Measuring unilateral spatial neglect during stepping.
OBJECTIVE
To examine the diaschisis of faultless conventional neuropsychological tests of unilateral spatial neglect (USN) and defects of activities of daily living (ADL) functions.


METHODS
The evaluations of USN by assessments now in wide use were compared with newly developed assessments using a dual-task methodology in which a stepping activity was used as a "distracter" during USN assessment.


METHODS
A rehabilitation unit in a medical school hospital.


METHODS
Subjects consisted of 31 patients who suffered from stroke (right hemisphere lesions, 19; left hemisphere lesions, 12).


METHODS
Observation of behavior of hemi-inattention, ADL evaluation (transfer and gait), and conventional tests of USN (line bisection, line cancellation, copying of flowers) were conducted. USN test during stepping was performed by stepping on two force plates connected to a microprocessor and to videocassette player so that the subject was required to step continuously.


RESULTS
Most of the subjects who had exhibited USN in the written tests on admission showed no defects in the test after about 60 days even if hemi-inattention was observed in behavior. In the test during stepping, subjects with hemi-inattention behavior neglected some visual stimulations applied from the direction contralateral to the hemisphere lesion.


CONCLUSIONS
Combined tests of visual attention and distracter activity (stepping) can more effectively reflect the ADL functions of USN patients than conventional tests.
Suzuki
E
E
Department of Rehabilitation Medicine, Saitama Medical School, Japan.
Chen
W
W
Kondo
T
T
D000203:Activities of Daily Living; D000368:Aged; D002561:Cerebrovascular Disorders / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012047:Rehabilitation Centers