Peii Chen1, Kimberly Hreha2, Yekyung Kong3, A M Barrett4. 1. Kessler Foundation, West Orange, NJ; Department of Physical Medicine and Rehabilitation, Rutgers University, Newark, NJ. Electronic address: PChen@KesslerFoundation.org. 2. Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY; Kessler Institute for Rehabilitation, West Orange, NJ. 3. Department of Physical Medicine and Rehabilitation, Rutgers University, Newark, NJ; Kessler Institute for Rehabilitation, West Orange, NJ. 4. Kessler Foundation, West Orange, NJ; Department of Physical Medicine and Rehabilitation, Rutgers University, Newark, NJ; Kessler Institute for Rehabilitation, West Orange, NJ.
Abstract
OBJECTIVE: To examine the impact of spatial neglect on rehabilitation outcome, risk of falls, and discharge disposition in stroke survivors. DESIGN: Inception cohort. SETTING: Inpatient rehabilitation facility (IRF). PARTICIPANTS: Individuals with unilateral brain damage after their first stroke (N=108) were assessed at IRF admission and discharge. At admission, 74 of them (68.5%) demonstrated symptoms of spatial neglect as measured using the Kessler Foundation Neglect Assessment Process (KF-NAP). INTERVENTIONS: Usual and standard IRF care. MAIN OUTCOME MEASURES: The FIM, Conley Scale, number of falls, length of stay (LOS), and discharge disposition. RESULTS: The greater the severity of spatial neglect (higher KF-NAP scores) at IRF admission and the lower the FIM scores at admission as well as at discharge. Higher KF-NAP scores also correlated with greater LOS and lower FIM improvement rate. The presence of spatial neglect (KF-NAP score>0), but not Conley Scale scores, predicted falls such that participants with spatial neglect fell 6.5 times more often than those without symptoms. More severe neglect, indicated by KF-NAP scores at IRF admission, reduced the likelihood of returning home at discharge. A model that took spatial neglect and other demographic, socioeconomic, and clinical factors into account predicted home discharge. Rapid FIM improvement during IRF stay and lower annual income level were significant predictors of home discharge. CONCLUSIONS: Spatial neglect after a stroke is a prevalent problem and may negatively affect rehabilitation outcome, risk of falls, and LOS.
OBJECTIVE: To examine the impact of spatial neglect on rehabilitation outcome, risk of falls, and discharge disposition in stroke survivors. DESIGN: Inception cohort. SETTING: Inpatient rehabilitation facility (IRF). PARTICIPANTS: Individuals with unilateral brain damage after their first stroke (N=108) were assessed at IRF admission and discharge. At admission, 74 of them (68.5%) demonstrated symptoms of spatial neglect as measured using the Kessler Foundation Neglect Assessment Process (KF-NAP). INTERVENTIONS: Usual and standard IRF care. MAIN OUTCOME MEASURES: The FIM, Conley Scale, number of falls, length of stay (LOS), and discharge disposition. RESULTS: The greater the severity of spatial neglect (higher KF-NAP scores) at IRF admission and the lower the FIM scores at admission as well as at discharge. Higher KF-NAP scores also correlated with greater LOS and lower FIM improvement rate. The presence of spatial neglect (KF-NAP score>0), but not Conley Scale scores, predicted falls such that participants with spatial neglect fell 6.5 times more often than those without symptoms. More severe neglect, indicated by KF-NAP scores at IRF admission, reduced the likelihood of returning home at discharge. A model that took spatial neglect and other demographic, socioeconomic, and clinical factors into account predicted home discharge. Rapid FIM improvement during IRF stay and lower annual income level were significant predictors of home discharge. CONCLUSIONS: Spatial neglect after a stroke is a prevalent problem and may negatively affect rehabilitation outcome, risk of falls, and LOS.
Authors: Laurel J Buxbaum; Mary Ann Palermo; Dina Mastrogiovanni; Mary Schmidt Read; Ellen Rosenberg-Pitonyak; Albert A Rizzo; H Branch Coslett Journal: J Clin Exp Neuropsychol Date: 2007-11-26 Impact factor: 2.475
Authors: B González-Rodriguez; N Serradell-Ribé; R Viejo-Sobera; J P Romero-Muñoz; Elena M Marron Journal: J Neurol Date: 2022-09-22 Impact factor: 6.682