Functional disability and rehabilitation outcome in right hemisphere damaged patients with and without unilateral spatial neglect
Functional disability and rehabilitation outcome in right hemisphere damaged patients with and without unilateral spatial neglect
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DOI：
10.1016/s0003-9993(99)90273-3
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发表时间：
1999-04-01
影响因子：
4.3
通讯作者：
Soroker, N
中科院分区：
文献类型：
--
作者：
Katz, N;Hartman-Maeir, A;Soroker, N
目的：评估单侧空间忽略（USN）对右半球受损（RHD）脑卒中患者日常生活活动（ADL）和工具性ADL（IADL）的康复结果和长期功能的影响。设计：在进入康复中心、从康复医院出院时和出院后6个月进行感觉运动和认知障碍以及功能残疾的评估，患者：40名连续入院的成年右利手患者，其患有通过计算机断层扫描证实的首次、单一、右半球中风，基于他们在行为疏忽测试中的疏忽总分，将患者分为两组：结果：RHD合并和不合并USN患者的功能缺损和残疾程度有明显差异。神经功能缺损与损害（感觉运动和认知）指标以及ADL和IADL残疾指标的表现较低相关。在所有测试期间差异显著。USN+患者的恢复模式更慢且更弱。在两组中，大多数改善发生在发病后的前5个月。从入院到随访的康复结果的主要预测指标是USN。结论：忽视作为中风相关的长期残疾的主要来源的重要性证明了进一步的研究工作，以开发适当的治疗方式，这种复杂的，多因素综合征。(C)1999年由美国康复医学大会和美国物理医学和康复学会。
Objective: To evaluate the impact of unilateral spatial neglect (USN) on the rehabilitation outcome and long-term functioning in activities of daily living (ADL) and instrumental ADL (IADL) of right hemisphere damaged (RHD) stroke patients.Design: Assessments of sensory-motor and cognitive impairment and of functional disability were conducted upon admission to rehabilitation, upon discharge from the rehabilitation hospital, and 6 months after discharge, up to a year postonset.Setting: The Loewenstein Rehabilitation Hospital, which receives patients from all general hospitals in Israel.Patients: Forty consecutive admissions of adult right-handed patients with a first, single, right hemispheric stroke proven by computed tomography, Based on their total score in the Behavioral Inattention Test for neglect, patients were divided into two groups: 19 with neglect (USN+) and 21 without neglect (USN-).Outcome Measures: Functional Independence Measure, for ADL; The Rabideau Kitchen Evaluation, for IADL.Results: Impairment and disability levels of RHD patients with and without USN were clearly differentiated. Neglect is associated with lower performance on measures of impairment (sensory-motor and cognitive), as well as on measures of disability in ADL and IADL. Differences were significant in all testing periods. The recovery pattern of USN+ patients is slower and more attenuated. In both groups, most improvement occurs in the first 5 months after onset. USN is the major predictor of rehabilitation outcome from admission to follow-up.Conclusions: The significance of neglect as a major source of stroke-related long-term disability justifies further research efforts to develop appropriate therapeutic modalities for this complex, multifactorial syndrome. (C) 1999 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.