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Cognitive rehabilitation for spatial neglect following stroke
A Bowen1, N B Lincoln, M Dewey
1Human Communication and Deafness, Faculty of Education, University of Manchester, Oxford Road, Manchester, UK, M13 9PL. audrey.bowen@man.ac.uk
The Cochrane Database of Systematic Reviews
|June 22, 2002
Summary
Cognitive rehabilitation shows promise for improving impairment in spatial neglect after stroke, but its impact on disability and long-term outcomes remains unclear. Further research is needed to confirm benefits and develop better measures.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Clinical Psychology
Background:
- Unilateral spatial neglect is a common deficit following stroke, impairing attention to one side of space.
- Existing treatment strategies for spatial neglect often lack robust evidence of efficacy.
Purpose of the Study:
- To evaluate the effectiveness of cognitive rehabilitation for stroke-induced spatial neglect.
- To assess impacts on impairment and disability levels, and hospital discharge destination.
- To determine if treatment effects persist at follow-up.
Main Methods:
- A systematic review of controlled trials investigating cognitive rehabilitation for spatial neglect in stroke patients.
- Searches conducted across multiple databases (Cochrane Stroke Group, MEDLINE, EMBASE, CINAHL, PsycLIT, ClinPsy) up to early 2001.
- Independent selection, data extraction, and quality assessment by two reviewers.
Main Results:
- Fifteen studies involving 400 participants were included, reporting diverse outcome measures.
- Cognitive rehabilitation demonstrated significant and persistent improvements in impairment-level assessments.
- Evidence for effects on disability or hospital discharge destination was insufficient; few studies assessed long-term effects.
Conclusions:
- Cognitive rehabilitation may improve specific impairment measures for spatial neglect in stroke survivors.
- The impact on functional disability and long-term outcomes requires further investigation.
- Well-designed randomized controlled trials and improved outcome measures are necessary.