Review of self-awareness and its clinical application in stroke rehabilitation

The objectives of this study were (i) to explore, following a literature review, the concepts of self-awareness, its assessment, and intervention for self-awareness deficits, as well as its clinical significance in stroke rehabilitation; and (ii) to apply the concepts of self-awareness in the context of a rehabilitation program. The search was conducted by the electronic databases Web of Science, Science Direct, MEDLINE, and PsychcInfo. A systematic literature search of publications written in English between 1980 and 2010 was conducted using the keywords, self-awareness or self-regulation. The search was limited to the following keywords: stroke, deficits, assessment, intervention, and rehabilitation. Two important conceptual models, namely, the Pyramid Model of Self-Awareness and the Dynamic Comprehensive Model of Awareness, were reviewed. Suggestions were made to the constraint-induced movement therapy for enhancement of both assessment and treatment of self-awareness deficits. In conclusion, self-awareness is essential for the success of rehabilitation. It is hoped that more studies can be conducted on the effectiveness of awareness enhancement programs incorporated in on-going therapies can be conducted, so that the evidence base can be further built up in this evolving area of practice.