A Systematic Review and Meta-Analysis of Rehabilitative Interventions for Unilateral Spatial Neglect and Hemianopia Poststroke From 2006 Through 2016

Karen P.Y. Liu (Corresponding Author), Jessica Hanly, Paul Fahey, Shirley S.M. Fong, Rosalind Bye

Research output: Journal article publicationReview articleAcademic researchpeer-review

28 Citations (Scopus)

Abstract

Objective: To evaluate the effectiveness of activity-based, nonactivity-based, and combined activity- and nonactivity-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 more in the Physiotherapy Evidence Database Scale that examined the effects of activity-based and nonactivity-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 I 2 statistic. Data Synthesis: A total of 20 RCTs for USN and 5 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; 95% confidence intervals [95% CI], 0.83-9.4; P=.019; I 2 =25.16% on visual outcomes), and optokinetic stimulation and smooth pursuit training for USN (SMD=0.49; 95% CI, 0.01-0.97; P=.045; I 2 =49.35%) on functional performance in activities of daily living, (SMD=0.96; 95% CI, 0.09-1.82; P=.031; I 2 =89.57%) on neglect. Conclusions: Activity-based interventions are effective and commonly used in the treatment of USN and hemianopia. Nonactivity-based and combined approaches, for both impairments, have not been refuted, because more studies are required for substantiated conclusions to be drawn.

Original languageEnglish
Pages (from-to)956-979
Number of pages24
JournalArchives of Physical Medicine and Rehabilitation
Volume100
Issue number5
DOIs
Publication statusPublished - May 2019
Externally publishedYes

Keywords

  • Activities of daily living
  • Hemianopia
  • Hemispatial neglect
  • Rehabilitation
  • Stroke

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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