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Left "Hemi" ADL Learning and Outcome: Limiting Factors

Departments of Neurology and Rehabilitation Medicine, University of Colorado Medical School, Denver Colorado

Barbara Boutell Friedman

Spalding Rehabilitation Hospital, Denver, Colorado

Forty consecutive cerebrovascular diseased left hemiparetic patients were prospectively evaluated for the ability to master activity of daily living (ADL) skills and for their outcome during a rehabilitation center hospitalization. Specifically, the influence of left spatial and body awareness on this learning process was assessed. Left hemianopsia was only a significant limitation for rehabilitation outcome if the patients could not learn self or verbal cuing compensation. All of these latter patients started and remained totally dependent. Patients with poor left body awareness also remained dependent. There was a large group of patients demonstrating significant improvement who, however, required the longest rehabilitation hospitalization. This was believed due to a gradual heightening of left awareness of compensatory spatial-body techniques. This enabled these patients to acquire the ADL skills to attain either a minimal assist or standby outcome status. Those patients not having left spatial or body awareness deficits, but having poor outcome, were limited by age-related systemic problems and poor psychological adaptation to their illness. The poorer outcome groups averaged a decade older than the better outcome patients.

Key Words: Left hemiplegic • Activities of daily living • Hemianopsia • Body awareness.

Neurorehabilitation and Neural Repair, Vol. 1, No. 3, 125-130 (1987)
DOI: 10.1177/136140968700100303


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