From the Department of Neuropsychology, Sunnyview Rehabilitation Hospital, Schenectady, New York.
Am J Phys Med Rehabil. 2021 May 1;100(5):443-449. doi: 10.1097/PHM.0000000000001710.
The aim of this study was to determine the prevalence and functional impact of unilateral spatial neglect on right hemisphere stroke patients in an inpatient rehabilitation facility using a multidimensional, functionally based behavioral measure (Catherine Bergego Scale [CBS]).
This was a retrospective cohort study of 742 consecutive admissions of patients with right hemispheric stroke to an inpatient rehabilitation facility. Spatial neglect was assessed using the CBS. Functional impact of neglect was measured by hospital length of stay, Functional Independence Measure change per day, discharge destination, and number of falls.
As measured by the CBS, 86% of the right hemisphere stroke patients had symptoms of spatial neglect. Moderate and severe neglect was associated with less Functional Independence Measure change per day and lower rates of community discharge. The presence of neglect was not significantly associated with fall rate or length of hospital stay after controlling for admission Functional Independence Measure scores and age. The "difficulty looking left" CBS item had the strongest relationship with total CBS scores and effectively predicted Functional Independence Measure change per day and discharge destination.
Using a sensitive measure, the CBS, rates of spatial neglect are extremely high in right hemisphere stroke patients entering inpatient rehabilitation. Both identification and determination of neglect severity are extremely important given their significant relationship to rehabilitation outcomes and discharge destinations.
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.
Upon completion of this article, the reader should be able to (1) describe why carefully assessing spatial neglect in right hemisphere stroke patients is important; (2) identify multiple dimensions of spatial neglect assessed by the Catherine Bergego Scale and how this approach differs from traditional paper and pencil assessment methods; and (3) describe the relationship between spatial neglect as measured by the Catherine Bergego Scale and functional outcomes of right hemisphere stroke patients in inpatient rehabilitation settings.
Advanced.
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
本研究旨在使用多维、基于功能的行为测量方法（Catherine Bergego 量表 [CBS]），确定住院康复机构中右侧半球卒中患者单侧空间忽略的患病率和对功能的影响。
这是一项对 742 例连续入院的右侧半球卒中患者的回顾性队列研究，使用 CBS 评估空间忽略。忽略的功能影响通过住院时间、每日功能独立性测量变化、出院去向和跌倒次数来衡量。
根据 CBS 测量，86%的右侧半球卒中患者有空间忽略症状。中度和重度忽略与每日功能独立性测量变化较少和社区出院率较低有关。在控制入院功能独立性测量评分和年龄后，忽略的存在与跌倒率或住院时间无显著相关性。“向左看困难”CBS 项目与总 CBS 评分的关系最强，有效预测每日功能独立性测量变化和出院去向。
使用敏感的测量方法，右侧半球卒中患者进入住院康复时，空间忽略的发生率极高。鉴于其与康复结果和出院去向的显著关系，识别和确定忽略的严重程度非常重要。
索取 CME 学分：在 http://www.physiatry.org/JournalCME 上完成自我评估活动和评估。
CME 目标：完成本文后，读者应能够：(1)描述为什么仔细评估右侧半球卒中患者的空间忽略很重要；(2)识别 Catherine Bergego 量表评估的空间忽略的多个维度，以及这种方法与传统纸笔评估方法的不同之处；(3)描述 Catherine Bergego 量表测量的空间忽略与右侧半球卒中患者在住院康复环境中的功能结果之间的关系。
高级。
学术物理治疗师协会经继续教育认证委员会认可，为医生提供继续医学教育。学术物理治疗师协会将这项基于期刊的 CME 活动指定为最多 1.0 项 AMA PRA 类别 1 学分™。医生只能声称与他们参与活动的程度相符的学分。
