Stroke researchers have determined that the Kessler Foundation Neglect Assessment Process (KF-NAP) measures severity of spatial neglect during activities of daily living. "Kessler Foundation Neglect Assessment Process Uniquely Measures Spatial Neglect during Activities of Daily Living" (doi: 10.1016/j.apmr.2014.10.023) was epublished by the Archives of Physical Medicine & Rehabilitation. The authors are Peii Chen, PhD, and A.M. Barrett, MD, of Kessler Foundation, Kimberly Hreha, MS, of Kessler Institute for Rehabilitation and Columbia University, Kelly M. Goedert of Seton Hall University, and Christine Chen, ScD, of the University of Texas.
Spatial neglect is a complication of stroke that contributes to poor rehabilitation outcomes, prolonged hospital stays, and increased risk for accidents. Seeing the need for better detection, these researchers developed the KF-NAP, which provides needed standardization for the functional performance measure, the Catherine Bergego Scale.
This study was conducted in 121 patients in inpatient rehabilitation who had unilateral damage from their first stroke. All were assessed with KF-NAP within 72 hours of admission; 108 were re-assessed at discharge. The prevalence of spatial neglect was 67% on admission and 47% at discharge. Results were compared with those from the Functional Independence Measure (FIM) and Barthel Index (BI). "We found that all three assessment tools were useful in examining deficits during activities of daily living," noted Dr. Chen, "but KF-NAP measured the deficits caused by spatial neglect that were not captured by the FIM or BI."
The persistently high prevalence of spatial neglect at discharge indicates the need for ongoing outpatient treatment, according to Dr. Chen. "The impact of spatial neglect on recovery is significant. Rehabilitation outcomes were poor among patient with spatial neglect," said Dr. Chen, "even in those who had prolonged inpatient rehabilitation. We need to look at whether early detection and intervention can reduce the impact of spatial neglect in stroke survivors."
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