Abstract
More research is needed to better understand the impact of occupational therapy (OT) in stroke patients and syndromes of unilateral neglect (UN) and anosognosia. A prospective, observational, longitudinal design was conducted on a sample of 27 OT patients. The objectives were to examine: (1) the presence of UN and anosognosia; (2) the functional outcomes; and (3) the association of UN at baseline with functional status at discharge from OT. The outcomes were Barthel (functional independence) and the Rivermead Mobility Index (RMI). The baseline proportion of participants with UN was 33% according to the Star Cancellation Test (STC), and 48.1% according to the Catherine Bergego Scale (CBS) therapist-version. There was a significant difference between the therapist and participant-rated CBS scores (p = 0.004). Functional independence improved significantly between the initial and final assessments (p < 0.001); the effect size (r) was large (r = 0.61). There was a significant improvement in RMI scores (p < 0.001), which was large in size (r = 0.59). Both the STC and CBS-therapist scores were significantly correlated with the Barthel (p < 0.001, p = 0.005, respectively) and with the RMI (p = 0.004, p = 0.028, respectively). The participants substantially enhanced their functional status skills. UN and anosognosia were common problems, and neglect was associated with worse OT program outcomes.
Highlights
Published: 15 July 2021Stroke is a common health condition in the adult population [1]
People with unilateral neglect (UN) typically fail to attend to, perceive, act upon, or move toward novel or meaningful stimuli presented on the side opposite to a brain lesion, and this failure cannot be explained by primary sensory or motor defects [5,6]
27 individuals with stroke were admitted to occupational therapy (OT)
Summary
Stroke is a common health condition in the adult population [1] This condition can lead to unilateral neglect (UN) and anosognosia. UN can spontaneously recover in whole or in part within the first months after a stroke, in many cases the effects are long-lasting [7] This syndrome may adversely affect patients’ ability to perform many daily living activities and limit the ability to move through the spaces of their daily environment [8,9]. Anosognosia refers to a lack of insight/awareness or the underestimation of impairments (e.g., hemiparesis, hemianopia, and UN) due to a brain lesion [10]. It has been associated with inferior parietal and superior temporal
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