Unilateral Spatial Neglect May Not Be Detected by Performance-Based Functional Neglect Assessment

Area of Science:

• Neurorehabilitation
• Stroke recovery
• Occupational therapy

Background:

• Unilateral spatial neglect (neglect) is a common and disabling post-stroke condition.
• Accurate identification of neglect is critical for effective treatment and maximizing patient independence.
• Existing therapist-rated assessments may not adequately detect all instances of neglect.

Purpose of the Study:

• To determine if stroke survivors self-report neglect symptoms not detected by standard therapist assessments.
• To compare self-reported neglect symptoms with therapist ratings.
• To investigate potential underdiagnosis of neglect poststroke.

Main Methods:

• A cross-sectional study involving 133 unilateral stroke survivors.
• Utilized the Catherine Bergego Scale (CBS) for therapist ratings.
• Employed a parallel self-evaluation anosognosia form for patient self-reporting of neglect symptoms.

Main Results:

• 36.1% of participants were classified as without neglect by therapist ratings.
• However, 62.5% of those participants reported neglect symptoms on the self-evaluation form.
• A statistically significant difference (p < .001) was found between therapist-rated and self-rated CBS scores.

Conclusions:

• Many stroke survivors experience neglect-related disability but may not meet criteria on performance-based measures.
• Current therapist-rated assessments may fail to comprehensively detect neglect symptoms.
• Incorporating patient self-report and comprehensive occupational profiles is recommended for accurate neglect assessment.