Bernardo Gialanella1, Vittoria Monguzzi, Raffaele Santoro, Silvana Rocchi. 1. Rehabilitation Department, Salvatore Maugeri Foundation, Istituto di Ricovero e Cura a Carattere Scientifico-Scientific Institute of Gussago/Lumezzane, Gussago, Italy. bgialanella@fsm.it
Abstract
BACKGROUND AND PURPOSE: The aim of this study was to verify whether the presence of anosognosia (A) affects the rehabilitative prognosis of hemiplegic subjects with neglect (N). METHODS: This study was carried out on 30 patients with left hemiplegia: 15 patients had neglect (group N) and 15 had neglect and anosognosia (group N+A). Mean age was 68.2+/-6.3 in group N (9 men and 6 women) and 72.1+/-6.4 in group N+A (7 men and 8 women). The average interval from onset of stroke to admission for rehabilitation was 23 and 23.6 days, respectively, in group N and in group N+A. Patients were assessed through the Mesulam test, Bisiach test, Wechsler Adult Intelligence Scale, Fugl-Meyer scale, Functional Independence Measure (FIM), and Rankin scale. RESULTS: Before rehabilitation, cognitive FIM scores of patients of group N were significantly higher than those of group N+A (P=0.001), whereas motor FIM scores and total FIM scores did not differ between the 2 groups. After rehabilitation, cognitive FIM scores (P=0.000) and even motor (P=0.009) and total FIM scores (P=0.000) were statistically higher in group N than in group N+A. Effectiveness (P=0.005) and efficiency (P=0.012) in the motor FIM scores of group N were significantly greater than those of group N+A. Disability was lower in group N (P=0.040). CONCLUSIONS: Our study shows that the presence of anosognosia worsens the rehabilitation prognosis in hemiplegic subjects who also have neglect.
BACKGROUND AND PURPOSE: The aim of this study was to verify whether the presence of anosognosia (A) affects the rehabilitative prognosis of hemiplegic subjects with neglect (N). METHODS: This study was carried out on 30 patients with left hemiplegia: 15 patients had neglect (group N) and 15 had neglect and anosognosia (group N+A). Mean age was 68.2+/-6.3 in group N (9 men and 6 women) and 72.1+/-6.4 in group N+A (7 men and 8 women). The average interval from onset of stroke to admission for rehabilitation was 23 and 23.6 days, respectively, in group N and in group N+A. Patients were assessed through the Mesulam test, Bisiach test, Wechsler Adult Intelligence Scale, Fugl-Meyer scale, Functional Independence Measure (FIM), and Rankin scale. RESULTS: Before rehabilitation, cognitive FIM scores of patients of group N were significantly higher than those of group N+A (P=0.001), whereas motor FIM scores and total FIM scores did not differ between the 2 groups. After rehabilitation, cognitive FIM scores (P=0.000) and even motor (P=0.009) and total FIM scores (P=0.000) were statistically higher in group N than in group N+A. Effectiveness (P=0.005) and efficiency (P=0.012) in the motor FIM scores of group N were significantly greater than those of group N+A. Disability was lower in group N (P=0.040). CONCLUSIONS: Our study shows that the presence of anosognosia worsens the rehabilitation prognosis in hemiplegic subjects who also have neglect.
Authors: Stephen E Nadeau; Bruce Dobkin; Samuel S Wu; Qinglin Pei; Pamela W Duncan Journal: Neurorehabil Neural Repair Date: 2015-10-23 Impact factor: 3.919