Effects of Neck Taping in the Treatment of Hemispatial Neglect in Chronic Stroke Patients: A Pilot, Single Blind, Randomized Controlled Trial (original) (raw)
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Neuropsychologia, 2003
In patients suffering from left unilateral neglect, their right-biased attention to the phenomenal world can be ameliorated, short-term, by making motor responses to left-right extended objects (rods) that immediately reveal to them that their phenomenal world is in fact skewed. In this study the extent to which more intensive experiences of this type produced enduring and useful improvements in neglect, was assessed by first examining the effect of a 3 day experimenter-administered practice of rod lifting, then by examining the effects of a self-administered practice for a further 2 week period and a further one month post-training. Despite the fact that by the time the patients were able to undergo the intervention they had progressed to the chronic neglect stage, significant improvements of the intervention over the control group were found for a third of the tests given after the three day practice.
Limb activation effects in hemispatial neglect
Archives of Physical Medicine and Rehabilitation, 2003
Objective: To assess the efficacy of passive and active limb movement to improve visual scanning in patients with hemispatial neglect. Design: Before-after trial: behavioral analyses of a case series. Setting: Stroke rehabilitation unit in a tertiary care hospital. Participants: Nine individuals with right-hemisphere stroke (mean time poststroke, 19.5mo) and left-sided neglect, as assessed by the Sunnybrook Bedside Neglect Battery. Intervention: Active left limb movement (button push; nϭ3) or passive left limb movement (nϭ8) with functional electric stimulation (FES) administered during visual scanning testing. Main Outcome Measures: Performance on visual scanning tests involving naming of letters and numbers. Results: Both active and passive movement significantly improved target detection on the left side, but not on the right side, on the visual scanning task. Positive results were seen in 2 of 3 active movement patients and 6 of 8 passive movement patients. Conclusions: Both active and FES-stimulated passive movements are potential techniques for the treatment of hemispatial neglect.
Neuropsychological rehabilitation, 2017
Hemispatial neglect is a severe cognitive condition frequently observed after a stroke, associated with unawareness of one side of space, disability and poor long-term outcome. Visuomotor feedback training (VFT) is a neglect rehabilitation technique that involves a simple, inexpensive and feasible training of grasping-to-lift rods at the centre. We compared the immediate and long-term effects of VFT vs. a control training when delivered in a home-based setting. Twenty participants were randomly allocated to an intervention (who received VFT) or a control group (n = 10 each). Training was delivered for two sessions by an experimenter and then patients self-administered it for 10 sessions over two weeks. Outcome measures included the Behavioural Inattention Test (BIT), line bisection, Balloons Test, Landmark task, room description task, subjective straight-ahead pointing task and the Stroke Impact Scale. The measures were obtained before, immediately after the training sessions and af...
International Journal of Nursing Studies, 2015
Objectives: To identify rehabilitation interventions that can be integrated into ward-based nursing for patients with hemispatial neglect following stroke in the right brain hemisphere. Design: A systematic review of interdisciplinary literature. Data sources: A preliminary literature search without time limits was conducted in the Cochrane Controlled Trials Register. We then searched the PubMed, CINAHL and PsychINFO databases for relevant articles published between January 2006 and June 2014. Selected journals were searched manually. Additional resources were explored by scrutinizing reference lists and tracking citations of the selected articles. Review methods: Titles and abstracts were matched with the inclusion criteria. Articles were read in their entirety if the abstracts adhered to inclusion criteria or if there was any uncertainty. Two reviewers evaluated the risk of methodological bias independently by using quantitative appraisal forms from the Johanna Briggs Institute (JBI). Any disagreements were resolved by consensus. Authors of nine studies were contacted to acquire additional information. The JBI Reviewers' Manual was used to guide the overall procedure of the review. We used the PRISMA statement to ensure precise reporting of the results. The selected studies were graded according to the strength of their evidence (Levels 1-5); the proposed interventions were given recommendation grades (Grades A-D). Results: Using 41 original studies, 11 interventions were identified. These comprise: (1) contralesional neck vibration (Grade C); (2) emotionally salient stimuli and reward (Grade D); (3) family participation and intensity of training (Grade C); (4) limb activation training (Grade C); (5) mental imagery training, (Grade D); (6) mirror therapy (Grade C); (7) music therapy (Grade D); (8) right half-field eye patching (Grade D); (9) smooth pursuit eyemovement training (Grade B); (10) virtual reality and computer-based training (Grade C); and (11) visual scanning training (Grade D). Conclusion: A total of 11 promising rehabilitation interventions were found. Encouraging results were, in particular, seen with smooth pursuit eye-movement training. It should be
Journal of rehabilitation medicine, 2017
To investigate the effects of kinaesthetic ability training with the Kinesthetic Ability Trainer (KAT) on unilateral neglect and functional outcomes in stroke patients. An assessor-blinded, randomized controlled, clinical trial. A total of 64 stroke patients with unilateral neglect (mean age 61 (standard deviation (SD) 12) years, 60.4% male, mean time since stroke 6.4 (SD 10.4) months, left hemiplegia 92.5%) were randomly assigned to a conventional rehabilitation programme (control group, n = 32) or KAT plus a conventional rehabilitation programme (KAT group, n = 32) for 4 weeks. Patients were assessed with the Behavioral Inattention Test (BIT) and Functional Independence Measure (FIM) before and after therapy. Both groups showed significant improvements in all subscales of the BIT (conventional and behavioural) (p < 0.001) and the FIM motor scale (p < 0.001) after therapy. Recovery from neglect was assessed, based on the BIT cut-off scores. The recovery rate for behavioural B...
Journal of NeuroEngineering and Rehabilitation, 2014
Background: A reduction of hemispatial neglect due to stroke has been associated with activation of the contralesional hand in the contralesional hemispace. Robot-assisted upper limb training was found to effectively improve paretic arm function in stroke patients. To date no proof of concept of robot-assisted hemispatial neglect therapy has been reported in literature. This study aimed to determine whether robot-assisted left (contralesional) hand activation alone could lead to an improvement in hemispatial neglect following stroke. Methods: Three stroke patients with right brain injury underwent a 2-week training program of robotic left hand activation with the Gloreha® hand rehabilitation glove, which provides repetitive, passive mobilization of the fingers. Outcomes were assessed using the Line Crossing test, the Bells test, the Sentence Reading test, the Saccadic Training, the Sustained Attention to Response Task, and the Purdue Pegboard test.
Advances in Physiotherapy, 2008
The aim of the review was to determine, from a physiotherapeutic perspective, existing tools that assess neglect and whether there was support for the positive effect of physiotherapeutic interventions on neglect after stroke. The review was based on publicized randomized controlled studies and reviews about neglect and stroke. The databases PubMed (Medline), Ahmed, Cinahl, PeDRO and PsycINFO were queried from 1980 until March 2007. A checklist from the Swedish Council on Technology Assessment in Health Care (SBU) was used to evaluate the quality of randomized controlled studies; a model for analysis of systematic reviews from SBU was used for reviews. Specific training for the neglect syndrome was recommended. There was moderate evidence for spatio-motor cueing and scanning training towards the effected side. The literature also indicated that trunk rotation or repeated neck muscle vibrations when associated with an extensive training programme, mental imagery training, video feedback training and prism adaptation could be recommended for the rehabilitation of stroke patients with neglect. Treatment with Constraint-Induced Movement Therapy (CIMT) has shown some promising results. None of the tools designed to assess neglect evaluated physical performance. From a physiotherapeutic point of view, there is limited evidence for treatment of patients with neglect after stroke and the way neglect should be assessed. Scanning training and activation of the affected hemisphere with spatio-motor cueing can be effectual. Several assessment tools in combination are recommended. Further randomized controlled trials with larger samples concerning physiotherapeutic interventions are warranted, in order to evaluate new techniques targeting cognitive processes contributing to clinical manifestations of neglect.
Archives of physical medicine and rehabilitation, 2017
To evaluate the effectiveness of noninvasive brain stimulation (NIBS) - repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) - on hemispatial neglect and performance in activities of daily living (ADL) after stroke. MEDLINE (Pubmed), Embase, Cochrane CENTRAL, SCOPUS, Scielo and Physiotherapy Evidence Database (PEDro) were searched from database inception to December 2016. Randomized controlled trials or crossover trials focused on determining the effects of tDCS or rTMS combined or not combined with other therapies for hemispatial neglect after stroke. Methodological characteristics of the studies, number of participants, comparison groups, interventions and outcomes were extracted. Ten trials comprising 226 participants had data that were suitable for the meta-analysis. Meta-analysis showed that NIBS combined with another therapy significantly improves hemispatial neglect [SMD -1.91 (95% CI, -2.57 to -1.25; I(2) 71%)]. A sensitivity...
Brain Sciences
Unilateral spatial neglect (USN) rehabilitation requires the development of new methods that can be easily integrated into conventional practice. The aim of the HEMISTIM protocol is to assess immediate and long-term recovery induced by an innovative association of left-side neck-muscle vibration (NMV) and anodal transcranial Direct Current Stimulation (tDCS) on the ipsilesional posterior parietal cortex during occupational therapy sessions in patients with left USN. Participants will be randomly assigned to four groups: control, Left-NMV, Left-NMV + sham-tDCS or Left-NMV + anodal-tDCS. NMV and tDCS will be applied during the first 15 min of occupational therapy sessions, three days a week for three weeks. USN will be assessed at baseline, just at the end of the first experimental session, after the first and third weeks of the protocol and three weeks after its ending. Our primary outcome will be the evolution of the functional Catherine Bergego Scale score. Secondary outcome measur...
Neuropsychological Rehabilitation, 2000
Robertson, North, and Geggie (1992) have suggested that the voluntary activation of the left upper limb in the left hemispace (spatio-motor cueing) could reduce unilateral neglect. This study assesses the efficacy of visuo-spatio-motor cueing, and particularly the generalisation to daily-life activities, in two patients with very severe neglect who had failed to improve with scanning training. The patients were included in the trial 4 and 7 months after a severe unilateral right hemispheric stroke. They both suffered from disabling unilateral neglect despite intensive conventional therapy. A single-case experimental ABAB design was used (A = baseline with conventional treatment; B = visuo-spatio-motor cueing; each period = 2 weeks). A randomisation test was used to assess the presence of a specific therapeutic effect. In both cases, there was a statistically significant treatment-related improvement on a line bisection test. A parallel improvement was found on neglect behaviourin daily life, as assessed by the Catherine Bergego Scale (Azouvi et al., 1996). The therapeutic effect was maintained at 1-month follow up. These results suggest that visuo-spatio-motor cueing may be efficient in very severe neglect and may help in obtaining generalisation to daily-life activities.