Article

BACKGROUND: In the last decades, several rehabilitation methods have been
developed to improve spatial neglect. These can be classified according to their
theoretical basis: (i) enhance awareness of neglect behaviour through a top-down
mechanism; (ii) low-level bottom-up sensory stimulation;
(iii) modulation of
inhibitory processes; (iv) increase arousal. OBJECTIVE: The purpose of this study
was to provide an overview of the evidence on the effectiveness of rehabilitation
procedures for unilateral neglect. METHOD: A systematic search was performed to
look for all randomised controlled trials aimed at reducing left spatial neglect
that included a functional assessment. In addition, recent review papers and
meta-analyses were analysed. RESULTS: Thirty-seven randomized controlled trials
were found (12 bottom-up; 12 top-down; 1 interhemispheric competition; 12
combination of approaches) that included 1027 patients with neglect. Although
there are some encouraging results, overall, the level of evidence remains low.
Poor methodological quality and small sample sizes are major limitations in many
published trials. CONCLUSION: There is a need for well-conducted, large-scale
randomised controlled trials that incorporate blinded assessments, evaluation of the generalization to activities of daily living and long-term follow-up.
CI - Copyright (c) 2016 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS