Adaptive Cueing Treatment of Neglect in Stroke Patients Leads to Improvements in Activities of Daily Living: A Randomized Controlled, Crossover Trial

Abstract

Background. Visuospatial neglect is a disabling syndrome with serious consequences for activities in daily life. This study investigated the effect of adaptive cueing during a reading task as a possible treatment for neglect by including (1) a task relevant for the patient's daily life, (2) a fading out procedure to stimulate independent orientation to the left by selfcueing, and (3) a clear definition of neglect severity for the adaptive treatment protocol. Methods. A randomized controlled crossover design was used, including 26 patients from an early rehabilitation unit with left-sided visuospatial neglect after stroke or hemorrhage. They were examined twice at baseline (T1, T2), after 15 daily sessions in 1 condition (T3), and again after 15 daily sessions in the other condition (T4). The intervention condition included a daily reading task combined with endogenous and exogenous cues provided by a therapist, which were continuously reduced after a patient had reached a defined level of performance. The control condition consisted of a neuropsychological treatment of the same length, not targeting visuospatial attention. Results. Significant improvements were shown after intervention on scores for reading (word and text reading), daily life activities (Catherine Bergego Scale), Line Bisection, and the Clock Drawing Task. Conclusion. This study shows that adaptive cueing in a reading task can improve neglect symptoms by using an intensive intervention lasting 3 weeks.

Zehn Argumente für dialogische Interaktion und kognitive Modelle als Grundlage neuropsychologischer Rehabilitation

“…Neglect kann weder als Syndrom noch in seinem Schweregrad unabhängig von einer wissenschaftlichen Konstruktion der Umgebung defi niert werden, in der die Patient_innen agieren. Umso klarer ist, dass auch seine Behandlung eine kognitive Theorie der visuellen Suche umfassen muss (siehe Ten Turgut et al, 2018).…”

“…Ganz ähnlich ging die neuropsychologische Therapie des Neglects in der Studie von Turgut et al (2018) vonstatten. Für die verschiedenen Schweregrade des Neglects wurden verschiedene geschützte kognitive Umgebungen defi niert, deren Bewältigung den Patient_innen gerade noch möglich war.…”

Effects of standing and walking training using a laser pointer based on stimulus-driven attention for behavioural outcome in spatial neglect: A single-case study

“…For USN, effective intervention methods such as prism adaptation (Eramudugolla, 2010;Goedert et al, 2020), visual scanning training (Van Kessel et al, 2013Weinberg et al, 1977), trunk rotation (Wiart et al, 1997), and limb activation (Eskes et al, 2003;Robertson & North, 1992) have been reported; however, these trainings are considered voluntary exploratory trainings based on the concept of goal-oriented attention. In this regard, Turgut et al (2018) recommended a reading training that combined an exogenous cue based on stimulus-driven attention, in addition to the endogenous cue based on goal-directed attention for patients with USN. They showed that the Catherine Bergego Scale (CBS), which measures the behavioural outcome for USN, improved in the intervention group compared to the control group.…”

“…Thus, stimulus-driven attentional function-based treatment may be effective in improving behavioural outcome for patients with USN. However, this training was performed primarily in a sitting position (Turgut et al, 2018), which is difficult to apply during walking.…”

Rehabilitation Treatment of Motor Dysfunction Patients Based on Deep Learning Brain–Computer Interface Technology

“…It is a new, highend way of human-computer interaction. The complete BCI system includes four parts: signal acquisition part, the feature extraction part, pattern recognition part, and control command output part (Turgut et al, 2018). The brain's thinking activity mainly depends on the central nervous system.…”