FACILITATORY EFFECT OF NEGLECT REHABILITATION ON THE RECOVERY OF LEFTHEMIPLEGIC STROKE PATIENTS - A CROSS-OVER STUDY

A study of the effect of specific training for visual neglect on the r ecovery of motor and functional impairment in stroke patients is repor ted. Two groups of right hemisphere stroke patients with hemispatial n eglect and one group without neglect were assessed by means of three f unctional and neurological scales (Rivermead Mobility Index, Barthel I ndex, Canadian Neurological Scale). Three evaluations were made at 0, 2 and 4 months from the beginning of physical rehabilitation. During t he first 2 months of physical rehabilitation one of the two groups of neglect patients was randomly assigned to specific training for neglec t, and the second group to a general cognitive intervention; during th e final 2 months of rehabilitation the types of training were switched in the two groups. The non-neglect patients improved steadily during physical rehabilitation. In contrast, the functional recovery of the t wo neglect groups was time-locked to the period of the specific traini ng for neglect. At the time of admission, the two neglect groups perfo rmed at the same level; after 2 months of rehabilitation, the group wi th neglect training showed higher functional recovery than the group w ith only general cognitive intervention. When the latter group receive d neglect training, there was no longer any difference between the two neglect groups. This pattern was present for both of the functional s cales used but not for the neurological scale. Motor and functional re covery of stroke patients with neglect seems to be significantly impro ved by the simultaneous presence of a treatment specifically focused o n neglect.