OBJECTIVE: To investigate the recovery processes of pusher behavior (PB) and unilateral spatial neglect (USN) based on the severity of PB and USN, and to determine the relationship between activities of daily living (ADL) independence levels. DESIGN: This retrospective study aimed to examine the temporal changes and their association with ADL independence levels based on the severity of PB and USN. SETTING: Recovery ward of Moriyama Neurological Center Hospital between March 2017 and October 2022. PARTICIPANTS: We included all patients with cerebrovascular disease admitted to the recovery ward of Moriyama Neurological Center Hospital between March 2017 and October 2022. A total of 174 patients with PB and USN were classified into 4 groups as follows: severe PB and severe USN (Group A), severe PB and mild USN (Group B), mild PB and severe USN (Group C), and mild PB and mild USN (Group D). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Kaplan-Meier survival analysis was used to determine whether the time to recovery from PB or USN (SCP: ≤1.75 points
Catherine Bergego Scale: 0 points) differed between groups. In addition, group differences in functional independence measure (FIM) scores and efficiencies were examined. RESULTS: There were significant differences among Groups A and B, and Groups A and C, as determined by the log-rank test (P<
.05), and recovery was prolonged when both PB and USN were severely impaired. Similarly, FIM scores and efficiencies were lower in Group A (P<
.05). When PB and USN were severely impaired, ADL was adversely affected, and the recovery process was prolonged. In addition, when 1 of the 2 symptoms was severe and the other was mild, each recovery course tended to show improvement, suggesting that they exerted a mutual influence on each other. CONCLUSIONS: These findings indicate that severity classification may help to determine functional prognosis in patients with PB and USN.