Abstract
ABSTRACTHemispatial 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 after four-months post-training. Significantly greater short and long-term improvements were obtained after VFT when compared to control training in line bisection, BIT and spatial bias in cancellation. VFT also produced improvements on activities of daily living. We conclude that VFT is a feasible, effective, home-based rehabilitation method for neglect patients that warrants further investigation with well-designed randomised controlled trials on a large sample of patients.
Highlights
Hemispatial neglect is a severe neurological disorder, classically defined as a failure to respond to stimuli in the contralesional hemispace (Kerkhoff, 2001)
This study demonstrates, for the first time, that visuomotor feedback training (VFT), a simple training of grasping-to-lift rods, yields a significant improvement of hemispatial neglect, which was observed after just one hour of training and persisted for at least four-months post-training
Visuomotor feedback training (VFT) produced long-term improvements in line bisection but, notably, the training effects generalised to untrained tasks, including visual search tasks
Summary
Hemispatial neglect is a severe neurological disorder, classically defined as a failure to respond to stimuli in the contralesional hemispace (Kerkhoff, 2001). Its clinical impact is substantial with a third of patients showing signs of neglect even more than a year after their stroke (Karnath, Rennig, Johannsen, & Rorden, 2011; Rengachary, He, Shulman, & Corbetta, 2011) and with its diagnosis being a major predictor of stroke disability (Buxbaum et al, 2004 Gillen, Tennen, & McKee, 2005; Kalra, Perez, Gupta, & Wittink, 1997; Katz, Hartman-Maeir, Ring, & Soroker, 1999). We examined whether VFT effects were maintained after fourmonths post-training, a considerably greater follow-up period than previous studies (Harvey et al, 2003; Robertson et al, 1997)
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