Hemispatial neglect and rehabilitation in acute stroke.
OBJECTIVE
To compare 2 methods for determining neglect in patients within 2 days of stroke, and to investigate whether early neglect was related to rehabilitation practice, and whether this relationship was affected by an early, intensive mobilization intervention.


METHODS
Data were collected from patients participating in a phase II randomized controlled trial of early rehabilitation after stroke.


METHODS
Acute hospital stroke unit.


METHODS
Stroke patients (N=71).


METHODS
The 2 arms of the trial were very early mobilization (VEM) and standard care (SC).


METHODS
Neglect was assessed using the Star Cancellation Test and the National Institutes of Health Stroke Scale (NIHSS) inattention item within 48 hours of stroke onset, and therapy details were recorded during the hospital stay.


RESULTS
Assessing neglect so acutely after stroke was difficult: 29 of the 71 patients were unable to complete the Star Cancellation Test, and agreement between this test and the NIHSS measure was only .42. Presence of neglect did not preclude early mobilization. SC group patients with neglect had longer hospital stays (median, 11d) than those without neglect (median, 4d); there was no difference in length of stay between patients with and without neglect in the VEM group (median, 6d in both).


CONCLUSIONS
Early mobilization of patients with neglect was feasible and may contribute to a shorter acute hospital stay.
Cumming
Toby B
TB
National Stroke Research Institute, 300 Waterdale Rd, Heidelberg Heights, Victoria 3081, Australia. tcumming@nsri.org.au
Plummer-D'Amato
Prudence
P
Linden
Thomas
T
Bernhardt
Julie
J
D000208:Acute Disease; D000368:Aged; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010468:Perceptual Disorders / Q000503:physiopathology* / Q000534:rehabilitation*; D011446:Prospective Studies; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome