MEASURING UNILATERAL SPATIAL NEGLECT DURING STEPPING

Objective: To examine the diaschisis of faultless conventional neurops ychological tests of unilateral spatial neglect (USN) and defects of a ctivities of daily living (ADL) functions. Design: The evaluations of USN by assessments now in wide use were compared with newly developed assessments using a dual-task methodology in which a stepping activity was used as a ''distracter'' during USN assessment. Setting: A rehabi litation unit in a medical school hospital. Patients: Subjects consist ed of 31 patients who suffered from stroke (right hemisphere lesions, 19; left hemisphere lesions, Main Outcome Measures: Observation of beh avior of hemi-inattention, ADL evaluation (transfer and gait), and con ventional tests of USN (Line bisection, line cancellation, copying of flowers) were conducted. USN test during stepping was performed by ste pping on two force plates connected to a microprocessor and to videoca ssette player so that the subject was required to step continuously. R esults: Most of the subjects who had exhibited USN in the written teal s on admission showed no defects in the tests after about 60 days even if hemi-inattention was observed in behavior. In the test during step ping, subjects with hemi-inattention behavior neglected some visual st imulations applied from the direction contralateral to the hemisphere lesion. Conclusions: Combined tests of visual attention and distracter activity (stepping) can more effectively reflect the ADL functions of USN patients than conventional tests. (C) 1997 by the American Congre ss of Rehabilitation Medicine and the American Academy of Physical Med icine and Rehabilitation.