Psychometric evaluation of neglect assessment reveals motor-exploratory predictor of functional disability in acute-stage spatial neglect.
OBJECTIVE
To determine the psychometric properties of 2 neglect measures, the Behavioral Inattention Test (BIT)-conventional and the Catherine Bergego Scale (CBS), in acute spatial neglect. Spatial neglect is a failure or slowness to respond, orient, or initiate action toward contralesional stimuli, associated with functional disability that impedes stroke recovery. Early identification of specific neglect deficits may identify patients likely to experience chronic disability. However, psychometric evaluation of assessments has focused on subacute/chronic populations.


METHODS
Correlational/psychometric study.


METHODS
Inpatient rehabilitation hospital.


METHODS
Screening identified 51 consecutive patients with a right-hemisphere stroke with left neglect (BIT score <129 or CBS score >11) tested an average of 22.3 days poststroke.


METHODS
Not applicable.


METHODS
We obtained BIT, CBS, and Barthel Index assessments for each participant and clinical and laboratory measures of perceptual-attentional and motor-intentional deficits.


RESULTS
The BIT showed good reliability and loaded onto a single factor. Consistent with our theoretical prediction, principal components analysis of the CBS identified 2 underlying factors: Where perceptual-attentional items (CBS-PA) and embodied, motor-exploratory items (CBS-ME). The CBS-ME uniquely predicted deficits in activities of daily living (ADLs) assessed by using the Barthel Index, but did not predict clinical and laboratory assessments of motor-intentional bias. More severe neglect on the CBS-PA correlated with greater Where perceptual-attentional bias on clinical and laboratory tests, but did not uniquely predict deficits in ADLs.


CONCLUSIONS
Our results indicate that assessments of spatial neglect may be used to detect specific motor-exploratory deficits in spatial neglect. Obtaining CBS-ME scores routinely might improve the detection of acute-stage patients with spatial action deficits requiring increased assistance that may persist to the chronic stage.
Department of Psychology, Seton Hall University, South Orange, NJ 07079, USA. kelly.goedert@shu.edu
Kelly M
KM
Goedert
Peii
P
Chen
Amanda
A
Botticello
Jenny R
JR
Masmela
Uri
U
Adler
Anna M
AM
Barrett
D000203:Activities of Daily Living; D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010468:Perceptual Disorders / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation*; D011237:Predictive Value of Tests; D011594:Psychometrics; D012047:Rehabilitation Centers; D015203:Reproducibility of Results; D018570:Risk Assessment; D012737:Sex Factors; D013037:Spatial Behavior / Q000502:physiology*; D020521:Stroke / Q000150:complications / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D058609:Visual Field Tests / Q000379:methods