Rehabilitation interventions of unilateral spatial neglect based on the functional outcome measure: A systematic review and meta-analysis

ABSTRACT

This review aimed to examine the bottom-up and top-down rehabilitation intervention effectiveness based on the functional outcome measure as immediate effect and long-term effect for unilateral spatial neglect conditions. The RCT studies were collected by searching in three databases J-Stage, PubMed, and PEDro from 2008 through 2018. The studies which used the following instruments: BI, CBS, FMA, and FIM, as the functional outcome with the PEDro score of six and above, were eligible for inclusion. A total of 492 participants in 13 studies included from 291 studies initially identified. The meta-analysis for overall ES revealed that BI and CBS had a significant mean of SMD = 0.65 (95% CI, 0.23–1.07; p = 0.003; I² = 65%), and SMD = −0.23 (95% CI, −0.45 to −0.01; p = 0.04; I² = 35%) respectively, while FMA and FIM had an insignificant mean of SMD = 0.14 (95% CI, −0.08–0.37; p = 0.22; I² = 0%), and SMD = −0.22 (95% CI, −0.69–0.25; p = 0.37; I² = 0%) respectively. Based on the results, although indicated the heterogeneity representation across studies, it showed that the top-down intervention approach of high-frequency rTMS was more effective in enhancing the functional abilities and ADL of unilateral spatial neglect patients on the immediate effects but not necessarily in the long-term effects.

KEYWORDS:

• Unilateral spatial neglect
• rehabilitation
• physiotherapy
• functional outcome measure
• systematic review

Acknowledgments

The authors wish to thank Tokyo Metropolitan University, the board of professors, all reviewers for their help and advice, and the Tokyo Human Resource Fund for City Diplomacy Scholar.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Tokyo Human Resource Fund for City Diplomacy Scholar.