Rehabilitation of hemispatial neglect: A randomized study using either arm activation or visual scanning training

Hemispatial neglect, a failure to orient to the contralateral side of the lesion, is a disabling disorder after stroke. Previously arm activation combined with visual training or visual scanning training were found effective in rehabilitation of hemispatial neglect. The aim of this study was to determine whether left arm activation alone could be sufficient to produce a long lasting amelioration of neglect comparable to the effect obtained with traditional visual scanning training.

Twelve neglect patients less than six months from stroke were randomized either into 20-30 hours of left arm activation training or 10 hours of traditional visual scanning training as a part of a comprehensive rehabilitation program. All patients received 48~hours of therapy during the 3-week rehabilitation.

Visual neglect of the arm activation group recovered significantly in the conventional subtests of the Behavioural Inattention Test both post-rehabilitation and at 6-months follow-up. The improvement of the visual scanning training group was almost significant at the end of the rehabilitation and significant by the follow-up. The behavioural neglect observed in the Catherine Bergego Scale was alleviated nearly significantly at the post-rehabilitation in both groups. The effect was maintained in the arm activation group at 6-months.

The arm activation training appears beneficial even without supplementary visual neglect rehabilitation, although the traditional visual scanning training may have further effects in cognition.