A Systematic Review and Meta-Analysis of Rehabilitative Interventions for Unilateral Spatial Neglect and Hemianopia from 2006 through 2016

Publication date: Available online 4 July 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Karen P.Y. Liu, Jessica Hanly, Paul Fahey, Shirley S.M. Fong, Rosalind Bye
ObjectiveTo evaluate the effectiveness of activity-based, non-activity-based, and combined activity- and non-activity-based, rehabilitative interventions for individuals presenting with unilateral spatial neglect (USN) and hemianopia.Data SourcesWe searched CINAHL, Cochrane Library, EMBASE, MEDLINE and PubMed from 2006 to 2016.Study SelectionRandomized controlled trials (RCTs), with a score of 6 or above in the PEDro Scale, that examined the effects of activity-based and non-activity-based rehabilitation interventions for people with USN or hemianopia. Two reviewers selected studies independently.Data ExtractionExtracted data from the published RCTs. Mean differences (MD) or Standardized mean differences (SMD), and 95% confidence intervals (CIs), were calculated. Heterogeneity was assessed using the I² statistic.aData SynthesisTwenty RCTs for USN and five for hemianopia, involving 594 and 206 stroke participants respectively, were identified. Encouraging results were found in relation to activity-based interventions for visual scanning training and compensatory training for hemianopia (MD=5.11; CI=0.83 to 9.4; P=0.019; I²=25.16% on visual outcomes), and optokinetic stimulation and smooth pursuit training for USN (SMD=0.49, CI=0.01 to 0.97, P=0.045, I²=49.35% on functional performance in activities of daily living; SMD=0.96; CI=0.09 to 1.82; P=0.031; I²=89.57% on neglect).ConclusionsActivity-based interventions are effective and commonly used in the treatment of USN and hemianopia. Non-activity-based and combined approaches, for both impairments, have not been refuted, as more studies are required for substantiated conclusions to be drawn.



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