ObjectivesVisuospatial neglect (VSN) is a common cognitive deficit of lateralized attention after stroke and can have a negative influence on patients’ daily activities, community participation, and .Show moreObjectivesVisuospatial neglect (VSN) is a common cognitive deficit of lateralized attention after stroke and can have a negative influence on patients’ daily activities, community participation, and caregiver burden. VSN prevalence has been investigated in several mixed-age populations, but rarely in only an older population. As the population in geriatric rehabilitation (GR) is understudied and VSN may influence rehabilitation goals in GR (return home), we examined the prevalence of VSN as well as associations between VSN (severity) and population characteristics and the impact of VSN on functioning, length of stay, and discharge destination after GR.DesignMulticenter cross-sectional study.Setting and ParticipantsStroke patients admitted to GR.MethodsThree VSN tests (Star cancelation task, Line bisection task, and Catherine Bergego Scale) were administered in the first 2 weeks of GR admission. To examine VSN severity, a composite score was calculated based on scores of the 3 tests.ResultsA total of 114 stroke patients were included [55.3% female; mean age 80.2 (SD 8.0) years]. VSN prevalence was 47.4%, in which allocentric and egocentric neglect were more prevalent than VSN during activities of daily living. Participants with VSN spent more days in GR compared to participants without VSN (median 68.5 vs 35.5 days) and had fewer home returns. In addition, VSN participants showed less mobility, lower cognitive functioning, and less independence during self-care compared to participants without VSN. Mobility, self-care, cognition, duration of rehabilitation, and home return were negatively associated with VSN severity.Conclusions and ImplicationsVSN is very prevalent in the GR stroke population. VSN severely hampers older people during daily activities and their rehabilitation process and, therefore, has a major personal and societal impact. Accordingly, systematic assessment of VSN in the early phase of geriatric rehabilitation with multiple VSN screening tests is recommended. Show less
Neurological disorders may impair various aspects of walking ability that are needed for safe and independent walking. A comprehensive assessment addressing the key components of walking ability... Show moreNeurological disorders may impair various aspects of walking ability that are needed for safe and independent walking. A comprehensive assessment addressing the key components of walking ability may help to tailor management strategies to the individual needs of each patient. The aspect of walking adaptability is usually not assessed in clinical tests, but seems important for safe walking and is related to fall risk. The Interactive Walkway is a promising, unobtrusive, low-cost and comprehensive assessment tool of walking ability in daily practice. It is a walkway instrumented with an integrated multi-Kinect v2 set-up for markerless registration of 3D full-body kinematics. Besides performing quantitative gait assessments, the Interactive Walkway may also be used to assess walking adaptability. The Interactive Walkway is equipped with a projector to augment the entire walkway with (gait-dependent) visual context, such as obstacles, sudden-stop-and-start cues and stepping targets, demanding step adjustments under time pressure demands in a safe manner. The aim of this thesis was to examine if 1) this approach can provide a valid assessment of walking ability and, if so, 2) if it has clinical potential in the assessment of walking ability and fall risk in patients with stroke and Parkinson’s Disease. Show less
