Computer-assisted training for improving wheelchair mobility in unilateral neglect patients.
OBJECTIVE
To investigate whether a computer-assisted training (CAT) program for patients with left unilateral neglect would decrease symptoms of this disorder.


METHODS
Case-control study.


METHODS
Inpatient rehabilitation unit of a government medical center.


METHODS
Twenty right-handed patients who showed left unilateral neglect on screening measures (Rey-Osterrieth Complex Figure, Random Letter Cancellation Test) were assigned to a CAT treatment group; and 20 patients who showed similar levels of unilateral neglect on the screening measures were assigned to a control group.


METHODS
All subjects were inpatients in an acute rehabilitation unit and received rehabilitation therapy, including physical and occupational therapy. The treatment group received the experimental, CAT program, 12 to 20 sessions of about 45 minutes each. Treatment consisted of 5 modules, each of increasing complexity, to improve attention to stimuli in the left hemisphere, and 2 simulated wheelchair obstacle courses to propel a wheelchair while avoiding obstacles.


METHODS
Computer tasks designed for this study (Video Tracking Test, Video Obstacle Course Test), a real-life wheelchair obstacle course (WCOC), and incident reports indicating falls and accidents.


RESULTS
Trained subjects performed significantly better on the WCOC than control subjects (F(1,36) = 23.41, p = .00003). Also, trained subjects had fewer incident reports than control subjects during their hospitalization (chi(2)(1,)(n)(=38) = 5.15, p = .023).


CONCLUSIONS
CAT can reduce unilateral neglect symptoms on experimental tasks and some measures of accident risk.
Webster
J S
JS
Mental Health Care Group, VA Healthcare System, Long Beach, CA 90822, USA. Webjef@hotmail.com
McFarland
P T
PT
Rapport
L J
LJ
Morrill
B
B
Roades
L A
LA
Abadee
P S
PS
D000704:Analysis of Variance; D001288:Attention; D001925:Brain Damage, Chronic / Q000534:rehabilitation*; D016022:Case-Control Studies; D003194:Computer-Assisted Instruction; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010468:Perceptual Disorders / Q000534:rehabilitation*; D013028:Space Perception; D014796:Visual Perception; D014910:Wheelchairs