Article

OBJECTIVE: To examine whether stroke survivors with more severe spatial neglect
during their acute inpatient rehabilitation had poorer mobility after returning
to their communities. DESIGN: A prospective observational study. SETTING: Acute
inpatient rehabilitation and follow-up in the community.
PARTICIPANTS: Thirty-one
consecutive stroke survivors with right-brain damage (women, n = 15 [48.4%]),
with the mean (standard deviation) age of 60 +/- 11.5 years, were included in the
study if they demonstrated spatial neglect within 2 months after stroke. METHODS:
Spatial neglect was assessed with the Behavioral Inattention Test (BIT) (range,
0-146 [a lower score indicates more severity]) and the Catherine Bergego Scale
(range, 0-30 [a higher score indicates more severity]). A score of the Behavioral
Inattention Test <129 or of the Catherine Bergego Scale >0 defined the presence
of spatial neglect. MAIN OUTCOME MEASUREMENTS: The outcome measure is community
mobility, defined by the extent and frequency of traveling within the home and in
the community, and is assessed with the University of Alabama at Birmingham Study
of Aging Life-Space Assessment (range, 0-120 [a lower score indicates less
mobile]). This measure was assessed after participants returned home >/=6 months
after stroke. The covariates were age, gender, functional independence at
baseline; follow-up interval; and depressed mood, which may affect the
relationship between spatial neglect and community mobility.
RESULTS: A lower
Behavioral Inattention Test score was a significant predictor of a lower
Life-Space Assessment score after controlling for all the covariates (beta =
0.009 [95% confidence interval, 0.008-0.017]); P = .020). The proportion of
participants unable to travel independently beyond their homes was 0%, 27.3%, and
72.7% for those with mild, moderate, and severe acute neglect, respectively
(Catherine Bergego Scale range, 1-10, 11-20, and 21-30, respectively).
CONCLUSIONS: Our result indicates that acute spatial neglect has a negative
impact on regaining of functional mobility in the community. Specific screening
and treatment of spatial neglect during acute stroke care may be necessary to
improve long-term mobility recovery.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS