Kessler Foundation neglect assessment process uniquely measures spatial neglect during activities of daily living

Peii Chen, Christine C. Chen, Kimberly Hreha, Kelly M. Goedert, A. M. Barrett

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Abstract Objectives To explore the factor structure of the Kessler Foundation Neglect Assessment Process (KF-NAP), and evaluate the prevalence and clinical significance of spatial neglect among stroke survivors. Design Inception cohort. Setting Inpatient rehabilitation facility (IRF). Participants Participants (N=121) with unilateral brain damage from their first stroke were assessed within 72 hours of admission to an IRF, and 108 were assessed again within 72 hours before IRF discharge. Interventions Usual and standard IRF care. Main Outcome Measures During each assessment session, occupational therapists measured patients' functions with the KF-NAP, FIM, and Barthel Index (BI). Results The KF-NAP showed excellent internal consistency with a single-factor structure. The exploratory factor analysis revealed the KF-NAP to be unique from both the FIM and BI even though all 3 scales were correlated. Symptoms of spatial neglect (KF-NAP>0) were present in 67.8% of the participants at admission and 47.2% at discharge. Participants showing the disorder at IRF admission were hospitalized longer than those showing no symptoms. Among those presenting with symptoms, the regression analysis showed that the KF-NAP scores at admission negatively predicted FIM scores at discharge, after controlling for age, FIM at admission, and length of stay. Conclusions The KF-NAP uniquely quantifies symptoms of spatial neglect by measuring functional difficulties that are not captured by the FIM or BI. Using the KF-NAP to measure spatial neglect, we found the disorder persistent after inpatient rehabilitation, and replicated previous findings showing that spatial neglect adversely affects rehabilitation outcome even after prolonged IRF care.

Original languageEnglish (US)
Article number56031
Pages (from-to)869-876.e1
JournalArchives of Physical Medicine and Rehabilitation
Issue number5
StatePublished - May 1 2015
Externally publishedYes


  • Hemispatial neglect
  • Outcome assessment
  • Rehabilitation
  • Symptom assessment

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


Dive into the research topics of 'Kessler Foundation neglect assessment process uniquely measures spatial neglect during activities of daily living'. Together they form a unique fingerprint.

Cite this