[Abstract] A Systematic Review and Meta-Analysis of Rehabilitative Interventions for Unilateral Spatial Neglect and Hemianopia from 2006 through 2016

Abstract

Objective

To evaluate the effectiveness of activity-based, non-activity-based, and combined activity- and non-activity-based, rehabilitative interventions for individuals presenting with unilateral spatial neglect (USN) and hemianopia.

Data Sources

We searched CINAHL, Cochrane Library, EMBASE, MEDLINE and PubMed from 2006 to 2016.

Study Selection

Randomized controlled trials (RCTs), with a score of 6 or above in the PEDro Scale, that examined the effects of activity-based and non-activity-based rehabilitation interventions for people with USN or hemianopia. Two reviewers selected studies independently.

Data Extraction

Extracted data from the published RCTs. Mean differences (MD) or Standardized mean differences (SMD), and 95% confidence intervals (CIs), were calculated. Heterogeneity was assessed using the I² statistic.

aData Synthesis

Twenty RCTs for USN and five for hemianopia, involving 594 and 206 stroke participants respectively, were identified. Encouraging results were found in relation to activity-based interventions for visual scanning training and compensatory training for hemianopia (MD=5.11; CI=0.83 to 9.4; P=0.019; I²=25.16% on visual outcomes), and optokinetic stimulation and smooth pursuit training for USN (SMD=0.49, CI=0.01 to 0.97, P=0.045, I²=49.35% on functional performance in activities of daily living; SMD=0.96; CI=0.09 to 1.82; P=0.031; I²=89.57% on neglect).

Conclusions

Activity-based interventions are effective and commonly used in the treatment of USN and hemianopia. Non-activity-based and combined approaches, for both impairments, have not been refuted, as more studies are required for substantiated conclusions to be drawn.

via A Systematic Review and Meta-Analysis of Rehabilitative Interventions for Unilateral Spatial Neglect and Hemianopia from 2006 through 2016 – Archives of Physical Medicine and Rehabilitation

[ARTICLE] Assessment of visual space recognition of patients with unilateral spatial neglect and visual field defects using a head mounted display system – Full Text PDF

Abstract

[Purpose] The purpose of this study was the development of a method for presenting diverse visual information and assessing visual space recognition using a new head mounted display (HMD) system.

[Subjects] Eight patients: four with unilateral spatial neglect (USN) and four with visual field defects (VFD).

[Methods] A test sheet was placed on a desk, and its image was projected on the display of the HMD. Then, space recognition assessment was conducted using a cancellation test and motion analysis of the eyeballs and head under four conditions with images reduced in size and shifted.

[Results] Leftward visual search was dominant in VFD patients, while rightward visual search was dominant in USN patients. The angular velocity of leftward eye movement during visual search of the right sheet decreased in both patient types. Motion analysis revealed a tendency of VFD patients to rotate the head in the affected direction under the left reduction condition, whereas USN patients rotated it in the opposite direction of the neglect.

[Conclusion] A new HMD system was developed for presenting diverse visual information and assessing visual space recognition which identified the differences in the disturbance of visual space recognition of VFD and USN patients were indicated.

Full Text PDF [754K]

Source: Assessment of visual space recognition of patients with unilateral spatial neglect and visual field defects using a head mounted display system

[ARTICLE] Effects of repetitive transcranial magnetic stimulation on arm function and decreasing unilateral spatial neglect in subacute stroke: A randomized controlled trial

Abstract

Objective: The objective of this study is to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the functional recovery of stroke patients with unilateral neglect.

Design: Randomized controlled experimental study.

Setting: Outpatient rehabilitation hospital.

Subjects: Thirty patients with stroke were randomly assigned to two groups: an rTMS group (experimental) and a control group.

Interventions: Stroke patients in the experimental group underwent comprehensive rehabilitation therapy and rTMS. Stroke patients in the control group underwent sham therapy and comprehensive rehabilitation therapy. Participants in both groups received therapy 5 days per week for 4 weeks.

Main measures: Line bisection, Albert, Box and block and Grip strength tests were assessed before and after the four-week therapy period.

Results: A significant difference in the post-training gains in Line bisection (16.53 SD 9.78 vs. 3.60 SD 5.02), Albert (14.13 SD 4.92 vs. 3.26 SD 2.01), Box and block (15.06 SD 9.68 vs. 6.93 SD 7.52), and Grip strength tests (3.60 SD 2.66 vs 0.80 SD 1.26) was observed between the experimental group and the control group (P<0.05). In addition, the effect size for gains in the experimental and control groups was very strong in AT, BBT (effect size=2.15, 0.77 respectively).

Conclusion: We conclude that rTMS might be effective in improvement in reduction of the unilateral neglect and motor function.

via Effects of repetitive transcranial magnetic stimulation on arm function and decreasing unilateral spatial neglect in subacute stroke: A randomized controlled trial.