Neuropsychological predictors in stroke rehabilitation

A mailed questionnaire, sent routinely to discharged stroke patients, divided left-hemisphere (n = 68) and right-hemisphere (n = 77) patients into three groups of general help dependency in basic activities-of-daily-life skills. A subsample of 29 patients was visited at home and asked to reanswer the questionnaire under guidance of a trained occupational therapist. The reliability of the questionnaire was considered satisfactory. Both neurological deficits and neuropsychological syndromes correlated significantly with the level of help needed for managing alone at home. Multiple regression analysis revealed a major gain in explained variance in help dependency when neuropsychological test results were added to information on degree of hemiplegia and hemianopia. Keeping in mind the subject characteristics of the study sample, apraxia and pathological emotional reactions were the more important variables in the left-hemisphere and right-hemisphere groups respectively. The challenge from rehabilitation psychology is discussed and the need for developing more sophisticated methods for assessing rehabilitation potential is stressed.