Rehabilitative management of post-stroke visuospatial inattention.
OBJECTIVE
Visuospatial inattention or sensory neglect is a common impairment following cerebrovascular accident and is thought to negatively impact on functional recovery and long-term outcome. This review examines various rehabilitative interventions available for the management of visuospatial inattention and the literature that supports their efficacy.


METHODS
Medical literature review.


RESULTS
Therapies geared toward improved visual scanning and 'retraining' of patients to attend to the neglected field are the mainstay of current therapy. While some studies support their efficacy, others have reported limited benefit. Newer approaches that may be efficacious include eye patching techniques, use of video feedback during therapy, training in visual imagery, and pharmacologic therapy with dopamine agonists. Protocols using vestibular, somatosensory and optokinetic stimulation have each been shown to produce transient improvements in neglect. However, therapeutic applications for these techniques have not been studied.


CONCLUSIONS
A number of approaches toward the rehabilitation of post-stroke neglect are described in the literature. Further research is needed to better define which techniques may prove most beneficial.
Diamond
P T
PT
Department of Physical Medicine and Rehabilitation, University of Virginia Health System, Charlottesville 22908-1004, USA. ptd2m@virginia.edu
D000368:Aged; D000818:Animals; D001971:Bromocriptine / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D018849:Controlled Clinical Trials as Topic; D015259:Dopamine Agents / Q000627:therapeutic use; D005246:Feedback; D005260:Female; D006423:Hemianopsia / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use; D008875:Middle Aged; D009483:Neuropsychological Tests; D010775:Photic Stimulation; D010812:Physical Stimulation; D011446:Prospective Studies; D012106:Research; D013028:Space Perception; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation; D014741:Video Recording; D014796:Visual Perception
D000697:Central Nervous System Stimulants; D015259:Dopamine Agents; D008774:Methylphenidate; D001971:Bromocriptine