Non-pharmacological interventions for spatial neglect or inattention following stroke and other non-progressive brain injury

Longley, Verity; Hazelton, Christine; Heal, Calvin; Pollock, Alex; Woodward-Nutt, Kate; Mitchell, Claire; Pobric, Gorana; Vail, Andy; Bowen, Audrey

doi:10.1002/14651858.cd003586.pub4

Cited by 32 publications

(33 citation statements)

References 156 publications

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“…For instance, rehabilitation programs based on one USN component can have an impact on another USN component not directly targeted by the program (Jacquin-Courtois et al, 2010). Thus, the assessment of the different USN symptoms could also help to determine the efficiency of current rehabilitation programs while evidence of the benefits of these programs is still lacking (Longley et al, 2021). Insufficient assessment of USN aspects may contribute to this lack of evidence (Azouvi et al, 2017) and to patients’ poor rehabilitation outcome (Evald et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Clinical assessment of unilateral spatial neglect dissociations and heterogeneities: A narrative synthesis.

Guilbert¹

2023

Neuropsychology

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Objective: Unilateral spatial neglect (USN) is a neuropsychological syndrome whose symptoms differ considerably between patients. Several heterogeneities and dissociations have been described between processing stages, spatial regions, reference frames, or sensory modalities. However, in clinical practice, current routine tests rarely assess the different USN subtypes. There is a real lack of practice guidance for clinicians to help them choosing the right USN assessment tools for specific USN aspects. Method: The present article is a narrative synthesis based on a systematic literature search of (a) the dissociations and heterogeneities that can appear in USN and of (b) the different clinical tools available for their assessment. Results: Several tools have been developed to better assess USN heterogeneities. This review highlights their potential relevance and advocates for their widespread use in a clinical practice context. However, it also raised the issue of the lack of standardized clinical tools for the evaluation of some USN aspects. Conclusion: While USN heterogeneities and dissociations are difficult to assess in current clinical practice, there is a real need to improve their assessment. This will allow clinicians to establish the individual USN profile of each patient not only in terms of severity but also of impaired aspects in order to provide them the rehabilitation program that suits the best their needs. Key PointsQuestion: This article aims at reviewing the dissociations and heterogeneities that can appear in unilateral spatial neglect and the different clinical tools available for its assessment. Findings: While a few tools have been developed to assess different unilateral spatial neglect aspects, some heterogeneities and/or dissociations are not considered in clinical practice. Importance: By reviewing unilateral spatial neglect assessment tools, the present article could guide clinicians during their diagnosis. Next Steps: Improving unilateral spatial neglect assessment is now critical to better understand each patient's profile and to propose individualized rehabilitation programs.

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Section: Discussionmentioning

confidence: 99%

Clinical assessment of unilateral spatial neglect dissociations and heterogeneities: A narrative synthesis.

Guilbert¹

2023

Neuropsychology

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“…Of the 80 studies in this review, only 22 were RCTs; this is significantly lower than, for example, the 65 current trials in neglect found in a recent review. 38 …”

Section: Discussionmentioning

confidence: 99%

Perceptual Disorders After Stroke: A Scoping Review of Interventions

Hazelton

McGill

Campbell

et al. 2022

Stroke

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Perceptual disorders relating to hearing, smell, somatosensation, taste, touch, and vision commonly impair stroke survivors’ ability to interpret sensory information, impacting on their ability to interact with the world. We aimed to identify and summarize the existing evidence for perceptual disorder interventions poststroke and identify evidence gaps. We searched 13 electronic databases including MEDLINE and Embase and Grey literature and performed citation tracking. Two authors independently applied a priori–defined selection criteria; studies involving stroke survivors with perceptual impairments and interventions addressing those impairments were included. We extracted data on study design, population, perceptual disorders, interventions, and outcomes. Data were tabulated and synthesized narratively. Stroke survivors, carers, and clinicians were involved in agreeing definitions and organizing and interpreting data. From 91 869 records, 80 studies were identified (888 adults and 5 children); participant numbers were small (median, 3.5; range, 1–80), with a broad range of stroke types and time points. Primarily focused on vision (34/80, 42.5%) and somatosensation (28/80; 35.0%), included studies were often case reports (36/80; 45.0%) or randomized controlled trials (22/80; 27.5%). Rehabilitation approaches (78/93; 83.9%), primarily aimed to restore function, and were delivered by clinicians (30/78; 38.5%) or technology (28/78; 35.9%; including robotic interventions for somatosensory disorders). Pharmacological (6/93; 6.5%) and noninvasive brain stimulation (7/93; 7.5%) approaches were also evident. Intervention delivery was poorly reported, but most were delivered in hospital settings (56/93; 60.2%). Study outcomes failed to assess the transfer of training to daily life. Interventions for stroke-related perceptual disorders are underresearched, particularly for pediatric populations. Evidence gaps include interventions for disorders of hearing, taste, touch, and smell perception. Future studies must involve key stakeholders and report this fully. Optimization of intervention design, evaluation, and reporting is required, to support the development of effective, acceptable, and implementable interventions. Registration: URL: https://www.crd.york.ac.uk/PROSPERO/ ; Unique identifier: CRD42019160270.

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“…While most studies examined interventions addressing motor function, there is a growing body of intervention studies addressing somatosensation, vision, cognition, perception, communication, and mood. Research in each of these areas is summarized in systematic reviews (e.g., Knapp et al, 2017; Loetscher et al, 2019; Longley et al, 2021; Pollock et al, 2019).…”

Section: Interventionmentioning

confidence: 99%

Stroke Rehabilitation: Recent Progress and Future Promise

Skidmore

Shih

2022

OTJR: Occupational Therapy Journal of Research

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Significant advancements in acute stroke medical management have changed stroke rehabilitation. In addition, an ever-changing health care ecosystem and heightened awareness of continued and new challenges requires that the occupational therapy profession consider new, innovative, and pragmatic approaches to measurement, intervention, and health services research, and clinical practice. The profession must elevate the focus and rigor of research examining occupation and participation after stroke, and their associations with health. Intervention research must progress beyond early phase pilot studies to a robust collection of meaningful large multisite studies that demonstrate the effectiveness of our interventions and the effectiveness of wide-scale implementation to ensure quality and consistent delivery of evidence-based practices in occupational therapy. These studies must address the accessibility of these practices for all people who have sustained stroke, and particularly those people who are most vulnerable to inaccessible stroke rehabilitation service delivery systems.

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Non-pharmacological interventions for spatial neglect or inattention following stroke and other non-progressive brain injury

Abstract: Non-pharmacological interventions for spatial neglect or inattention following stroke and other non-progressive brain injury (Review)

Cited by 32 publications

References 156 publications

Clinical assessment of unilateral spatial neglect dissociations and heterogeneities: A narrative synthesis.

Clinical assessment of unilateral spatial neglect dissociations and heterogeneities: A narrative synthesis.

Perceptual Disorders After Stroke: A Scoping Review of Interventions

Stroke Rehabilitation: Recent Progress and Future Promise

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