute and rehabilitation elderly care wards in a teaching district. 37 Subjects with a first ever hemisphere stroke were randomized to treatment with standard physiotherapy either alone...
Chapter
The thesis that the primary function of art is not political or moral — that art does not have a social mission and would be diminished by being subordinated to such a mission — is greatly strengthened by the observation that music, for some the paradigm art, is at best weakly referential and, for this reason, can hardly serve a moral or political...
Chapter
Over the last few decades, the realistic novel has been derided by literary theorists associated with the Structuralist and Post-Structuralist schools of thought — the so-called post-Saussurean critics. Their criticisms have not been adequately answered because the underlying theoretical arguments — supposedly derived from Saussure — have not been...
Article
There are no data on prevalence or incidence of treated epilepsy, and no data on fertility of women with epilepsy from an unselected UK population. We used the General Practice Research Database to ascertain the incidence and prevalence of people with treated epilepsy in an unselected population of 2,052,922 people in England and Wales, and also ag...
Article
The aim of this study was to determine the mechanism for recovery of swallowing after dysphagic stroke. Twenty-eight patients who had a unilateral hemispheric stroke were studied 1 week and 1 and 3 months after the stroke by videofluoroscopy. Pharyngeal and thenar electromyographic responses to magnetic stimulation of multiple sites over both hemis...
Article
Full-text available
Oropharyngeal dysphagia occurs in up to a third of patients presenting with a unilateral hemiplegic stroke, yet its neurophysiological basis remains unknown. To explore the relation between cortical motor function of swallowing and oropharyngeal dysphagia, mylohyoid, pharyngeal, and thenar electromyographic responses to stimulation of affected and...
Article
Patients with cerebral multi-infarct states (CMIS) may sometimes have severe gait impairments in the absence of obvious neurological deficits. In these higher-level gait disorders or gait apraxia, there may be prominent features of gait initiation failure, shuffling, freezing, difficulty making turns and disequilibrium. The detailed clinical featur...
Chapter
Over the last few decades, the realistic novel has been derided by literary theorists associated with the structuralist and post-structuralist schools of thought — the so-called post-Saussurean critics. Their criticisms have not been adequately answered because the underlying theoretical arguments — supposedly derived from Saussure — have not been...
Article
Full-text available
Urinary continence has been promoted as the single most useful predictor of stroke outcome in clinical practice. The value of this measure as an carry predictor of rehabilitation outcome was studied prospectively in 450 hospitalised stroke survivors (mean age 76.8 ± 9.7, range 60-93 years). The study was limited to previously independent patients w...
Article
Because no detailed information exists regarding the topographic representation of swallowing musculature on the human cerebral cortex in health or disease, we used transcranial magnetic stimulation to study the cortical topography of human oral, pharyngeal and esophageal musculature in 20 healthy individuals and the topography of pharyngeal muscul...
Article
Adverse drug reactions and drug errors - Volume 6 Issue 1 - Raymond Tallis
Article
The significance of a very elevated erythrocyte sedimentation rate (ESR) in elderly patients is debated. In a retrospective study, we searched the records of a laboratory providing the sole service to a health district for ESR measurement and identified all non-surgical and non-psychiatric patients over the age of 65 who had had an ESR above 50 mm/...
Chapter
The anti-realist case thrives on myths about realism. One such myth is that those who write, or attempt to write, realistic fiction imagine they can do so only because they believe that language is a reflecting mirror or a transparent window — at any rate, a passive surface that effaces itself before an extra-linguistic reality which it undistortin...
Chapter
Like many of the more startling ideas developed by literary theorists, the thesis that a work owes its origin to, and primarily refers to, other works has its roots in common sense.
Chapter
The Correspondence Theory of Truth (referred to throughout this chapter as ‘the Theory’) has assumed many different forms since Aristotle, developing an argument in Plato’s Sophist, first brought it to the forefront of the debate about the nature of truth. Much of the controversy surrounding the Theory has arisen because its advocates and opponents...
Chapter
At first sight, it seems obvious that speech has priority over writing; that the former is the central linguistic phenomenon while the latter is merely a device for capturing speech in a less transient form and permitting its diffusion beyond the temporal or spatial reach of an individual voice. This is, of course, a simplification. Many texts — fo...
Chapter
Much hostility towards realism in fiction is, consciously or unconsciously, rooted in fundamental doubts about the relationship between language and reality and the true status of apparently referential discourse. These doubts may crystallise into one of two theses: either that referential discourse is impossible because extra-linguistic reality li...
Article
Thirty-eight patients (median age 77 years; range 62-88 years) with elderly-onset seizures were entered into a single-blind, randomized study designed to compare the impact of phenytoin (PHT) and valproate (VPA) on cognitive function. A stratified minimization program matched the two groups for age, sex, and seizure type. Attention, concentration,...
Article
A large primary-care computerized database was searched to determine the incidence and prevalence of epilepsy and epileptic seizures in old age compared with the general population. The prevalence of subjects with a diagnosis of epileptic seizures was higher in older age groups: 10.9/1000 for sexagenarians, 12.0 for septuagenarians and 13.1 for tho...
Article
This second paper on perceptual problems in neurological disease discusses the prevalence of perceptual problems and their correlation with the anatomical site of damage. Hypotheses as to the mechanism of perceptual deficit are reviewed. The clinical tests for perceptual deficits are described. Finally, the authors discuss the practical management...
Article
Perceptual impairments are an important feature of neurological diseases, especially stroke, but they are poorly understood. This article discusses the difference between sensation and perception, and attempts to define and classify different forms of perceptual disturbance and their functional and behavioural consequences.

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