Background and Purpose-The aim of this study was to verify whether the presence of anosognosia (A) affects the rehabilitative prognosis of hemiplegic subjects with neglect (N). Methods-This study was carried out on 30 patients with left hemiplegia: 15 patients had neglect (group N) and 15 had neglect and anosognosia (group NϩA). Mean age was 68.2Ϯ6.3 in group N (9 men and 6 women) and 72.1Ϯ6.4 in group NϩA (7 men and 8 women). The average interval from onset of stroke to admission for rehabilitation was 23 and 23.6 days, respectively, in group N and in group NϩA. Patients were assessed through the Mesulam test, Bisiach test, Wechsler Adult Intelligence Scale, Fugl-Meyer scale, Functional Independence Measure (FIM), and Rankin scale. Results-Before rehabilitation, cognitive FIM scores of patients of group N were significantly higher than those of group NϩA (Pϭ0.001), whereas motor FIM scores and total FIM scores did not differ between the 2 groups. After rehabilitation, cognitive FIM scores (Pϭ0.000) and even motor (Pϭ0.009) and total FIM scores (Pϭ0.000) were statistically higher in group N than in group NϩA. Effectiveness (Pϭ0.005) and efficiency (Pϭ0.012) in the motor FIM scores of group N were significantly greater than those of group NϩA. Disability was lower in group N (Pϭ0.040). Conclusions-Our study shows that the presence of anosognosia worsens the rehabilitation prognosis in hemiplegic subjects who also have neglect.

Our data seem to indicate that STS has a worse rehabilitative prognosis than ITS, and that hemiparesis is more difficult to rehabilitate than ataxia.

In stroke rehabilitation, the patients' motor patterns according to the synergies strongly relate with functional outcomes and are important outcome predictors.

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