Rehabilitation interventions for unilateral neglect after stroke: A systematic review from 1997 through 2012

Nicole Y.H. Yang, D. Zhou, Raymond C.K. Chung, Wai Ping Cecilia Tsang, Nai Kuen Fong

Research output: Journal article publicationJournal articleAcademic researchpeer-review

61 Citations (Scopus)

Abstract

A systematic review of the effectiveness of rehabilitation for persons with unilateral neglect (UN) after stroke was conducted by searching the computerized databases from 1997 through 2012. Randomized controlled trials (RCTs) of neglect treatment strategies for stroke patients which used the Behavioral Inattention Test (BIT) as the primary outcome measure were eligible for inclusion. Out of 201 studies initially identified, 12 RCTs covering 277 participants were selected for analysis. All had the same weakness of lower power with smaller samples and limitation in the blindingness of the design. Prism Adaptation (PA) was the most commonly used intervention while continuous Theta-burst stimulation (cTBS) appeared to be a new approach. Meta-analysis showed that for immediate effects, the BIT conventional subscore had a significant and large mean effect size (ES=0.76; 95% CI 0.28-1.23; p=0.002) whereas the BIT total score showed a modestly significant mean ES (ES=0.55; 95% CI 0.16-0.94; p=0.006). No significant mean ES in sensitivity analysis was found for long-lasting effects across all BIT outcomes. PA appeared to be the most effective intervention based on the results of pooled analysis. More rigorous studies should be done on repetitive transcranial magnetic stimulation (rTMS) before it can be concluded that it is a promising treatment for UN.
Original languageEnglish
JournalFrontiers in Human Neuroscience
Issue numberAPR 2013
DOIs
Publication statusPublished - 24 Apr 2013

Keywords

  • Behavioral inattention test
  • Rehabilitation
  • Stroke
  • Systematic review
  • Unilateral neglect

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Neurology
  • Psychiatry and Mental health
  • Biological Psychiatry
  • Behavioral Neuroscience

Cite this