Using limb movements to improve spatial neglect: the role of functional electrical stimulation

Spatial neglect is common after right-hemisphere stroke and has proven resilient to a number of therapeutic interventions. Both active and experimenter-induced passive movements of the left limb in left hemispace have been shown to ameliorate neglect in subsets of patients by improving performance on tasks requiring attention to the left side of space. However, the high incidence of contralesional hemiparesis and poor motor recovery in neglect makes active limb movement therapies applicable to only a small subset of patients. The purpose of our studies was to investigate the effects of passive movements of the left hand by functional electrical stimulation (FES), a common and portable motor rehabilitation technique, on performance in a visual scanning task.

The effect of FES-induced passive movement on target detection in a visual scanning task was compared to no movement and active movement conditions and also investigated in scanning tasks in both near and far space.

Passive limb movement effects in neglect were variable across and within studies, reference spaces, and individuals, with a subset of positive responders differing from non-responders in regard to constructional deficits and lesion location.

The potential viability of FES as a therapy for neglect deserves further investigation and directions for future research in this area are discussed.