Spatial Neglect Predicts Upper Limb Use in the Activities of Daily Living.

Vanbellingen, Tim; Ottiger, Beatrice; Maaijwee, Noortje; Pflugshaupt, Tobias; Bohlhalter, Stephan; Müri, René Martin; Nef, Tobias; Cazzoli, Dario; Nyffeler, Thomas (2017). Spatial Neglect Predicts Upper Limb Use in the Activities of Daily Living. Cerebrovascular diseases, 44(3-4), pp. 122-127. Karger 10.1159/000477500

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BACKGROUND AND PURPOSE Motor tests performed at stroke onset have been shown to predict the recovery of upper limb motor impairment. Less is known about upper limb recovery at the level of functional activity or of participation and how spatial neglect may influence the integration of the upper limb in the activities of daily living (ADL). Our objective was to investigate whether the initial severity of spatial neglect may predict upper limb use in ADL. METHODS Eighty-two patients with a right-hemispheric stroke (RHS) were prospectively included in the study. They were assessed twice in the acute/subacute and in the subacute/chronic phases (mean time interval of 45 days) after stroke. The Catherine Bergego Scale (CBS) was used to quantify the influence of spatial neglect on the ADL. Contralesional upper limb use in the ADL was evaluated with the Lucerne international classification of function, disability and health-based Multidisciplinary Observation Scale. Hand strength was measured using the Jamar, dexterity with the Nine Hole Peg test, and tactile perception using the stereognosis subtest of the Nottingham Sensory Assessment. Cognitive functions were assessed with the Montreal Cognitive Assessment. RESULTS Regression analyses revealed that spatial neglect is an independent and a significant predictor of upper limb outcome. A CBS score of ≤5 at the time of admission to neurorehabilitation care was highly predictive for good upper limb use in the ADL 45 days later. CONCLUSIONS This study demonstrates that spatial neglect severity, as observed in the ADL, is a significant and an independent predictor of upper limb outcome. Neglect therapy is thus needed to further improve contralesional upper limb use in the ADL in RHS patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DCR Unit Sahli Building > Forschungsgruppe Neurologie
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Gerontechnology and Rehabilitation
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Vanbellingen, Tim; Bohlhalter, Stephan; Müri, René Martin; Nef, Tobias; Cazzoli, Dario and Nyffeler, Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1015-9770

Publisher:

Karger

Language:

English

Submitter:

Stefanie Hetzenecker

Date Deposited:

20 Oct 2017 09:47

Last Modified:

01 Nov 2018 02:30

Publisher DOI:

10.1159/000477500

PubMed ID:

28605738

BORIS DOI:

10.7892/boris.102101

URI:

https://boris.unibe.ch/id/eprint/102101

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