Adaptive Cueing Treatment of Neglect in Stroke Patients Leads to Improvements in Activities of Daily Living: A Randomized Controlled, Crossover Trial. (November 2018)

• Record Type: Journal Article
• Authors: Turgut, Nergiz; Möller, Lisa; Dengler, Kerstin; Steinberg, Katrin; Sprenger, Andreas; Eling, Paul; Kastrup, Andreas; Hildebrandt, Helmut
• Is Part Of: Neurorehabilitation & neural repair. Volume 32:Number 11(2018)
• Page Start: 988
• Page End: 998
• Publication Date: 2018-11
• Subjects: hemispatial neglect -- activities of daily living -- cueing -- rehabilitation -- neuropsychology -- stroke; Nervous system -- Diseases -- Patients -- Rehabilitation -- Periodicals; Brain damage -- Patients -- Rehabilitation -- Periodicals; Spinal cord -- Wounds and injuries -- Patients -- Rehabilitation -- Periodicals; Nervous system -- Regeneration -- Periodicals; Neuroplasticity -- Periodicals; 616.804305
• DOI: 10.1177/1545968318807054
• Languages: English
• ISSNs: 1545-9683

Abstract

Background . Visuospatial neglect is a disabling syndrome with serious consequences for activities in daily life. This study investigated the effect of adaptive cueing during a reading task as a possible treatment for neglect by including (1) a task relevant for the patient's daily life, (2) a fading out procedure to stimulate independent orientation to the left by self-cueing, and (3) a clear definition of neglect severity for the adaptive treatment protocol. Methods . A randomized controlled crossover design was used, including 26 patients from an early rehabilitation unit with left-sided visuospatial neglect after stroke or hemorrhage. They were examined twice at baseline (T1, T2), after 15 daily sessions in 1 condition (T3), and again after 15 daily sessions in the other condition (T4). The intervention condition included a daily reading task combined with endogenous and exogenous cues provided by a therapist, which were continuously reduced after a patient had reached a defined level of performance. The control condition consisted of a neuropsychological treatment of the same length, not targeting visuospatial attention. Results . Significant improvements were shown after intervention on scores for reading (word and text reading), daily life activities (Catherine Bergego Scale), Line Bisection, and the Clock Drawing Task. Conclusion . This study shows that adaptive cueing in a reading task can improve neglect symptoms by using an intensive intervention lasting 3 weeks.