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Stroke researchers report uniqueness of KF-NAP for assessing spatial neglect after stroke

Kessler Foundation Neglect Assessment Process compared with FIM and Barthel Index during ADL

Kessler Foundation

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IMAGE: Kimberly Hreha, MSOTR/L, A.M. Barrett, MD, and Peii Chen, PhD, conduct clinical research in spatial neglect after stroke. view more

Credit: Kessler Foundation

West Orange, NJ. February 17, 2015. Stroke researchers have determined that the Kessler Foundation Neglect Assessment Process (KF-NAP) measures severity of spatial neglect during activities of daily living. "Kessler Foundation Neglect Assessment Process Uniquely Measures Spatial Neglect during Activities of Daily Living" (doi: 10.1016/j.apmr.2014.10.023) was epublished by the Archives of Physical Medicine & Rehabilitation. The authors are Peii Chen, PhD, and A.M. Barrett, MD, of Kessler Foundation, Kimberly Hreha, MS, of Kessler Institute for Rehabilitation and Columbia University, Kelly M. Goedert of Seton Hall University, and Christine Chen, ScD, of the University of Texas.

Spatial neglect is a complication of stroke that contributes to poor rehabilitation outcomes, prolonged hospital stays, and increased risk for accidents. Seeing the need for better detection, these researchers developed the KF-NAP, which provides needed standardization for the functional performance measure, the Catherine Bergego Scale.

This study was conducted in 121 patients in inpatient rehabilitation who had unilateral damage from their first stroke. All were assessed with KF-NAP within 72 hours of admission; 108 were re-assessed at discharge. The prevalence of spatial neglect was 67% on admission and 47% at discharge. Results were compared with those from the Functional Independence Measure (FIM) and Barthel Index (BI). "We found that all three assessment tools were useful in examining deficits during activities of daily living," noted Dr. Chen, "but KF-NAP measured the deficits caused by spatial neglect that were not captured by the FIM or BI."

The persistently high prevalence of spatial neglect at discharge indicates the need for ongoing outpatient treatment, according to Dr. Chen. "The impact of spatial neglect on recovery is significant. Rehabilitation outcomes were poor among patient with spatial neglect," said Dr. Chen, "even in those who had prolonged inpatient rehabilitation. We need to look at whether early detection and intervention can reduce the impact of spatial neglect in stroke survivors."

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The study was funded by Kessler Foundation, the Healthcare Foundation of New Jersey, National Institutes of Health (K24HD062647), the National Institute on Disability, Independent Living, and Rehabilitation Research (H133G120203).

About Stroke Rehabilitation Research at Kessler Foundation

Research studies span all domains of post-stroke cognitive dysfunction, but emphasize hidden disabilities after stroke, including hidden disabilities of functional vision (spatial bias and spatial neglect). Students, resident physicians, and post-doctoral trainees are mentored in translational neuroscience of rehabilitation. Dr. Barrett and her colleagues work closely with the clinical staff at Kessler Institute for Rehabilitation. Among their collaborative efforts are the founding of the Network for Spatial Neglect and development of the Kessler Foundation Neglect Assessment Process (KF-NAPTM). Stroke Research receives funding from the Department of Education/NIDILRR; the National Institutes of Neurological Disorders & Stroke, the National Institutes of Health/NICHD/NCMRR; Kessler Foundation; the Healthcare Foundation of New Jersey; and the Wallerstein Foundation for Geriatric Improvement. Scientists have faculty appointments at Rutgers New Jersey Medical School.

About A.M. Barrett, MD

A.M. Barrett, MD, a cognitive neurologist and clinical researcher, studies brain-behavior relationships from the perspectives of cognitive neurology, cognitive neuroscience, and cognitive neurorehabilitation. Dr. Barrett is an expert in hidden cognitive disabilities after stroke, which contributes to safety problems & rehospitalization, increased caregiver burden, & poor hospital-to-home transition. She is a founder of the Network for Spatial Neglect, which promotes multidisciplinary research for this underdiagnosed hidden disability. Dr. Barrett is also professor of physical medicine & rehabilitation at Rutgers New Jersey Medical School and adjunct professor of neurology at Columbia University School of Medicine. She is Chair of the Neural Repair and Rehabilitation Section, the American Academy of Neurology, and a former president of the American Society for Neurorehabilitation.

Dr. Barrett is author of the reference article Spatial Neglect on emedicine.com. Relevant publications by Stroke Rehabilitation Research:

  • Barrett AM, Muzaffar T. Spatial cognitive rehabilitation and motor recovery after stroke. Curr Opin Neurol 2014;27:653-8. doi:10.1097/WCO.0000000000000148

  • Barrett AM. Picturing the body in spatial neglect: descending a staircase. Neurology. 2013 Oct 8;81(15):1280-1.

  • Goedert KM, Chen P, Boston RC, Foundas AL, Barrett AM. Presence of motor-intentional aiming deficit predicts functional improvement of spatial neglect with prism adaptation. Neurorehabilitation and Neural Repair epub Dec 27 2013. DOI: 10.1177/1545968313516872

  • Barrett AM, Oh-Park M, Chen P, Ifejika NL. Five new things in neurorehabilitation. Neurology Clinical Practice. Epub Nov 13 2014. doi: 10.1212/01.CPJ.0000437088.98407.fa.

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities.

For more information, visit KesslerFoundation.org; Facebook.com/KesslerFoundation; Tweet us @KesslerFdn Contacts

Carolann Murphy
973.324.8382
CMurphy@KesslerFoundation.org

Lauren Scrivo
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LScrivo@KesslerFoundation.org

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