Abstract Details

Title A Care Pathway for Post-Stroke Spatial Neglect: Initial Analysis of a Practice-Based Rehabilitation Research Network

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 1-006

Objective The purpose of this study is to evaluate the launch success of a care pathway for spatial neglect within the Practice-RRuN network.

Background Spatial neglect is a failure to respond, orient, or initiate action towards contralesional space, causing significant disability. Over half of stroke patients receiving rehabilitation are affected, but only 20-50% are identified. Spatial neglect is associated with prolonged hospital stay, increased fall risk and decreased likelihood of discharge home. Despite this, it is rarely treated effectively. A practice-based rehabilitation research network (Practice-RRuN) was formed with the goal of implementing standardized assessment and evidence-based treatment of spatial neglect.

Design/Methods We recorded through observation, survey, and patient logs: success rate recruiting network facilities, number of therapists trained in functional assessment (Catherine Bergego Scale, CBS) and prism adaptation treatment (PAT), number of patient assessments, and PAT treatment / clinical outcomes.

Results

From March 2016 to August 2018, we approached 20 rehabilitation sites; 10 joined Practice-RRuN. 103 therapists learned standardized CBS and PAT. 838 neglect assessments were performed across 7 facilities. Of 553 patients with spatial neglect, 271 received PAT (49%), 93 patients with neglect received no PAT; 189 lacked documentation. Of 90, full-protocol (10-session) patients (mean age 66. 3 years, SD 10. 4; mean 10. 0 days post-insult; SD 9. 98), 92% had stroke, and 16% right-sided neglect. Functional abilities improved in full-protocol patients a mean 6. 94 CBS points (SD 5. 6) and mean 27. 1 total FIM points (SD 13. 5), comparing favorably with the improvement reported in a previous randomized controlled trial.

Conclusions Through the implementation of Practice-RRuN, 103 therapists were trained, 540 patients with spatial neglect were identified and 261 were treated with PAT. Patients receiving 10 sessions of PAT met improvement benchmarks. Using this information, futures goals include increasing utilization of treatment and evaluating outcomes including falls and discharge setting.

Authors/Disclosures
A. M. Barrett, MD, FAAN (UMass Memorial) PRESENTER	The institution of Dr. Barrett has received research support from Veterans Health Association. The institution of Dr. Barrett has received research support from National Institutes of Health. The institution of Dr. Barrett has received research support from Mabel H Flory Trust. Dr. Barrett has received personal compensation in the range of $0-$499 for serving as a author, chapter with WebMD. Dr. Barrett has received personal compensation in the range of $10,000-$49,999 for serving as a scientific advisor with Winifred Masterson Burke Foundation.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
A. M. Barrett, MD, FAAN (UMass Memorial)	The institution of Dr. Barrett has received research support from Veterans Health Association. The institution of Dr. Barrett has received research support from National Institutes of Health. The institution of Dr. Barrett has received research support from Mabel H Flory Trust. Dr. Barrett has received personal compensation in the range of $0-$499 for serving as a author, chapter with WebMD. Dr. Barrett has received personal compensation in the range of $10,000-$49,999 for serving as a scientific advisor with Winifred Masterson Burke Foundation.

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