Article

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.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS