London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 761 785 Rehabilitation and reorganisation after stroke Evaluation of Right Unilateral spatial neglect (USN) in the acute phase of the stroke A. Potet1, E. Regrain2, S. Bakchine3, F.C. Boyer4, P. Pradat-Diehl5 Groupe Hospitalier Pitié-Salpétrière; service de Médecine Physique et réadaptation, Paris, FRANCE1, CHU de Reims; service de Médecine Physique et Réadaptation, Reims, FRANCE2, CHU de Reims; service de neurologie, Reims, FRANCE3, CHU de Reims; service de Médecine Physique et Réadaptation, Reims, FRANCE4, Groupe Hospitalier Pitié-Salpétrière; service de Méde-cine Physique et réadaptation, Paris, FRANCE5 Introduction: Unilateral spatial neglect (USN) after a left stroke is reported less frequently, less often studied and is less characterized. The purpose of this prospective study is to analyze right-side USN in the acute phase of the stroke. Materials and methods: This bicentric prospective study included patients affected by an ischemic or haemorrhagic left stoke in the first fifteen days. Our evaluation tool includes a clinical neurological examination, four paper-and-pencil nonverbal tests (from the BEN), four items of behavioural evaluation in the activ-ities of daily living (from the ECB) and a descriptive analysis of MRIs of the initial lesions of the patients. Results: Forty seven patients were assessed; eleven were excluded because of severe oral comprehension dif-ficulties. Thirty six patients were finally included, of which sixteen (44.4%) patients showed some degree of right USN (defined by at least two positive results from the eight paper-and-pencil and behavioural evaluation tests). The patients with right USN significantly presented a higher initial NI-HSS (p<0.001), more verbal disorders (p<0.001) and right hemiplegia (p =0.03). Line bisection and figure copying tests are positive to 14 (38.9%) and 13 (36.1%) patients respectively. The activities of daily living evaluation showed pathological results in 13 (36.1%) patients. Twelve of the 16 patients with USN had at least five positive tests among the eight paper-and-pencil tests and ecological eval-uations. The MRI analysis showed a high frequency of infra-cortical lesions, notably in the periven-tricular white matter. Discussion: In this study, the use of nonverbal tests and an ecological evaluation revealed right USN in 44.4% of patients with acute left stroke and demonstrated the important consequences right USN has on activ-ities of daily living. 786 Rehabilitation and reorganisation after stroke The relevance of clinical measures to physical activity after stroke N.M. Salbach1, D. Brooks2, J. Romano3, L. Woon4 Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, CAN-ADA1, Department of Physical Therapy, Faculty of Medicine, University of Toronto; Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, CANADA2, Department of Respirato-ry Medicine, West Park Healthcare Centre, Toronto, CANADA3, Department of Respiratory Medi-cine, West Park Healthcare Centre, Toronto, CANADA4 Objective: To examine the relationship between daily physical activity and six clinical measures of motor function, balance, balance self-efficacy, functional mobility, and walking speed and distance in community-dwelling individuals with stroke. Methods: Daily physical activity was estimated using average steps/day measured over a five-day period with a uniaxial accelerometer (activPAL) attached to the thigh of the participant’s unaffect-ed lower limb. The Chedoke-McMaster stroke assessment (CMSA; leg and foot scales), Berg bal-ance scale (BBS), activities-specific balance confidence (ABC) scale, timed ‘up and go’ test (TUG), 5-metre walk test (5mWT), and the 6-minute walk test (6MWT) were used to measure motor function, balance, balance self-efficacy, functional mobility, walking speed, and walking distance, respectively. Associations were estimated using the Pearson correlation coefficient for normally distributed variables or the Spearman rank correlation coefficient for variables without a normal dis-tribution (significance level 0.05). Results: Fifteen men and two women with a mean +/- standard deviation age of 71.4 +/- 9.7 years, who were 2.0 +/- 1.0 years post-stroke, participated. Participants walked 1905 +/- 2148 steps/ day (range 0-7242). Average steps/day was associated with scores on the ABC scale (rho=0.603, p=0.010), 5mWT (r=0.586, p=0.013), 6MWT (r=0.561, p=0.019), TUG (r=-0.515, p=0.034), and CMSA leg scale (rho=0.495, p=0.043) but not scores on the CMSA foot scale (r=0.243, p=0.348) or BBS (r=0.320, p=0.210). Conclusions: Balance self-efficacy and walking speed and distance were more strongly associated with daily physical activity than voluntary leg movement and functional mobility. Findings support the relevance of the clinical measures used and suggest that improvement in not only walking capac-ity but also balance self-efficacy in stroke rehabilitation may be necessary to promote daily physical activity following discharge to the community setting. Rehabilitation and reorganisation after stroke (PO 785 - 855 )
Karger_ESC London_2013
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