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Importance: Unilateral spatial neglect (neglect) poststroke is disabling. It is critical that people with neglect are identified so that treatment can be provided to maximize independence. However, there is some evidence to suggest that existing assessments may not adequately measure neglect. It is unclear whether assessments also fail to identify people with neglect entirely., Objective: To determine whether there are stroke survivors who self-report neglect symptoms that are not detected by therapist-rated assessments and to compare self-report and therapist-ratings., Design: Cross-sectional study., Setting: U.S. university research center., Participants: Unilateral stroke survivors (N = 133)., Intervention: Not applicable., Outcomes and Measures: The Catherine Bergego Scale (CBS) was administered to participants and scored by a trained occupational therapist. The parallel self-evaluation anosognosia form was also administered to participants to self-report and rate neglect symptoms., Results: Forty-eight participants (36.1%) were classified as without neglect on the basis of therapist-rated total CBS scores, yet 30 (62.5%) of these 48 participants reported symptoms of neglect on the CBS self-evaluation anosognosia form. There was a significant difference (p < .001) between therapist-rated and self-rated total CBS scores., Conclusions and Relevance: Our results indicate that many stroke survivors report some level of disability associated with neglect yet do not meet the criteria to be classified as having neglect according to a commonly used therapist-rated performance-based measure. Plain-Language Summary: The findings of this study contribute to the evidence that existing assessments used by occupational therapists to measure performance-based neglect may not always detect neglect symptoms comprehensively in people poststroke. The finding also suggest that we may be missing neglect symptoms entirely. Occupational therapists should consider using various methods to assess for neglect, including patient self-report and comprehensive occupational profiles. Clinicians should also thoroughly screen all clients with stroke for neglect, regardless of lesion location., (Copyright © 2024 by the American Occupational Therapy Association, Inc.)

Importance: Along with growth in telerehabilitation, a concurrent need has arisen for standardized methods of tele-evaluation., Objective: To examine the feasibility of using the Kinect sensor in an objective, computerized clinical assessment of upper limb motor categories., Design: We developed a computerized Mallet classification using the Kinect sensor. Accuracy of computer scoring was assessed on the basis of reference scores determined collaboratively by multiple evaluators from reviewing video recording of movements. In addition, using the reference score, we assessed the accuracy of the typical clinical procedure in which scores were determined immediately on the basis of visual observation. The accuracy of the computer scores was compared with that of the typical clinical procedure., Setting: Research laboratory., Participants: Seven patients with stroke and 10 healthy adult participants. Healthy participants intentionally achieved predetermined scores., Outcomes and Measures: Accuracy of the computer scores in comparison with accuracy of the typical clinical procedure (immediate visual assessment)., Results: The computerized assessment placed participants' upper limb movements in motor categories as accurately as did typical clinical procedures., Conclusions and Relevance: Computerized clinical assessment using the Kinect sensor promises to facilitate tele-evaluation and complement telehealth applications., What This Article Adds: Computerized clinical assessment can enable patients to conduct evaluations remotely in their homes without therapists present., (Copyright © 2019 by the American Occupational Therapy Association, Inc.)

Objective: We determined whether various assessment tools detect neglect differently by administering a battery of assessments to people with stroke., Method: We conducted a case series study and administered five neglect assessments (paper-and-pencil, functional, virtual reality) to participants poststroke., Results: Twelve participants (6 men, 6 women) with stroke completed the assessment battery, which required approximately 2 hr to administer (over one to two sessions). All participants demonstrated neglect on three or more assessments. Functional assessments and the virtual reality assessment detected neglect more frequently than the paper-and-pencil assessments. Participants performed differently on the paper-and-pencil assessments and functional assessments., Conclusion: Because neglect is complex, detection may depend largely on the assessment administered., (Copyright © 2017 by the American Occupational Therapy Association, Inc.)