Spatial neglect (SN) impedes functional recovery after stroke, leading to reduced rehabilitation gains and slowed recovery. The objective of the present study was to investigate whether integrating prism adaptation treatment (PAT) into a highly intensive rehabilitation program eliminates the negative impact of spatial neglect on functional and motor recovery. We examined clinical data of the 355 consecutive first-time stroke patients admitted to a sub-acute inpatient neurorehabilitation program that integrated PAT. The 7-item Motor Functional Independence Measure, Berg Balance Scale, and Motor Activity Log were used as main outcome measures. We found that 84 patients (23.7%) had SN, as defined by a positive score on the Catherine Bergego Scale via the Kessler Foundation Neglect Assessment Process (KF-NAP®). Although 71 patients (85%) received PAT, the presence of SN at baseline, regardless of PAT completion, was associated with lower functional independence, higher risk of falls, and a lower functional level of the affected upper limb both at admission and at discharge. The severity of SN was associated with inferior rehabilitation outcomes. Nonetheless, patients with SN who received PAT had similar rehabilitation gains compared to patients without SN. Thus, the present study suggests that integrating PAT in an intensive rehabilitation program will result in improved responses to regular therapies in patients with SN.

Department of Informatics and Mathematics in Transport Faculty of Transport Engineering University of Pardubice 532 10 Pardubice Czech Republic

Department of Physical Medicine and Rehabilitation Rutgers University Newark NJ 07101 USA

Department of Physiotherapy Faculty of Physical Education and Sport Charles University 162 52 Prague Czech Republic

Department of Psychiatry 1st Faculty of Medicine Charles University 121 08 Prague Czech Republic

Department of Rehabilitation Medicine 1st Faculty of Medicine Charles University 128 00 Prague Czech Republic

Kessler Foundation West Orange NJ 07052 USA

Rehabilitation Center Kladruby 257 62 Kladruby Czech Republic

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