Keywords:Unilateral spatial neglect, USN, limb activation, sensory stimulation, visual scanning, prisms, feedback, computer-based training, eye-patching, trunk rotation, vestibular stimulation, galvanic stimulation, optokinetic stimulation, neck vibration, TENS, rTMS, tDCS
This review examines the treatment perceptual disorders following stroke focussing primarily on unilateral spatial neglect (USN). Reported incidence of USN ranges from 8% to 95%, however, sample selection, definitions of USN and methods used to assess USN are not consistent in all studies that report its incidence. Unilateral spatial neglect has been reported to have a negative impact on functional recovery, length of rehabilitation stay, and need for assistance after discharge.
In general, rehabilitation interventions to improve neglect may be classified into a) those which attempt to increase the stroke patient's awareness of or attention to the neglected space or b) those which focus on the remediation of deficits of position sense or body orientation. Interventions of the first type included in the present review are: visual scanning retraining, arousal or activation strategies and feedback to increase awareness of neglect behaviours. Identified interventions that attempt to improve neglect by targeting deficits associated with position sense and spatial representation include the use of prisms, eyepatching and hemispatial glasses, caloric stimulation, optokinetic stimulation, TENS and neck vibration. The use of dopaminergic medication therapy is also discussed.
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