Recovery of functional status after right hemisphere stroke: relationship with unilateral neglect.
OBJECTIVE
To evaluate relationships between unilateral spatial neglect and both overall and cognitive-communicative functional outcomes in patients with right hemisphere stroke.


METHODS
Assessment of overall and cognitive-communicative function was conducted on admission to acute rehabilitation, at discharge, and at 3-month follow-up.


METHODS
Urban, acute inpatient rehabilitation facility.


METHODS
Fifty-two consecutive admissions of adult right-handed patients with a single, right hemispheric stroke, confirmed by computed tomography scan.


METHODS
The FIM instrument and reading comprehension and written expression items of the Rehabilitation Institute of Chicago Functional Assessment Scale(R).


RESULTS
Patients made significant functional gains between admission and discharge, and between discharge and follow-up on the FIM. Severity of neglect was correlated with total, motor, and cognitive FIM scores at admission, discharge, and follow-up. Subjects with neglect had significantly more days from onset to admission and a longer length of rehabilitation stay than subjects without neglect. FIM outcomes were significantly different for subject groups with more severe neglect. Both the presence of neglect and its severity were significantly related to functional outcomes for reading and writing.


CONCLUSIONS
Patients with neglect show reduced overall and cognitive-communicative functional performance and outcome than patients without neglect. Further studies are needed to explore causal relationships between these factors.
Rehabilitation Institute of Chicago and Physical Medicine and Rehabilitation, Northwestern University Medical School, Chicago, IL, USA. lcherney@rehabchicago.org
L R
LR
Cherney
A S
AS
Halper
C M
CM
Kwasnica
R L
RL
Harvey
M
M
Zhang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000377:Agnosia / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D003147:Communication Disorders / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D004185:Disability Evaluation; D007839:Functional Laterality; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D011932:Reading; D020127:Recovery of Function; D012720:Severity of Illness Index; D000071939:Stroke Rehabilitation; D014796:Visual Perception; D014956:Writing