Unilateral spatial neglect: Relation to rehabilitation outcomes in patients with right hemisphere stroke
Unilateral spatial neglect: Relation to rehabilitation outcomes in patients with right hemisphere stroke
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DOI：
10.1016/j.apmr.2004.10.029
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发表时间：
2005-04-01
影响因子：
4.3
通讯作者：
McKee, T
中科院分区：
文献类型：
--
作者：
Gillen, R;Tennen, H;McKee, T
目的：探讨右半球卒中患者左侧空间忽略(USN)与康复效果的关系。设计：对右半球卒中患者数据库进行回顾性分析。地点：急性住院康复医院。参与者：175例确诊为右半球卒中的患者，接受神经心理筛查，包括入院时的USN和抑郁症状的评估。干预：不适用。主要观察指标：入院和出院时用FIM量表评估功能状态。通过单因素(相关分析)和多因素(COX回归)分析USN与抑郁症状、认知功能、住院时间(LOS)和康复进展率的关系。结果：与非USN患者相比，USN患者的LOS时间更长，进展更慢。当与入院时功能状态同样差的患者配对时，USN患者的入院时间更长，进展更慢。结论：USN是右半球卒中患者康复结果的唯一预测因子。确定受USN影响最大的特定功能技能领域可能使针对这些关键领域制定有针对性的干预措施成为可能。(C)2005年由美国康复医学大会和美国物理医学和康复学会主办
Objective: To examine the relation between left unilateral spatial neglect (USN) and rehabilitation outcomes in patients with right hemisphere stroke.Design: A retrospective analysis of a database of right hemisphere stroke patients.Setting: Acute inpatient rehabilitation hospital.Participants: Patients (N = 175) with a diagnosis of right hemisphere stroke who had undergone a neuropsychologic screening including assessment of USN and depressive symptoms at time of admission to an inpatient rehabilitation program.Interventions: Not applicable.Main Outcome Measures: Functional status was evaluated with the FIM instrument at admission and discharge. The relationship between USN, depressive symptoms, cognitive functioning, length of stay (LOS), and rate of progress in rehabilitation was examined via univariate (correlational) and multivariate (Cox regression) analyses.Results: Patients with USN had longer LOS and progressed more slowly compared with those without USN. When matched against patients with equally poor functional status at admission, USN patients still had longer admissions and progressed more slowly.Conclusions: USN is a unique predictor of rehabilitation outcomes in patients with right hemisphere stroke. Identification of those specific functional skill areas most affected by USN may make possible the development of targeted interventions aimed at these key areas. (c) 2005 by American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation