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Kimberly Hreha

Kimberly Hreha

Assistant Professor in Orthopaedic Surgery
Orthopaedic Surgery, Occupational Therapy
kimberly.hreha@duke.edu
Box 3003, Durham, NC 27710
40 Duke Medicine Circle, Blue Zone #2506, Durham, NC 27710

Selected Publications

Identifying spatial neglect - an updated systematic review of the psychometric properties of assessment tools in adults post-stroke.

Journal Article Neuropsychol Rehabil · April 2025 Spatial neglect commonly occurs after a stroke, resulting in diverse impacts depending on the type and severity. There are almost 300 tools for assessing neglect, yet there is a lack of knowledge on the psychometric properties of these tools. The objective ... Full text Link to item Cite

A Patient Education Guide to Manage the Effects of Cataracts While Waiting for Surgery.

Journal Article Archives of physical medicine and rehabilitation · February 2025 Full text Cite

Research Best Practices for Eye Stroke Vision Rehabilitation: A Qualitative Study.

Journal Article Curr Eye Res · January 28, 2025 PURPOSE: Central retinal artery occlusion, also known as an eye stroke, results in visual impairment and functional challenges. Our study objectives were to identify meaningful measures and factors that indicate or enable successful recovery after eye stro ... Full text Link to item Cite

Does prism adaptation treatment reduce spatial neglect and improve function?

Journal Article Front Rehabil Sci · 2025 The potential of using prism adaptation for treating spatial neglect (SN) was questioned when recent meta-analyses found inconsistent evidence. However, analyses of clinical datasets support the use of prism adaptation treatment (PAT) in reducing SN and im ... Full text Link to item Cite

Life after stroke: changes in sensory health and the impact on participation.

Journal Article Top Stroke Rehabil · December 8, 2024 BACKGROUND: Research has demonstrated that adults post-stroke may experience sensory impairments across different sensory systems. There is a gap in research describing how sensory changes after stroke affect participation in health promoting activities. O ... Full text Link to item Cite

An International and Multidisciplinary Consensus on the Labeling of Spatial Neglect Using a Modified Delphi Method.

Journal Article Arch Rehabil Res Clin Transl · June 2024 Survivors of neurologic injury (most commonly stroke or traumatic brain injury) frequently experience a disorder in which contralesionally positioned objects or the contralesional features of individual objects are often left unattended or underappreciated ... Full text Link to item Cite

The Association of Vision and Hearing Impairment on Cognitive Function and Loneliness: Evidence From the Mexican Health and Aging Study.

Journal Article J Aging Health · April 15, 2024 Objectives: We investigated whether self-reported vision and hearing were associated with cognitive function and loneliness among Mexican adults aged 50 and older. Methods: Mexican Health and Aging Study data. Vision/hearing status was self-reported (excel ... Full text Link to item Cite

Identifying Spatial Neglect in Chronic Right Hemisphere Stroke Survivors Using the RHDBank Outcomes.

Journal Article J Speech Lang Hear Res · February 12, 2024 PURPOSE: The chronicity of spatial neglect (SN) and the utility of existing diagnostic measures used by speech-language pathologists remain poorly understood. In this retrospective study, we examined how the RHDBank test battery informs the identification ... Full text Link to item Cite

Feasibility and Clinician Perspectives of the Visual Symptoms and Signs Screen: A Multisite Pilot Study

Journal Article Topics in Geriatric Rehabilitation · January 1, 2024 Background: The Visual Symptoms and Signs Screen (V-SASS) is a tool to identify vision deficits and facilitate referrals to vision specialists. The study objectives were to determine feasibility and clinician perspectives of the V-SASS. Methods: Prospectiv ... Full text Cite

Trends and risk factors among adults admitted to the emergency department with fall-related eye injuries.

Journal Article Am J Emerg Med · December 2023 BACKGROUND/PURPOSE: Eye injuries can happen to people of any age and for many reasons; among these is a fall. The aims of this study were to: (1) examine trends among fall-related eye injuries in working-age and older adults admitted to the emergency depar ... Full text Link to item Cite

The Pre-Adaptation of a Stroke-Specific Self-Management Program Among Older Adults.

Journal Article J Aging Health · October 2023 Objectives: Managing multimorbidity as aging stroke patients is complex; standard self-management programs necessitate adaptations. We used visual analytics to examine complex relationships among aging stroke survivors' comorbidities. These findings inform ... Full text Link to item Cite

Education on the consequences of traumatic brain injury for children and adolescents with TBI and families/caregivers: a systematic scoping review.

Journal Article Brain Inj · January 2, 2023 OBJECTIVE(S): To examine the breadth of education or training on the consequences of traumatic brain injury (TBI) for children and adolescents with TBI and their families/caregivers. METHODS: Systematic scoping review of literature published through July 2 ... Full text Link to item Cite

Effect of Missed Items on the Reliability of the Kessler Foundation Neglect Assessment Process.

Journal Article Arch Phys Med Rehabil · November 2022 OBJECTIVE: To determine the maximum permissible number of missed items on the 10-item Catherine Bergego Scale administered after the Kessler Foundation Neglect Assessment Process (KF-NAP). Secondary objectives were to determine the frequency, characteristi ... Full text Link to item Cite

Impacts of Prism Adaptation Treatment on Spatial Neglect and Rehabilitation Outcome: Dosage Matters.

Journal Article Neurorehabil Neural Repair · August 2022 We examined whether number of prism adaptation treatment (PAT) sessions in regular clinical practice would predict spatial neglect (SN) improvement and rehabilitation outcomes. We reviewed clinical records from 16 U.S. rehabilitation hospitals where neurol ... Full text Link to item Cite

Development of a physical function outcome measure to harmonize comparisons between three Asian adult populations.

Journal Article Qual Life Res · January 2022 PURPOSE: The purpose of this study was to use modern measurement techniques and create a precise functional status metric for Asian adults. METHODS: The study subjects included Asian American adults from the 2012 Health and Retirement Study (n = 211), Chin ... Full text Link to item Cite

Lessons Learned and Future Actions: Modifying a Stroke Specific Self-Management Program.

Journal Article Front Health Serv · 2022 BACKGROUND: Self-management programs have been shown to be effective at providing support to individuals who want to manage chronic health conditions independently. It has been shown that adapting self-management programs for different diagnostic groups, s ... Full text Link to item Cite

The Implementation Process of Two Evidence-Based Protocols: A Spatial Neglect Network Initiative.

Journal Article Front Health Serv · 2022 INTRODUCTION: Spatial neglect, a neurocognitive disorder of lateralized spatial attention, is prevalent among stroke survivors especially in inpatient rehabilitation facilities (IRFs). The ultimate goal of the project was to improve spatial neglect care in ... Full text Open Access Link to item Cite

Functional Status Across Post-Acute Settings is Associated With 30-Day and 90-Day Hospital Readmissions.

Journal Article J Am Med Dir Assoc · December 2021 OBJECTIVE: To examine the association between cocalibrated functional scores across post-acute care settings and the subsequent risk of hospital readmission. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: We analyzed 781,021 fee-for-service ... Full text Link to item Cite

Current clinical practice in the screening and diagnosis of spatial neglect post-stroke: Findings from a multidisciplinary international survey.

Journal Article Neuropsychol Rehabil · October 2021 Spatial neglect has profound implications for quality of life after stroke, yet we lack consensus for screening/diagnosing this heterogeneous syndrome. Our first step in a multi-stage research programme aimed to determine which neglect tests are used (with ... Full text Link to item Cite

Association between vision impairment and cognitive decline in older adults with stroke: Health and Retirement Study.

Journal Article Aging Clin Exp Res · September 2021 Stroke survivors may experience multiple residual symptoms post-stroke, including vision impairment (VI) and cognitive decline. Prior studies have shown that VI is associated with cognitive decline, but have not evaluated the contribution of VI to post-str ... Full text Link to item Cite

Prism Adaptation Treatment Improves Inpatient Rehabilitation Outcome in Individuals With Spatial Neglect: A Retrospective Matched Control Study

Journal Article Archives of Rehabilitation Research and Clinical Translation · September 1, 2021 Objective: To determine whether prism adaptation treatment (PAT) integrated into the standard of care improves rehabilitation outcome in patients with spatial neglect (SN). Design: Retrospective matched control study based on information extracted from Jun ... Full text Cite

Differences in physical function across cancer recovery phases: Findings from the 2015 National Health Interview Survey

Journal Article British Journal of Occupational Therapy · March 1, 2021 Introduction: Recent cancer survivors (<2 years post-diagnosis) report poorer general health and physical weakness compared to long-term cancer survivors (≥2 years post-diagnosis), but differences in functional limitations are unknown. It is unclear which ... Full text Cite

Post-acute care use patterns among Hospital Service Areas by older adults in the United States: a cross-sectional study.

Journal Article BMC Health Serv Res · February 25, 2021 BACKGROUND: Despite the success of stroke rehabilitation services, differences in service utilization exist. Some patients with stroke may travel across regions to receive necessary care prescribed by their physician. It is unknown how availability and com ... Full text Link to item Cite

The impact of stroke on psychological and physical function outcomes in people with long-term physical disability.

Journal Article Disabil Health J · October 2020 BACKGROUND: An increased number of people who have a long-term physical disability (LTPD) are aging. Similar to older adults without previous disability, individuals with LTPD may experience age-related comorbidities secondary to aging. A leading cause of ... Full text Link to item Cite

Use of the ICD-10 vision codes to study ocular conditions in Medicare beneficiaries with stroke.

Journal Article BMC Health Serv Res · July 8, 2020 BACKGROUND: Ocular conditions are common following stroke and frequently occur in combination with pre-existing ophthalmologic disease. The Medicare International Statistical Classification of Diseases and Related Health Problems (ICD-10) coding system for ... Full text Link to item Cite

Prism adaptation treatment for spatial neglect post brain tumour removal: A case report.

Journal Article Hong Kong J Occup Ther · June 2020 PURPOSE/AIM: Spatial neglect is caused by damage to neural networks critical for spatial attention. Spatial neglect without proper treatment impedes rehabilitation outcomes. Prism adaptation treatment, a visuomotor protocol, has been used with stroke survi ... Full text Link to item Cite

Relationship Between Fear of Falling and Physical Activity in People Aging With a Disability.

Journal Article PM R · May 2020 BACKGROUND: An estimated one billion people worldwide live with some form of disability and may face many challenges as they age, including increased fall risk. Understanding the risk factors linking falls, fear of falling, and activity restriction is crit ... Full text Link to item Cite

A case of comorbidities highlighting cerebral stroke, vision impairment, and dementia.

Journal Article SAGE Open Med Case Rep · 2020 This case report is of a two-time stroke survivor with significant health comorbidities. This report highlights A.R.'s pre-existing, non-neurological vision impairments, stroke-related vision impairments, in addition to cognitive impairment and possible de ... Full text Link to item Cite

A One-Year Follow-Up Study on Community Dwelling Multiple Stroke Survivors with Spatial Neglect.

Journal Article Occup Ther Health Care · January 2020 This study assessed nine participants, who sustained multiple strokes and had spatial neglect, one year after participation in a prior trial on whether Prism Adaptation Treatment (PAT) was a feasible and effective treatment for spatial neglect remediation ... Full text Link to item Cite

Impact of secondary health conditions on social role participation for a long-term physical disability cohort.

Journal Article Psychol Health Med · December 2019 For people living with long-term physical disability (LTPD) social participation may involve managing physical impairments and secondary health conditions (SHCs) that are not due to the pathophysiology of the LTPD diagnosis itself. Prior research found a n ... Full text Link to item Cite

Identification of targets for improving access to care in persons with long term physical disabilities.

Journal Article Disabil Health J · July 2019 BACKGROUND: People with long-term physical disability (LTPD) continue to experience difficulties in accessing health care despite the focus of highlighting disparities in the last two decades. OBJECTIVES: To describe health care utilization, accommodations ... Full text Link to item Cite

Comprehensive, technology-based, team approach for a patient with locked-in syndrome: A case report of improved function & quality of life.

Journal Article Assist Technol · 2019 One of the most severe types of stroke is locked-in syndrome (LIS) due to the loss of almost all voluntary motor functions and a high mortality rate. The majority of the literature regarding LIS is based on case reports that utilized multidisciplinary inte ... Full text Link to item Cite

Implementation of a Multidisciplinary Diabetes Self-Management Training Class in Acute Rehabilitation.

Journal Article Occup Ther Health Care · October 2018 As a chronic medical condition, diabetes mellitus affects 29.1 million individuals in the United States. Since diabetes education reduces cost, there is a need for inpatient rehabilitation facilities to have education classes to address preexisting medical ... Full text Link to item Cite

Delirium Screening and Management in Inpatient Rehabilitation Facilities.

Journal Article Am J Phys Med Rehabil · October 2018 Delirium is an acute and fluctuating disturbance in cognition attention and awareness that is often a reflection of abnormal physiological condition of an individual. Delirium is highly prevalent among an older population and is associated with high mortal ... Full text Link to item Cite

The use of animal-assisted therapy in combination with physical therapy in an inpatient rehabilitation facility: A case report.

Journal Article Complement Ther Clin Pract · August 2018 BACKGROUND: Animal-assisted therapy (AAT) is a growing form of intervention in the field of rehabilitation often with the goals of decreasing pain, anxiety, and depression. There is a lack of literature on the use of AAT in inpatient rehabilitation facilit ... Full text Link to item Cite

Illustrating where spatial perception versus memory-based representation: spatial neglect in a distinguished artist; a case report.

Journal Article Neurocase · June 2018 Spatial neglect is a disorder of attention, perception, and processing of stimuli in contralesional space. The heterogeneous behaviors involve diverse neuroanatomical mechanisms. Anecdotal evidence suggests that neural circuitry of active spatial perceptio ... Full text Link to item Cite

The feasibility and effectiveness of using prism adaptation to treat motor and spatial dysfunction in stroke survivors with multiple incidents of stroke.

Journal Article Top Stroke Rehabil · May 2018 Background Strokes resulting in cognitive and motor problems can be debilitating and prolong recovery. Risk of a second stroke occurs for 40% of all first-time stroke survivors within five years. Prism adaptation treatment (PAT) may simultaneously improve ... Full text Link to item Cite

Assessing chronic stroke survivors with aphasia sheds light on prevalence of spatial neglect.

Journal Article Top Stroke Rehabil · March 2017 BACKGROUND: Stroke is a chronic disease. Standardized assessment is essential in order to determine areas for treatment. Individuals with aphasia are often excluded from research, because it is believed that their language impairments may impact their abil ... Full text Link to item Cite

Informal caregivers' burden and stress in caring for stroke survivors with spatial neglect: an exploratory mixed-method study.

Journal Article Top Stroke Rehabil · January 2017 BACKGROUND: Spatial neglect prolongs stroke survivors' recovery to independence. However, little is known about the impact of spatial neglect on caregivers of stroke survivors. OBJECTIVE: To explore the factors associated with burden and stress among infor ... Full text Link to item Cite

Spatial Neglect Hinders Success of Inpatient Rehabilitation in Individuals With Traumatic Brain Injury: A Retrospective Study.

Journal Article Neurorehabil Neural Repair · June 2016 Background Current knowledge about spatial neglect and its impact on rehabilitation mostly originates from stroke studies. Objective To examine the impact of spatial neglect on rehabilitation outcome in individuals with traumatic brain injury (TBI). Method ... Full text Link to item Cite

A conceptual model for vision rehabilitation.

Journal Article J Rehabil Res Dev · 2016 Vision impairments are highly prevalent after acquired brain injury (ABI). Conceptual models that focus on constructing intellectual frameworks greatly facilitate comprehension and implementation of practice guidelines in an interprofessional setting. The ... Full text Link to item Cite

Impact of spatial neglect on stroke rehabilitation: evidence from the setting of an inpatient rehabilitation facility.

Conference Arch Phys Med Rehabil · August 2015 OBJECTIVE: To examine the impact of spatial neglect on rehabilitation outcome, risk of falls, and discharge disposition in stroke survivors. DESIGN: Inception cohort. SETTING: Inpatient rehabilitation facility (IRF). PARTICIPANTS: Individuals with unilater ... Full text Link to item Cite

Kessler Foundation Neglect Assessment Process uniquely measures spatial neglect during activities of daily living.

Conference Arch Phys Med Rehabil · May 2015 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 rehabil ... Full text Link to item Cite

Effectiveness of interventions to improve occupational performance of people with motor impairments after stroke: an evidence-based review.

Journal Article Am J Occup Ther · 2015 We conducted a review to determine the effectiveness of interventions to improve occupational performance in people with motor impairments after stroke as part of the American Occupational Therapy Association's Evidence-Based Practice Project. One hundred ... Full text Link to item Cite

Functional assessment of spatial neglect: a review of the Catherine Bergego scale and an introduction of the Kessler foundation neglect assessment process.

Journal Article Top Stroke Rehabil · 2012 Spatial neglect is a debilitating poststroke neurocognitive disorder associated with prolonged hospitalization and poor rehabilitation outcomes. The literature suggests a high prevalence of this disorder, but clinicians have difficulty reliably identifying ... Full text Link to item Cite

We all can call: Enhancing accessible cell phone usage for clients with spinal cord injury

Journal Article Assistive Technology · June 1, 2011 The ability to successfully access a cellular phone is an essential part of life for both able-bodied individuals, and for those with functional mobility deficits following an injury or illness. While a variety of options are currently available on the mar ... Full text Cite