Article

Neglect is associated with disability, unawareness, poor long-term
outcome, and dependence from caregivers. No randomized trial has evaluated the
effects of smooth pursuit eye movement training (SPT) and visual scanning
training (VST) at the bedside on these variables. Objective. To compare the
effects of SPT and VST in postacute stroke at 1 month with left neglect. Methods:
We carried out an assessor-blinded, randomized controlled trial. The 24
participants were randomly allocated to either SPT or VST (n = 12 each). They
received 20 treatment sessions lasting 30 minutes each at the bedside over 4
weeks. Outcome measures included the Functional Neglect Index (FNI) based on 4
tasks: find objects on a tray, stick bisection, picture search, and gaze
orientation. In addition, the Unawareness and Behavioral Neglect Index (UBNI)
with 6 items about unawareness and 4 about neglect in activities of daily living,
the Help index (required assistance in 10 functional activities), the Barthel
Index, and the rehabilitation phase were rated by treatment-blinded assessors.
Outcome measures were obtained before and immediately after the end of the
interventions and at a 2-week follow-up. Results. Significantly greater
improvements were obtained after SPT versus VST treatment in the FNI and UBNI,
and there were continued improvements selectively in the SPT group 2 weeks later.
Conclusions. SPT accelerates recovery from functional neglect and reduces
unawareness significantly. Bedside neglect treatment using SPT is effective and
feasible early after stroke.
CI - (c) The Author(s) 2013.

Langue : ANGLAIS