Patient Functional Independence Research Articles

Đánh giá gánh nặng chăm sóc và một số yếu tố liên quan của người chăm sóc người bệnh đột quỵ tại Khoa Nội - Hồi sức Thần kinh Bệnh viện Hữu Nghị Việt Đức

Objective: To assess caregiver burden and related factor to constipation among caregivers of stroke patients in Department of Neurology and Neuro Intensive Care, Viet Duc University Hospital. Methodology: This is a cross-sectional study performed in 90 caregivers of stroke patients. Zarit Burden Interview was used to assess caregiver burden Results: The mean score of caregiver burden was 20.83 ± 13.02; and majority of caregivers had mild to moderate burden (47.8%), there were 6.7% of caregiver had moderate to severe burden (p < 0.05). Perceived self-health, the number of days for caregiving, and functional dependence of stroke patients had statistically significant associations with caregiver burden, in which the number of days for caregiving, and functional dependence of stroke patients statistically significant predicted caregiver burden (p < 0.05). Conclusion: Caregiver burden of caregivers of stroke patients in our study were moderate. Early interventions that focus on risk factors, support caregivers in caring for patients, and increase the patient's functional independence will help reduce caregiver burden.

Family bonds and personal factors in caregiver burden in patients at the end of life.

Family caregivers are defined as those who assume substantial responsibilities for the care of an ill loved one without formal health care training. This study aims to analyze the predictors of physical and emotional burden in caregivers of palliative patients using qualitative comparative analysis methodologies (QCA) and taking into account patient and caregiver personal and relational variables. A total of 125 caregivers of patients at the end of life were assessed using an ad hoc emotional and physical burden questionnaire and patient and caregiver personal and relational variables were recorded. Results indicate moderately high levels of both emotional and physical burden. Differences in burden are found only as a function of kinship. Emotional burden is positively associated with the use of physical health medication in the caregiver and kinship; meanwhile, physical burden is positively associated with time since diagnosis, patient functional independence, and economic problems. For the QCA models, several pathways predict the observed variance in the emotional and physical burden of family caregivers of patients at the end of life, based on patient, caregiver, and relationship variables. In conclusion, it is relevant to design intervention programs focused on patient-caregiver relationship to prevent the development of emotional and physical burden.

Assessing Quality of Life, Economic Burden, and Independence Across the Alzheimer's Disease Continuum Using Patient-Caregiver Dyad Surveys.

Alzheimer's disease (AD) and mild cognitive impairment (MCI) have negative quality of life (QoL) and economic impacts on patients and their caregivers and may increase along the disease continuum from MCI to mild, moderate, and severe AD. To assess how patient and caregiver QoL, indirect and intangible costs are associated with MCI and AD severity. An on-line survey of physician-identified patient-caregiver dyads living in the United States was conducted from June-October 2022 and included questions to both patients and their caregivers. Dementia Quality of Life Proxy, the Care-related Quality of Life, Work Productivity and Activity Impairment, and Dependence scale were incorporated into the survey. Regression analyses investigated the association between disease severity and QoL and cost outcomes with adjustment for baseline characteristics. One-hundred patient-caregiver dyads were assessed with the survey (MCI, n = 27; mild AD, n = 27; moderate AD, n = 25; severe AD, n = 21). Decreased QoL was found with worsening severity in patients (p < 0.01) and in unpaid (informal) caregivers (n = 79; p = 0.02). Dependence increased with disease severity (p < 0.01). Advanced disease severity was associated with higher costs to employers (p = 0.04), but not with indirect costs to caregivers. Patient and unpaid caregiver intangible costs increased with disease severity (p < 0.01). A significant trend of higher summed costs (indirect costs to caregivers, costs to employers, intangible costs to patients and caregivers) in more severe AD was observed (p < 0.01). Patient QoL and functional independence and unpaid caregiver QoL decrease as AD severity increases. Intangible costs to patients and summed costs increase with disease severity and are highest in severe AD.

Enhancing early functional independence following cardiac surgery: a quality improvement programme

Early mobility and activity programmes following cardiac surgery are vital for improved patient outcomes, as they accelerate the recovery of functional capacity and walking distance. We observed that only 5.3%...

Evaluating the cost-utility of a direct transfer to angiosuite protocol within 6 h of symptom onset in suspected large vessel occlusion patients

Introduction A direct transfer to angiosuite (DTAS) protocol has shown to be effective and safe by shortening in-hospital workflows and encouraging long-term outcome benefits. To implement DTAS at a new facility, a large organizational effort is necessary. We performed a cost-utility analysis and budget impact analysis (BIA) of the operation of a new angiosuite, primarily dedicated to stroke patients, that allows facilities to approximate the cost implications of utilizing a DTAS pathway. Methods Sixty-one patients who underwent endovascular treatment (EVT) following DTAS were matched for baseline variables to 117 patients who underwent a conventional imaging protocol at a hospital in Catalonia, Spain. An economic model, based on actual data from these patients, was developed to assess the short- and long-term clinical and economic implications of DTAS. In the BIA, the DTAS scenario was gradually implemented for 20% of patients each year until reaching a plateau at 80% of patients in the DTAS pathway. Initial investment and additional organizational costs, €4 million, were taken into consideration to compare the budget impact of the DTAS scenario with no organizational changes over five years. Results DTAS was associated with better patient functional independence rates (mRS 0–2: 50.9% vs. 41.0%) and a quality-adjusted life-years gain of 0.82 per patient. Despite the additional initial investment, DTAS development was associated with an estimated 10.2% reduction (€14.7 million) of the total costs (€144.5 million). Cost savings were mainly due to long-term associated costs related to patient disability (€13.2 million). Limitations The study relies on data obtained from a single-center, and therefore it may be difficult to generalize the findings Conclusions Our economic model predicts that the implementation of a DTAS program is cost-effective compared with no organizational changes. Our model also predicts better clinical outcomes for patients in terms of functional independence and quality-adjusted life years.

Differential diagnosis and theories of pathophysiology of post-traumatic photophobia: A review.

Photophobia is a common sensory symptom after traumatic brain injury (TBI) that may have a grave impact on a patient's functional independence, neurorehabilitation, and activities of daily living. Post-TBI photophobia can be difficult to treat and the majority of patients can suffer chronically up to and beyond one year after their injury. This review evaluates the current theories of the pathophysiology of photophobia and the most-common co-morbid etiologies of light sensitivity in TBI to help guide the differential diagnosis and individualized management of post-TBI photophobia. Primary articles were found via PubMed and Google Scholar search of key terms including "photophobia" "light sensitivity" "photosensitivity" "photo-oculodynia" "intrinsically photosensitive retinal ganglion cells" "ipRGC" and "concussion" "brain injury" "dry eye". Due to paucity of literature papers were reviewed from 1900 to present in English. Recent advances in understanding the pathophysiology of photophobia in dry eye and migraine and their connection to intrinsically photosensitive retinal ganglion cells (ipRGC) have revealed complex and multifaceted trigeminovascular and trigeminoautonomic pathways underlying photophobia. Patients who suffer a TBI often have co-morbidities like dry eye and migraine that may influence the patient's photophobia. Post-traumatic photophobia is a complex multi-disciplinary complaint that can severely impact a patient's quality of life. Exploration of underlying etiology may allow for improved treatment and symptomatic relief for these patients beyond tinted lenses alone.

PHYSIOTHERAPY REHABILITATION OF DISTAL RADIAL FRACTURE TO ENHANCE THE ACTIVITY OF DAILY LIVING

Fracture of distal radius is the commonest fracture present in the upper limb. In fact, it is most commonly treated by the doctor. An outstretched hand is the most common cause of distal radius or wrist fractures. The fracture of distal radius can also lead to nerve injury mostly median nerve. Physical Therapy plays important role which provides positive effect in treating post fracture cases. A case of 45 years female is presented in this report who had an fall over right wrist joint and diagnosed with distal radius fracture and operated conservatively results into pain over wrist joint, decrease in physical activities. Rehabilitation protocol is explained below in the report. We report that there were improvement in patient outcomes level increases in muscles strength, provide pain relief and improvement in patient functional Independence.

QSAR STUDIES OF SOME SUBSTITUTED IMIDAZOLE DERIVATIVES AS POTENT ANTIFUNGAL AGENTS

Fracture of distal radius is the commonest fracture present in the upper limb. In fact, it is most commonly treated by the doctor. An outstretched hand is the most common cause of distal radius or wrist fractures. The fracture of distal radius can also lead to nerve injury mostly median nerve. Physical Therapy plays important role which provides positive effect in treating post fracture cases. A case of 45 years female is presented in this report who had a fall over right wrist joint and diagnosed with distal radius fracture and operated conservatively results into pain over wrist joint, decrease in physical activities. Rehabilitation protocol is explained below in the report. We report that there were improvement in patient outcomes level increases in muscles strength, provide pain relief and improvement in patient functional Independence.

Use of a force measuring walker to optimize recovery after median sternotomy

Abstract Funding Acknowledgements Type of funding sources: None. BACKGROUND Patients often need to use their arms to assist with functional activities, but after open-heart surgery, pushing with the arms is often limited to &amp;lt;10 lb (4.5 kg), to minimize force across the healing sternum. Restricting arm use often limits patient functional independence which can contribute to longer hospital stays and greater need for care after hospitalization. Therefore, appropriate arm use is important for return to function. Currently, no method exists to measure patient upper extremity weight bearing (UEWB) forces objectively in clinical settings. The ultimate goal was to develop a walker that provides UEWB force feedback to patients recovering from median sternotomy. This research project included three interrelated parts that sequentially built on each other. PART 1 First, I conducted a secondary data analysis comparing UEWB force and Pectoralis Major Muscle EMG during functional mobility in younger vs. older subjects (n = 65). Results showed that the mean arm force was &amp;gt;10 lb before feedback training during all functional mobility tasks for both groups. There were significant differences in UEWB force and EMG between groups (young vs. old) and trials (pre- vs. post-feedback training). There was significantly greater improvement (change) in the UEWB force in the older than younger subjects. We also found a significantly greater reduction in EMG activity in the older subjects than younger subjects for all tasks except during stand-to-sit. Results suggested that patients, particularly older ones, may not accurately estimate UEWB force &amp;lt;10 lb, and feedback training is effective for improving accuracy. This established proof-of-concept, the need for a Clinical Force Measuring (CFM) walker, and the efficacy of its use with feedback training. PART 2 Next, I completed a qualitative study to obtain critiques of a CFM walker prototype from rehabilitation professionals through structured interviews that were recorded and transcribed. I coded key statements and phrases that allowed "themes" to emerge (Table 1), which guided device revisions. PART 3 Lastly, I fabricated and tested a second CFM Walker prototype (Figure 1) based on key design elements including: 1) integrated vertical force measuring capability, 2) ergonomic handles, 3) simple visual and auditory feedback with upper limit alarms, 4) streamline, stable, and manoeuvrable frame, 5) lightweight construction, 6) minimal drag, 7) adjustable height, 8) ability to disinfect, and 9) affordable cost. CONCLUSIONS The CFM Walker could help patients recover safer and faster from open heart surgery, especially elderly adults.

Patient functional independence and occupational therapist time-use in inpatient services: Patient demographic and clinical correlates.

IntroductionHealth care expenditure has rapidly increased in Australia. Effective management of occupational therapy services is required to meet clinical demand. Improving our understanding of factors which influence occupational therapy service delivery is a vital step to manage workload distribution and optimise service efficiency. This study aims to examine the influence of patient sociodemographic characteristics, diagnosis and functional independence on the utilisation of occupational therapy resources in hospital inpatients over 18 years old.MethodsProspective, cross-sectional, observational cohort study of 4549 inpatients from three hospital sites in Melbourne, Australia. Data extracted from organisational databases and included in this study were: patient demographics, diagnosis, functional level assessed using the SMAF (Functional Autonomy Measurement System) and occupational therapy time-use. Data were analysed using univariable and multivariable modelling.ResultsOccupational therapy time-use was significantly associated with all variables included in analysis (p < 0.05). For each variable the amount and direction of effect differed between hospital sites. The SMAF was the only variable consistently associated with occupational therapy time-use. Higher occupational therapy time-use was associated with lower functional independence (leading to a 3.5 min increase in median occupational therapy time for every unit decrease in SMAF score).ConclusionsManagement of resources within busy hospitals require knowledge of factors associated with occupational therapist time-use. This study identified that time-use could in part be predicted by functional independence, diagnosis and sociodemographic characteristics. Occupational therapy managers can use this information to support decision making while acknowledging other patient and therapist level factors also influence time-use.

Benefits of robotic devices in medical rehabilitation of a case with neurofibromatosis type1

The term neurofibromatosis (NF) describes a group of genetic disorders that primarily affect the cell growth of neural tissues. Three clinically and genetically distinct forms of neurofibromatosis have been described: neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis. The inheritance pattern is autosomal dominant for all three types. We present the case of a 57 years old man, admitted to the Medical Rehabilitation Clinical Hospital Baile Felix, Romania, who was diagnosed with spastic tetraparesis, neurofibromatosis type 1, chronic viral hepatitis B and D, hypercholesterolemia, sarcopenia and osteoporosis. The objectives of the rehabilitation treatment were combating pain; preventing and correcting vicious postures at rest and during activity; maintaining or increasing joint mobility; increasing the mobility of the cervical and lumbar spine; decreasing spasticity; increasing strength of paralyzed muscles; improving motor control of paralyzed limbs; transfers re-education, gait re-education; improving breathing; improving ADLs; maintaining autonomy; gaining daily independence; prevention of recurrent complications and increasing the quality of life. The rehabilitation treatment was complex, performed over a period of 2 weeks and included various physiotherapy approaches, hydrokinetotherapy, massage, occupational therapy, robotic devices and virtual reality. It improved the patient's functional independence and quality of life. Innovations in information technology will refine and increase the efficiency, expertise and competence of medical rehabilitation, in order to ensure comfort for the patient and an appropriate and safe therapeutic approach. Keywords: neurofibromatosis, robotic devices, medical rehabilitation,

Balance and gait disturbances and the quality of life in patients with idiopathic Parkinson's disease and progressive supranuclear palsy

Background: Motor and non-motor symptoms of Parkinsonism increase the disease severity and burden. This progressive disease disrupts the patient's functional independence, motor skills and quality of life.

Mortalidad y uso de recursos sanitarios en pacientes ancianos en la provincia de Sevilla: diferencias entre pacientes institucionalizados y en atención domiciliaria

ObjectivesSociety is ageing, and as a consequence, the population with increased frailty and comorbidity is growing. The aim is to analyse the mortality and its potential factors, as well as the use of healthcare resources in elderly patients, and to study the differences between institutionalised patients and those included in a home care program. Materials and methodsAn observational, longitudinal and prospective cohort study was conducted in Seville during 2016. The study subjects consisted of 1314 elderly patients (1061 institutionalised and 253 at home). The variables studied included mortality and its potential factors, and the use of healthcare resources. ResultsNo differences were found in mortality between institutionalised and home care program patients (RR=1.044; 95% CI; 0.74-1.46; P=.799). The leading cause of death was circulatory diseases followed by respiratory diseases. Among the factors explaining the mortality, it is important to highlight: age, dependency and admissions in the hospital or the emergency department. The patient's functional independence is associated with a higher survival rate. Differences were found between both groups in the number of calls to the Critical Care and Emergency Services (P=.022) or the primary care doctor (P<.001) and in the hospital admissions (P<.001), the first 2differences being higher in home care program patients, and the latter in institutionalised patients. ConclusionsThere are no differences between groups either in the mortality or in the cause of death. Age, functional dependency and admissions in the hospital are factors which explain the mortality. The use of healthcare resources is higher in patients at home.

Association between postural patterns of spastic upper extremity and functional independence after TBI and stroke.

Spastic hypertonia of the upper limb after stroke or traumatic brain injuries (TBI) is a prevalent clinical sign causing abnormal postures and movement patterns due to hyperexcitability of the upper motor neurons and rheological alterations in the affected muscles. These alterations limit the use of the upper limb, restricting its functional activities and affecting the individual's quality of life and social participation. To determine the association between spastic patterns of the upper limb, wrist, fingers and thumb, and independence in everyday activities after a stroke or TBI. The design is a cross-sectional descriptive and correlational study. The sample consisted of 206 individuals who complied with the eligibility criteria and signed an informed consent. Clinical evaluation was carried out, including determination of the postural pattern of the upper extremity according to Hefter's taxonomy and postural pattern classification of the wrist, fingers and thumb. Functional independence was evaluated using the Functional Independence Measure (FIM) and the Barthel Index (BI). Univariate between-subject ANOVAs were used to examine associations of the four pattern classifications with the two independence measures, FIM and BI. Results indicate that Pattern I of Hefter's upper limb taxonomy is associated with lesser functional independence according to FIM and BI mean scores. The postural pattern of the upper limb after TBI or stroke is related to the patient's functional independence. Specifically, Pattern I tends to co-occur with low independence.

Latina/o and non-latina/o brain injury and dementia patients’ and caregivers’ health: An actor/partner interdependence model

AbstractBackground:The interdependence between patient and caregivers’ health, which is when the patients’ and informal caregivers’ emotion, cognition and/or behavior affects that of the other person is well documented among dyads experiencing cancer and heart disease, but scant research has assessed interdependence among those with brain injuries or dementia and Latina/o populations. This study aimed to assess the interdependence of patient and caregiver depression, patient functional independence and caregiver burden among non-Latina/o and Latina/o and patients with brain injuries and dementia and their caregivers.Methods:Patients and caregiver dyads (n = 96) were recruited from a trauma hospital. Participants completed measures on patient and caregiver depression, patient functional independence and caregiver burden. Participants provided written informed consent. Patient inclusion criteria included: (1) diagnosis with a brain injury or dementia, (2) minimum age of 12, (3) community dwelling and (4) ability to verbally communicate and complete study measures. Caregivers were only included if they were informal, unpaid, family or a friend. Nonparametric Spearman’s Rho correlations were conducted to test the study hypotheses.Discussion:There was consistently a statistically significant positive relationship between caregiver depression and caregiver burden for all groups. For non-Latina/o patient and caregiver dementia dyads, there were associations between patient depression and caregiver depression. For non-Latina/o dementia dyads, functional ability was only associated with patient depression. For Latina/o patient and caregiver brain injury and dementia dyads, the only statistically significant relationship was between caregiver depression and caregiver burden. Health services should embrace family-focused mental health and respite interventions.

The association between effectiveness of clinical supervision of allied health professionals and improvement in patient function in an inpatient rehabilitation setting

Purpose: Clinical supervision is widely accepted as an important element of practice for allied health professionals to ensure a high quality of patient care. However, it is unknown whether effective clinical supervision of allied health professionals improves patients’ outcomes. This study investigated whether effective clinical supervision of allied health professionals is associated with improved patient functional independence. Methods: A prospective longitudinal study design and multi-level regression analysis were used to explore the association between effective clinical supervision and patient functional independence. The effectiveness of clinical supervision was assessed using the Manchester Clinical Supervision Scale. Functional improvement in patients treated by allied health professionals was measured utilising the mobility and self-care subscales of the functional independence measure.Results: Physiotherapists (n = 27) and occupational therapists (n = 26) in inpatient rehabilitation were recruited and the medical records of their patients (n = 1846) audited. The effectiveness of clinical supervision of physiotherapists was positively associated with improvement in personal care. Therapist variables accounted for less than 2.5% of the variation in patient improvement in functional independence.Conclusions: Effectiveness of a reflective model of clinical supervision of physiotherapists and occupational therapists was not associated with an improvement in their patients’ mobility or personal care, respectively.Implications for rehabilitationEffective clinical supervision of physiotherapists and occupational therapists using a reflective model of practice is a poor predictor of improved functional independence in rehabilitation inpatients.Patient variables, such as the intensity of therapy, were more important predictors of patient functional improvement than effective clinical supervision.Initiatives aimed at increasing intensity of therapy will likely have a greater effect on improving patient functional independence compared with initiatives aimed at improving the effectiveness of clinical supervision using a reflective model of practice.Initiatives to improve the effectiveness of clinical supervision in improving quality of care could explore the use of a direct model of practice where supervisors directly observe and support supervisees during patient treatment sessions.

Cortical atrophic-hypometabolic dissociation in the transition from premanifest to early-stage Huntington's disease.

Huntington's disease (HD) is a fatal neurodegenerative disorder with no effective treatment currently available. Although the pathological hallmark of HD is massive striatal atrophy, it has been suggested that cortical deterioration may concomitantly occur and play a major role in the patient's functional independence. Our objective was to characterize cortical structural and metabolic neurodegeneration in the transition from premanifest to early-stage Huntington's disease (HD). Using a surface-based neuroimaging approach, we compared cortical thickness and intracortical FDG-PET uptake in 19 early-symptomatic HD patients with respect to 21 premanifest HD individuals. Early-HD patients showed significant cortical atrophy and intracortical hypometabolism when compared to premanifest subjects (p < 0.05, corrected for multiple comparisons). However, whereas the atrophy pattern was restricted to precentral and parieto-occipital regions, a pronounced frontotemporal hypometabolism was observed. Importantly, structural changes correlated with motor and cognitive performance, and metabolic changes were associated with the presence and severity of apathy in this population, a core neuropsychiatric feature of this disorder. Our findings reveal an asynchronous neuronal loss and metabolic compromise across the cerebral cortex in early HD. Hence, the use of structural and metabolic imaging indicators to characterize disease progression in this population should take into consideration the dissociation which occurs between cortical atrophy and hypometabolism.

PMD33 - BUDGET IMPACT ANALYSIS OF A DUAL-LAYER STENT RETRIEVER (DLSR) FOR THE TREATMENT OF PATIENTS WITH ACUTE ISCHEMIC STROKE (AIS) IN ENGLAND

The National Institute for Health and Care Excellence (NICE) recommends mechanical clot retrieval (MCR) for the treatment of acute ischemic stroke (AIS). Recently, a large clinical trial in AIS patients treated with a dual-layer stent retriever (DLSR) reported excellent functional independence outcomes, an important goal of stroke therapy that impacts patient quality of life. While the clinical benefits of MCR have been demonstrated, studies assessing the economic implications of technology selection are limited. Thus, this study estimated the budget impact of adopting a DLSR for patients with AIS from a 12-month National Health Service (NHS) perspective. The analysis compared a cost scenario considering a DLSR to a scenario with single-layer stent retrievers only, assuming a 25% adoption rate of DSLR. Acute (90-day) healthcare costs based on patient functional independence measured using the modified Rankin Scale (mRS) were included. Index procedure costs were limited to the acquisition cost of MCR technology, as evidence indicates other procedural resources to be similar between MCR devices. Functional outcomes, acute costs per mRS, and MCR technology acquisition costs were obtained from peer-reviewed literature. Case volume, treatment mix, and cost of the DLSR were obtained from market research data. Costs were reported as 2018 GBP. Among 655 patients treated with MCR over 12 months, 246 patients achieved good functional outcomes (mRS 0-2) in the scenario without the DLSR, compared with 294 patients in the scenario with the DLSR. Total 90-day costs in the scenario with the DLSR were £401,738 lower than the scenario with the DLSR (£10,127,235 vs. £10,528,973). In this analysis, adoption of a DLSR for AIS was associated with improvements in patient functional status. Functional independence may be achieved in 20% more patients in a scenario with the DLSR , which may translate to cost-savings for the NHS.

Neurobehavioral disability in stroke patients during subacute inpatient rehabilitation: prevalence and biopsychosocial associations

ABSTRACTBackground and Objectives: There are scarce data on post-stroke neurobehavioral disability (NBD). The aim of this study was to identify the prevalence of NBD in a subacute inpatient stroke population and examine potential associations with demographic, stroke-related, functional and psychosocial variables.Methods: 82 survivors of stroke were consecutively recruited during their inpatient rehabilitation admission. Nursing staff rated NBD in patients using the St Andrews –Swansea Neurobehavioral Outcome Scale (SASNOS). Measures of patient functional independence (FIM), cognition (MoCA), and mood symptoms (HADS) were collected in addition to nursing reports of whether observed NBD negatively impacted on the patient or those around them.Results: NBD relating to interpersonal relationships (44.4% of participants) and cognition (52.4%) were highly prevalent within the sample while NBD relating to inhibition (1.2%), aggression (3.6%), and communication (2.5%) were relatively rare. Presence of NBD was significantly associated with reduced functional independence (rs=0.39, p < 0.01) and associated with trends in cognitive impairment (rs=0.29, p = 0.03), increased anxiety (rs=-0.43, p = 0.02) and depressive symptoms (rs=-0.43, p = 0.02). Presence of NBD was significantly correlated with negative impact to the patient and those around them across all SASNOS domains (rs range 0.42 - 0.45, all p ≤ 0.01).Conclusions: NBD is common within a subacute stroke inpatient population, particularly interpersonal and cognitive difficulties and preliminary analyses indicate associations with reduced functional ability, cognition and mood. There is a need to provide education and support to clinicians to facilitate routine assessment and management of NBD following stroke.

Neurocognitive functioning is associated with functional independence in newly diagnosed patients with temporal lobe glioma.

Cancer and treatment-related neurocognitive dysfunction has the potential to significantly disrupt the lives of survivors. While neurocognitive functioning is known to predict aspects of patient-reported quality of life in individuals with glioma, little is known regarding the association between neurocognitive functioning and clinician-rated functional independence. Newly diagnosed patients with glioma in the left (n = 73; 49% glioblastoma) or right (n = 30; 57% glioblastoma) temporal lobe completed comprehensive neuropsychological testing. Clinicians rated patient functional independence using the Functional Independence Measure (FIM) and Karnofsky Performance Status (KPS) scale. Correlational and regression analyses were conducted to determine relationships between neurocognitive functioning and functional independence. Tests of verbal learning, executive function, and language comprehension were moderately to strongly associated with clinician-rated functional independence, particularly for items pertaining to need for assistance with memory, problem-solving, and language functions. Stepwise linear regression showed that tests of verbal learning, executive functioning, and language comprehension predicted FIM ratings, together accounting for 40% of variance (P < .001). A test of executive functioning also predicted KPS scores and accounted for 19% of variance (P < .001). In patients with newly diagnosed temporal lobe glioma, neurocognitive functioning is associated with functional independence. Verbal learning, executive functioning, and language comprehension demonstrated the strongest associations across both measures of functional independence. These findings provide support for the ecological validity of neuropsychological assessment by demonstrating the real-world clinical significance of objectively assessed neurocognitive functioning in glioma patients.