Clinical and demographic correlates of unilateral spatial neglect among community-dwelling Nigerian stroke survivors

Abstract

Background: Unilateral Spatial Neglect (USN) is important sequelae of stroke which has been linked with poor clinical recovery. Its prevalence among post hospital discharge stroke survivors and clinical and demographic correlates of the USN have not been well documented. This study explored the occurrence of USN and its associated factors among Nigerian community-dwelling stroke survivors.
Method: A descriptive research approach was employed in this study carried out at a Physiotherapy outpatient facility. Forty post-stroke individuals receiving physiotherapy on out-patient basis were screened for the existence of USN using the bells and star cancellation tests. Information on age, gender, stroke laterality, time after stroke and motor function assessed using modified motor assessment scale were also documented. Prevalence of USN was determined while differences in prevalence by demographic and clinical variables were analyzed using Chi-square and Mann Whitney U tests at P=0.05.
Results: Neglect was observed in 15 (37.0%) stroke patients, with an almost equal proportion in both right and left hemispheric stroke. Among the demographic and clinical variables investigated, only gender and motor function were found to have significant association with USN. Conclusions: A considerable proportion of community-dwelling stroke survivors receiving physiotherapy as part of their rehabilitation program were observed to experience neglect, a disorder identified with prolonged rehabilitation efforts and poor outcome. Routine screening for existence or persistence of USN should be carried out for individuals who have suffered a stroke considering that its presence is associated with poor motor performance.