F-2-19-05
NEUROPSYCHOLOGICAL CORRELATES PREDICTING THE ADL IMPROVEMENTS IN STROKE REHABILITATION WITH RIGHT HEMISPHERE DAMAGE
Kazumasa Yokoyamasa (Hyogo Prefectural Rehabilitation Center, Kobe, Japan)
Jiro Onishi, Chihiro Hasegawa (Hyogo Prefectural Rehabilitation Center, Kobe, Japan)
purpose: We investigated neuropsychological profiles which could predict and correlate the improvements of ADL's resulting from stroke rehabilitation with right hemisphere (RH) damage.
method: 66 right-handed patients with lesions limited to RH were selected out of the stroke patients consecutively admitted to our hospital for rehabilitation for the last five years and evaluated for their ADL's, extents of motor weakness, and neuropsychological findings at both admission and discharge. The extents of the ADL improvements during their hospital stay were analyzed in relation to the neuropsychological data. Neuropsychological examination included visual reaction time (RT) tasks, and line bisection and drawing of daisy aiming to detect unilateral spatial neglect (USN).
result: Protracted USN with general attentional impairment judged from RT slowing was best correlated to the poor ADL scores attained at discharge. The preserved RCPM scores at admission tended to lead to the greater ADL improvements.
conclusion: The combinations of RT performance, USN test results and RCPM scores could be good neuropsychological predictors for the ADL improvements of RH damage patients.
F-2-19-06
UNILATERAL SPATIAL NEGLECT (USN) IN STROKE PATIENTS - HOW IT RELATES TO OTHER IMPAIRMENTS AND DISABILITY -
Yoichiro Aoyagi, Meigen Liu, Kazuto Tsujiuchi, Tetsuya Tsuji, Naoichi Chino (Saitama Prefecture General Rehabilitation Center and Keio University, Saitama and Tokyo, Japan)
[Objective] To study how the severity of USN relates to other impairments and disability in stroke patients.
[Methods] The subjects were 224 stroke inpatients (mean age 59.3±12.2 years). 118 had right brain (R) and 106 left brain lesion (L). They were examined with a 50cm tape bisection task at the start (median; 63 days from onset) and the end (median; 154 days) of a comprehensive rehabilitation program. We classified USN severity into four groups based on the degree of deviation from the midpoint; 0. severe:≧ 15cm, 1. moderate:5 to 15cm, 2. minimal:3 to 5cm, 3. none:<3cm, and analyzed how its severity related to Stroke Impairment Assessment Set (SIAS) motor and sensory scores, Mini-Mental State Examination scores (MMSE), scores for copying task, Functional Independence Measure (FIM) and FIM efficiency (FIM change/length of stay).
[Results] 1) On admission, 29.7% of the R group and 18.9% of the L group had USN, and there were more cases with severe USN in the former (χ2=10.3, p<0.05). At discharge, the percentages decreased to 20.3 and 10.4%. 2) Both on admission and at discharge, the USN severity correlated with SIAS motor and sensory scores, MMSE scores and scores for copying (Spearman's rho=0.263〜0.549, P <0.001). 3) It correlated with admission and discharge FIM scores and FIM efficiency (rho=0.425, 0.270 and 0.339).
[Conclusion] USN was more frequent in the R group, and its severity correlated with the degree of other impairments and disability.
