Treatment and assessment of neglect after stroke – from a physiotherapy perspective: A systematic review

Birgit Vahlberg ; Karin Hellström

The aim of this review was to determine, from a physiotherapeutic perspective, existing tools that assess neglect and whether there was support for the positive effect of physiotherapeutic interventions on neglect after stroke. Specific training for the neglect syndrome was recommended. There was moderate evidence for spatio-motor cueing and scanning training towards the effected side. The literature also indicated that trunk rotation or repeated neck muscle vibrations when associated with an extensive training programme, mental imagery training, video feedback training and prism adaptation could be recommended for the rehabilitation of stroke patients with neglect. Treatment with Constraint-Induced Movement Therapy (CIMT) has shown some promising results. None of the tools designed to assess neglect evaluated physical performance. From a physiotherapeutic point of view, there is limited evidence for treatment of patients with neglect after stroke and the way neglect should be assessed. Scanning training and activation of the affected hemisphere with spatio-motor cueing can be effectual. Several assessment tools in combination are recommended.

Advances in Physiotherapy, Oct 2007, online article ahead of print

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