most stroke survivors display a degree of motor , sensory , perception , or language 
 dysfunction1 , 2 . these people have difficulty performing their occupations 
 continually owing to their impairment even after returning to the community3 , 4 . in 
 particular , patients who have had a left hemiparetic stroke experience poorer rehabilitation 
 outcomes , longer hospital admissions , and greater dependence on others in activities of 
 daily living ( adl ) than patients who have had a right hemiparetic stroke . the specific factors underlying the negative 
 outcomes caused by hemineglect have been reported previously5 . hemineglect is a disorder that can reduce a person s ability to 
 look , listen , or make movements toward one - half of their environment . therefore , patients 
 with hemineglect display a limited response to rehabilitation in the recovery of independent 
 performance in daily activities , as well as social and leisure activities6 . patients who have a left hemiparetic stroke have also been shown to exhibit specific 
 behavioral patterns due to motor and perception disabilities , thereby affecting their 
 abilities to carry out many everyday tasks such as eating , reading , and getting dressed on 
 the right side only7 . this hemineglect 
 makes it difficult for patients to be involved in instrumental activities of daily living 
 ( iadl ) , recreational activities , and social roles when they transition from the 
 rehabilitation setting to their communities . the purpose of this study was to examine the 
 relationship of motor and processing skills with iadl in individuals who have hemineglect 
 after a left hemiparetic stroke . thirty - five patients who had had a left hemiparetic stroke participated in this study . the 
 inclusion criteria for participation in this study were as follows : ( 1 ) community - dwelling 
 adults who had had a stroke ; ( 2 ) adults with hemineglect after having a left hemiparetic 
 stroke ; ( 3 ) adults who provided consent ; ( 4 ) sufficient cognitive ability to understand and 
 follow simple verbal instructions , as indicated by a mini - mental state examination score of 
 24 ; ( 5 ) sufficient visual acuity to conduct the experimental process ; and ( 6 ) absence of 
 other neurological diseases other than stroke . all the participants were informed of the 
 purpose and procedures of the study , after which signed consent was obtained . this study was 
 conducted in accordance with the interventional ethical guidelines and the declaration of 
 helsinki . three clinical measurement tools were used , including activity card sorting 
 ( acs ) , assessment of motor and processing skills ( amps ) , and a modified barthel index ( mbi ) . the acs 
 assessment by occupational therapists was designed to help patients describe their 
 occupational histories and their social , instrumental , and leisure activities . the tool is 
 composed of 89 photographs depicting the performance of various activities , including 20 
 instrumental activities , 35 low physical - demand leisure activities , 17 high physical - demand 
 leisure activities , and 17 social activities , and allows for the calculation of the 
 percentage of activity retained . the amps is an observational assessment 
 that allows for the simultaneous evaluation of motor and process skills , and their effect on 
 the ability of an individual to perform complex or instrumental and personal activities of 
 daily living . motor skills are the 
 observable goal - directed actions people perform during adl in order to move themselves or 
 the task objects . processing skills refer to the ability of an individual to logically 
 sequence the actions related to the adl over time9 . the mbi is an easily administered 10-item tool for assessing 
 self - care and mobility adl . it takes approximately 5 to 10 minutes to complete if the 
 observational method is used . a higher number is associated with a greater likelihood of 
 being able to live at home with a degree of independence after hospital discharge . this study used assumptions for regression analysis to investigate the relationship between 
 instrumental adl , motor and process skills , and recreational activities . thirty - five participants with left hemiparetic stroke participated in this study ( 22 males , 
 13 females , aged 57.1  16.9  years ) . table 
 1table 1.demographic characteristics of the subjectscharacteristicright brain damage ( n=35)gendermale22female13age ( years)57.1  16.9etiologyhemorrhage18infarction17onset period ( months)40.7  27.5brunnstrom stage4.1  1.4mmse - k27.0  2.5data are presented as mean  sd . the mbi scores revealed that participation in leisure and social 
 activities was affected ( table 2table 2.results of the analysis of the influencing factors of the recovery of functions 
 after a left hemiparetic stroke in community - dwelling patientsdependent variableindependent variablebstandard erroriadlmotor skill1.6591.809process skill20.5940.308*mbi1.1488.678*leisuremotor skill9.6054.971process skill1.9785.077mbi0.4270.177*social participationmotor skill6.7427.220process skill11.4717.374mbi0.9330.257**p<0.05 ) . previous studies have reported that patients who have had a left hemiparetic stroke showed 
 specific behavioral patterns due to motor and perception disabilities7 . these behavioral patterns include the inability to orient 
 or respond to stimuli on the side contralateral to the brain lesion . this specific 
 behavioral pattern is associated with a greater risk of falls , longer stay in rehabilitation 
 facilities , and poorer functional recovery . for this reason , these patients do not 
 participate in iadl , leisure , or social activities . therefore , stroke rehabilitation could 
 influence their participation in iadl , leisure , and social activities . the results of this study show that participation in iadl was affected by a reduction in 
 the processing skills of amps and that participation in leisure and social activities 
 affected the independence of daily living as assessed using the mbi . in other words , 
 participation in iadl correlates with perceptual and cognitive functions , and participation 
 in leisure and social activities affects independence . a limitation of this study was that it did not evaluate the sensory or language functions 
 associated with participation in iadl . therefore , future research that evaluates various 
 functions in patients who have had a left hemiparetic stroke will clarify the results of 
 this study . nevertheless , the results of this study have clinical implications for 
 rehabilitation intervention because left hemiparetic stroke has been identified as a factor 
 that affects processing skills and independent daily living .
[ purpose ] the purpose of this study was to evaluate the relationships between daily 
 activities , information processing , and motor skills in individuals with hemineglect after 
 having a left hemiparetic stroke . 
 [ subjects and methods ] the instrumental activities of 
 daily living of 35 patients ( 22 male and 13 female ; age : 57.1  16.9  years ) with 
 hemineglect after having a left hemiparetic stroke were assessed by using three clinical 
 measurement tools , including activity card sorting , assessment of motor and process 
 skills , and the modified barthel index . 
 [ results ] the results of the regression analysis 
 indicated that the patients processing skills in instrumental activities of daily living 
 after having a left hemiparetic stroke were reduced . 
 participation in leisure and social 
 activities was also affected as assessed by using the modified barthel index . 
 [ conclusion ] 
 this study supports the clinical need for rehabilitation intervention after a left 
 hemiparetic stroke to improve patients processing skills and independence in performing 
 activities of daily living .