Performance on Spatial Attention Tests by Adults with and without Unilateral Stroke: Functional Implications of spatial neglect

• Main Authors: Hsing-Fen Tu, 杜杏芬
• Other Authors: 林克忠
• Format: Others
• Language: en_US
• Published: 2006
• Online Access: http://ndltd.ncl.edu.tw/handle/15846909581488719265

碩士 === 國立臺灣大學 === 職能治療研究所 === 94 === Background: Previous studies on neglect have shown that there is significant influence to functional outcome to patients with stroke. Less evidence provided neglect subtypes, such as egocentric and allocentric neglect related to function. Purpose: (a) to investigate the performance on spatial attention tests of healthy adults to establish cut-off level; and (b) to investigate personal neglect and extra-personal neglect in patients groups related to function; (c) to exam the neglect subtypes predictive of anosognosia for functional deficits. The hypotheses of this study were (a) neglect subtypes would influence the functional performance in patients groups; (b) anosognosia for functional deficit related to neglect subtypes; (c) when further control age, motor, and sensory, the relationship between spatial attention and function would still remain. Methods: Four extrapersonal neglect tests and one personal neglect test were applied to assess neglect. Self-report and therapist-report Barthel Index (BIS and BIT) were used to measure functional performance. Cut-off level on extrapersonal neglect tests was determined by 81 healthy adults. And 58 patients with right brain damage (RBD) and 57 with left brain damage (LBD) were recruited from the hospital in north Taiwan. Results: The random shape cancellation test was the most sensitive to RBD (62%) and so was the Random Chinese Word Cancellation test to LBD (32%). Besides, neglect subtypes (extra-personal vs. personal neglect; egocentric vs. allocentric neglect) related to different functional status. Anosognosia showed predictive to function of RBD (p<0.001). And after controlling confounders, the correlation still remained. Conclusions: Sensitivity differed from tasks and brain lesion sites. And neglect subtypes influence function, as well as egocentric and allocentric neglect would influence functional performance significantly, especially to patients with RBD. And BIS could be differentiated functional performance of egocentric and allocentric neglect better than BIT. If further analyzed anosognosia score (BID), personal neglect showed the predictive for unawareness of functional deficit.