Unilateral spatial neglect in the acute phase of ischemic stroke can predict long-term disability and functional capacity

Autor(es)

Gustavo José Luvizutto ^[1] ; Augusta Fabiana Moliga ^[2] ; Gabriela Rizzo Soares Rizzatti ^[3] ; Marcelo Ortolani Fogaroli ^[3] ; Eduardo de Moura Neto ^[4] ; Hélio Rubens de Carvalho Nunes ^[6] ; Luiz Antônio de Lima Resende ^[7] ; Rodrigo Bazan ^[7]

Afiliação do(s) autor(es)

^[1] Universidade Federal do Triangulo Mineiro. Departamento de Fisioterapia Aplicada - Brasil

^[2] UNESP, Fac Med Botucatu, Dept Reabil, Botucatu, SP - Brazil

^[3] Fac Med Botucatu, Botucatu, SP - Brazil

^[4] Fac Talentos Humanos FACTHUS, Dept Fisioterapia, Uberaba, MG - Brazil

^[5] Faculdade de Medicina de Botucatu. Departamento de Estatistica - Brasil

^[6] Faculdade de Medicina de Botucatu. Departamento de Estatistica - Brasil

^[7] UNESP, Fac Med Botucatu, Dept Neurol Psicol & Psiquiatria, Botucatu, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Clinics; v. 73, 2018-05-21.

Resumo

OBJECTIVE: The aim of this study was to assess the relationship between the degree of unilateral spatial neglect during the acute phase of stroke and long-term functional independence. METHODS: This was a prospective study of right ischemic stroke patients in which the independent variable was the degree of spatial neglect and the outcome that was measured was functional independence. The potential confounding factors included sex, age, stroke severity, topography of the lesion, risk factors, glycemia and the treatment received. Unilateral spatial neglect was measured using the line cancellation test, the star cancellation test and the line bisection test within 48 hours of the onset of symptoms. Functional independence was measured using the modified Rankin and Barthel scales at 90 days after discharge. The relationship between unilateral spatial neglect and functional independence was analyzed using multiple logistic regression that was corrected for confounding factors. RESULTS: We studied 60 patients with a median age of 68 (34-89) years, 52% of whom were male and 74% of whom were Caucasian. The risk for moderate to severe disability increased with increasing star cancellation test scores (OR=1.14 [1.03-1.26], p=0.01) corrected for the stroke severity, which was a confounding factor that had a statistically positive association with disability (OR=1.63 [1.13-2.65], p=0.01). The best chance of functional independence decreased with increasing star cancellation test scores (OR=0.86 [0.78-0.96], p=0.006) corrected for the stroke severity, which was a confounding factor that had a statistically negative association with independence (OR=0.66 [0.48-0.92], p=0.017). CONCLUSION: The severity of unilateral spatial neglect in acute stroke worsens the degree of long-term disability and functional independence. (AU)

• Processo FAPESP: 15/14231-0 - Efeito da estimulação elétrica transcraniana na negligência espacial unilateral após Acidente Vascular Cerebral.
• Beneficiário: Rodrigo Bazan
• Modalidade de apoio: Auxílio à Pesquisa - Regular