Spatial Neglect Hinders Success of Inpatient Rehabilitation in Individuals with Traumatic Brain Injury

Peii Chen, Irene Ward, Ummais Khan, Yan Liu, Kimberly Hreha

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background. Current knowledge about spatial neglect and its impact on rehabilitation mostly originates from stroke studies. Objective. To examine the impact of spatial neglect on rehabilitation outcome in individuals with traumatic brain injury (TBI). Methods. The retrospective study included 156 consecutive patients with TBI (73 women; median age = 69.5 years; interquartile range = 50-81 years) at an inpatient rehabilitation facility (IRF). We examined whether the presence of spatial neglect affected the Functional Independence Measure (FIM) scores, length of stay, or discharge disposition. Based on the available medical records, we also explored whether spatial neglect was associated with tactile sensation or muscle strength asymmetry in the extremities and whether specific brain injuries or lesions predicted spatial neglect. Results. In all, 30.1% (47 of 156) of the sample had spatial neglect. Sex, age, severity of TBI, or time postinjury did not differ between patients with and without spatial neglect. In comparison to patients without spatial neglect, patients with the disorder stayed in IRF 5 days longer, had lower FIM scores at discharge, improved slower in both Cognitive and Motor FIM scores, and might have less likelihood of return home. In addition, left-sided neglect was associated with asymmetric strength in the lower extremities, specifically left weaker than the right. Finally, brain injury-induced mass effect predicted left-sided neglect. Conclusions. Spatial neglect is common following TBI, impedes rehabilitation progress in both motor and cognitive domains, and prolongs length of stay. Future research is needed for linking specific traumatic injuries and lesioned networks to spatial neglect and related impairment.

Original languageEnglish (US)
Pages (from-to)451-460
Number of pages10
JournalNeurorehabilitation and Neural Repair
Volume30
Issue number5
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Fingerprint

Inpatients
Rehabilitation
Brain Injuries
Length of Stay
Touch
Muscle Strength
Medical Records
Lower Extremity
Extremities
Retrospective Studies
Stroke
Traumatic Brain Injury
Wounds and Injuries

Keywords

  • hemispatial neglect
  • length of stay
  • rehabilitation outcome
  • traumatic brain injury

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology

Cite this

Spatial Neglect Hinders Success of Inpatient Rehabilitation in Individuals with Traumatic Brain Injury. / Chen, Peii; Ward, Irene; Khan, Ummais; Liu, Yan; Hreha, Kimberly.

In: Neurorehabilitation and Neural Repair, Vol. 30, No. 5, 01.01.2016, p. 451-460.

Research output: Contribution to journalArticle

@article{c7d25362f0604288b4a3e4c9d8bbbc41,
title = "Spatial Neglect Hinders Success of Inpatient Rehabilitation in Individuals with Traumatic Brain Injury",
abstract = "Background. Current knowledge about spatial neglect and its impact on rehabilitation mostly originates from stroke studies. Objective. To examine the impact of spatial neglect on rehabilitation outcome in individuals with traumatic brain injury (TBI). Methods. The retrospective study included 156 consecutive patients with TBI (73 women; median age = 69.5 years; interquartile range = 50-81 years) at an inpatient rehabilitation facility (IRF). We examined whether the presence of spatial neglect affected the Functional Independence Measure (FIM) scores, length of stay, or discharge disposition. Based on the available medical records, we also explored whether spatial neglect was associated with tactile sensation or muscle strength asymmetry in the extremities and whether specific brain injuries or lesions predicted spatial neglect. Results. In all, 30.1{\%} (47 of 156) of the sample had spatial neglect. Sex, age, severity of TBI, or time postinjury did not differ between patients with and without spatial neglect. In comparison to patients without spatial neglect, patients with the disorder stayed in IRF 5 days longer, had lower FIM scores at discharge, improved slower in both Cognitive and Motor FIM scores, and might have less likelihood of return home. In addition, left-sided neglect was associated with asymmetric strength in the lower extremities, specifically left weaker than the right. Finally, brain injury-induced mass effect predicted left-sided neglect. Conclusions. Spatial neglect is common following TBI, impedes rehabilitation progress in both motor and cognitive domains, and prolongs length of stay. Future research is needed for linking specific traumatic injuries and lesioned networks to spatial neglect and related impairment.",
keywords = "hemispatial neglect, length of stay, rehabilitation outcome, traumatic brain injury",
author = "Peii Chen and Irene Ward and Ummais Khan and Yan Liu and Kimberly Hreha",
year = "2016",
month = "1",
day = "1",
doi = "10.1177/1545968315604397",
language = "English (US)",
volume = "30",
pages = "451--460",
journal = "Neurorehabilitation and Neural Repair",
issn = "1545-9683",
publisher = "SAGE Publications Inc.",
number = "5",

}

TY - JOUR

T1 - Spatial Neglect Hinders Success of Inpatient Rehabilitation in Individuals with Traumatic Brain Injury

AU - Chen, Peii

AU - Ward, Irene

AU - Khan, Ummais

AU - Liu, Yan

AU - Hreha, Kimberly

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background. Current knowledge about spatial neglect and its impact on rehabilitation mostly originates from stroke studies. Objective. To examine the impact of spatial neglect on rehabilitation outcome in individuals with traumatic brain injury (TBI). Methods. The retrospective study included 156 consecutive patients with TBI (73 women; median age = 69.5 years; interquartile range = 50-81 years) at an inpatient rehabilitation facility (IRF). We examined whether the presence of spatial neglect affected the Functional Independence Measure (FIM) scores, length of stay, or discharge disposition. Based on the available medical records, we also explored whether spatial neglect was associated with tactile sensation or muscle strength asymmetry in the extremities and whether specific brain injuries or lesions predicted spatial neglect. Results. In all, 30.1% (47 of 156) of the sample had spatial neglect. Sex, age, severity of TBI, or time postinjury did not differ between patients with and without spatial neglect. In comparison to patients without spatial neglect, patients with the disorder stayed in IRF 5 days longer, had lower FIM scores at discharge, improved slower in both Cognitive and Motor FIM scores, and might have less likelihood of return home. In addition, left-sided neglect was associated with asymmetric strength in the lower extremities, specifically left weaker than the right. Finally, brain injury-induced mass effect predicted left-sided neglect. Conclusions. Spatial neglect is common following TBI, impedes rehabilitation progress in both motor and cognitive domains, and prolongs length of stay. Future research is needed for linking specific traumatic injuries and lesioned networks to spatial neglect and related impairment.

AB - Background. Current knowledge about spatial neglect and its impact on rehabilitation mostly originates from stroke studies. Objective. To examine the impact of spatial neglect on rehabilitation outcome in individuals with traumatic brain injury (TBI). Methods. The retrospective study included 156 consecutive patients with TBI (73 women; median age = 69.5 years; interquartile range = 50-81 years) at an inpatient rehabilitation facility (IRF). We examined whether the presence of spatial neglect affected the Functional Independence Measure (FIM) scores, length of stay, or discharge disposition. Based on the available medical records, we also explored whether spatial neglect was associated with tactile sensation or muscle strength asymmetry in the extremities and whether specific brain injuries or lesions predicted spatial neglect. Results. In all, 30.1% (47 of 156) of the sample had spatial neglect. Sex, age, severity of TBI, or time postinjury did not differ between patients with and without spatial neglect. In comparison to patients without spatial neglect, patients with the disorder stayed in IRF 5 days longer, had lower FIM scores at discharge, improved slower in both Cognitive and Motor FIM scores, and might have less likelihood of return home. In addition, left-sided neglect was associated with asymmetric strength in the lower extremities, specifically left weaker than the right. Finally, brain injury-induced mass effect predicted left-sided neglect. Conclusions. Spatial neglect is common following TBI, impedes rehabilitation progress in both motor and cognitive domains, and prolongs length of stay. Future research is needed for linking specific traumatic injuries and lesioned networks to spatial neglect and related impairment.

KW - hemispatial neglect

KW - length of stay

KW - rehabilitation outcome

KW - traumatic brain injury

UR - http://www.scopus.com/inward/record.url?scp=84965058045&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84965058045&partnerID=8YFLogxK

U2 - 10.1177/1545968315604397

DO - 10.1177/1545968315604397

M3 - Article

VL - 30

SP - 451

EP - 460

JO - Neurorehabilitation and Neural Repair

JF - Neurorehabilitation and Neural Repair

SN - 1545-9683

IS - 5

ER -