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(Stroke. 2007;38:2869.)
© 2007 American Heart Association, Inc.

Cochrane Corner

Rehabilitation for Spatial Neglect Improves Test Performance but Not Disability

From the University of Manchester (A.B.), UK; and the University of Nottingham (N.B.L.), UK.

Correspondence to Dr Audrey Bowen, Human Communication and Deafness, Humanities Devas Street, University of Manchester, School of Psychological Sciences, Oxford Rd, Manchester M13 9PL, UK. E-mail audrey.bowen@manchester.ac.uk

Graeme J. Hankey MD, FRCP Section Editor

Key Words: attention • neglect • rehabilitation • systematic review

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Unilateral spatial neglect causes difficulty attending to one side of space and adversely affects activities of daily living.

	Objective

 
This updated systematic review examined the effectiveness of cognitive rehabilitation aimed at spatial neglect after stroke. The primary outcome was at the level of disability (restricted activity), specifically whether any benefits were maintained beyond the end of the intervention. Immediate effects, impairment measures and discharge destination were also investigated.

	Materials and Methods

 
We searched the Cochrane Stroke Group Trials Register (last searched July 4, 2005), MEDLINE (1966 to July 2005), EMBASE (1980 to July 2005), CINAHL (1983 to July 2005), PsycINFO (1974 to July 2005), UK National Research Register (July 2005). We hand-searched relevant journals, screened reference lists, and tracked citations using SCISEARCH. Two reviewers independently selected trials, extracted data, and assessed trial quality. To reduce bias we included only randomized controlled trials (RCT) of neglect rehabilitation. We excluded studies of general stroke rehabilitation and those with mixed patient groups, unless >75% of their sample were stroke patients, or separate stroke data were available.

	Main Results

 
There were 12 eligible RCTs with 306 participants. Only 4 had adequate allocation concealment, ie, low risk of selection bias. A large number of outcome measures were reported. Only 6 studies measured disability and 2 investigated whether the effects persisted (the primary outcome). The overall effect was not statistically significant (SMD 0.61, 95% CI, –0.42, 1.63).

In contrast, there was improved performance on some, but not all of the secondary outcomes (impairment measures). As shown in the Figure, there was . . . [Full Text of this Article]