{"title":"Analysis of the recovery process and activities of daily living independence in pusher behavior and unilateral spatial neglect.","authors":"Yuichi Kato, Yu Sato, Takumi Orimoto, Yuto Sudo, Masafumi Suzuki, Shigeyasu Ishida, Tokihide Jyashiki, Masanari Kikura, Yumi Ikeda, Kazu Amimoto","doi":"10.1016/j.apmr.2024.09.019","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the recovery processes of pusher behavior (PB) and unilateral spatial neglect (USN) based on the severity of PB and USN, to determine the relationship between activities of daily living (ADL) independence levels.</p><p><strong>Design: </strong>This retrospective study aimed to examine the temporal changes and their association with ADL independence levels based on the severity of PB and USN.</p><p><strong>Setting: </strong>Recovery ward of Moriyama Neurological Center Hospital between March 2017 and October 2022.</p><p><strong>Participants: </strong>We included all patients with cerebrovascular disease admitted to the recovery ward of Moriyama Neurological Center Hospital between March 2017 and October 2022. A total of 174 patients with PB and USN were classified into four groups as follows; severe PB and severe USN (Group A), severe PB and mild USN (Group B), mild PB and severe USN (Group C), and mild PB and mild USN (Group D).</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Kaplan-Meier survival analysis was used to determine whether the time to recovery from PB or USN (SCP: ≤1.75 points; CBS: 0 points) differed between groups. Additionally, group differences in Functional Independence Measure (FIM) scores and efficiencies were examined.</p><p><strong>Results: </strong>There were significant differences among Groups A and B and Groups A and C, as determined by the log-rank test (P<0.05), and recovery was prolonged when both PB and USN were severely impaired. Similarly, FIM scores and efficiencies were lower in Group A (P<0.05). When PB and USN were severely impaired, ADL was adversely affected, and the recovery process was prolonged. In addition, when one of the two symptoms was severe and the other was mild, each recovery course tended to show improvement, suggesting that they exerted a mutual influence on each other.</p><p><strong>Conclusions: </strong>These findings indicate that severity classification may help to determine functional prognosis in patients with PB and USN.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physical medicine and rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.apmr.2024.09.019","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To investigate the recovery processes of pusher behavior (PB) and unilateral spatial neglect (USN) based on the severity of PB and USN, to determine the relationship between activities of daily living (ADL) independence levels.
Design: This retrospective study aimed to examine the temporal changes and their association with ADL independence levels based on the severity of PB and USN.
Setting: Recovery ward of Moriyama Neurological Center Hospital between March 2017 and October 2022.
Participants: We included all patients with cerebrovascular disease admitted to the recovery ward of Moriyama Neurological Center Hospital between March 2017 and October 2022. A total of 174 patients with PB and USN were classified into four groups as follows; severe PB and severe USN (Group A), severe PB and mild USN (Group B), mild PB and severe USN (Group C), and mild PB and mild USN (Group D).
Interventions: Not applicable.
Main outcome measures: Kaplan-Meier survival analysis was used to determine whether the time to recovery from PB or USN (SCP: ≤1.75 points; CBS: 0 points) differed between groups. Additionally, group differences in Functional Independence Measure (FIM) scores and efficiencies were examined.
Results: There were significant differences among Groups A and B and Groups A and C, as determined by the log-rank test (P<0.05), and recovery was prolonged when both PB and USN were severely impaired. Similarly, FIM scores and efficiencies were lower in Group A (P<0.05). When PB and USN were severely impaired, ADL was adversely affected, and the recovery process was prolonged. In addition, when one of the two symptoms was severe and the other was mild, each recovery course tended to show improvement, suggesting that they exerted a mutual influence on each other.
Conclusions: These findings indicate that severity classification may help to determine functional prognosis in patients with PB and USN.
期刊介绍:
The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities.
Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.