Unilateral neglect in stroke: A comparative study

OBJECTIVE: To evaluate the effectiveness of a comprehensive visual scanning training program for patients with unilateral neglect after stroke. DESIGN: Before and after trial. SETTINGS: Occupational Therapy Department of Pok Oi Hospital and Tuen Mun Hospital, Hospital Authority, Hong Kong. PARTICIPANTS: Forty patients with stroke and associated unilateral neglect were randomly assigned equally into either an experimental group or a control group. INTERVENTIONS: Patients in the experimental group were treated with a 12-session visual scanning program for 4 weeks, whereas the patients in the control group received standard rehabilitation services only. MAIN OUTCOME MEASURES: Subjects were assessed before and after the rehabilitation program by The Modified Barthel Index, Mini-Mental State Examination, and 2 neglect-related measures, namely, The Behavioural Inattention Test - Conventional subtests and Catherine Bergego Scale. RESULTS: The experimental group achieved a statistically significant improvement in neglect behavior in daily activities (t = -3.30, df = 38, P = .004), as reflected by the Catherine Bergego Scale scores and when compared with the control group. Participants in the experimental group also showed significant improvement in personal (t = 3.48, df = 38, P = .003) and peripersonal (t = 3.47, df = 38, P = .016) neglect. CONCLUSIONS: A visual scanning training program was found to be a more effective treatment strategy for reducing neglect behavior. Further studies carried out for an extended follow-up period are recommended to better evaluate the long-term effects of the specific training program delivered in our study.