Current trends in the treatment of patients with post-stroke unilateral spatial neglect: a scoping review

Abstract

Purpose

The purpose of this scoping review was to explore the current treatment approaches for patients with post-stroke unilateral spatial neglect.

Methods

A three-step search strategy using the Johanna Briggs Institute (JBI) guidelines, was undertaken. PubMed, CINAHL, The Cochrane Central Register of Controlled Trial, SCOPUS, PROSPERO, JBI, Sport Discus, and Google Scholar databases were searched. Searches were limited to publications from January 1, 2008, to May 1, 2020. Critical appraisal was undertaken by two independent reviewers using a standardized critical appraisal instrument developed by JBI. Data were extracted using a study-specific charting table.

Results

A total of 3,648 articles were identified, 311 full-text articles were screened and 86 articles were critically appraised, with 83 articles included in the review. Intervention approaches for post-stroke unilateral spatial neglect symptom amelioration were identified and categorized as prism adaptation and visual scanning, mental practice and mirror therapy, electrical stimulation and robotics, combination therapy, pharmacological therapy, and other interventions. Both positive and negative results across identified interventions were identified without specific reference to the phase of recovery.

Conclusion

This review provides insight into current interventions for post-stroke unilateral spatial neglect. A plethora of intervention studies have been explored to ameliorate neglect symptoms post-stroke.

IMPLICATION FOR REHABILITATION

• Prism adaptation (PA) and combination therapy are most commonly investigated intervention for unilateral spatial neglect (USN) and showed promise in ameliorating USN symptoms.

• No single treatment approach seems optimally superior in the rehabilitation of USN post-stroke.

• Evidence for the selection of treatment at a specific phase of recovery is not conclusive as both positive and negative outcome on neglect measure were observed across all treatment approaches without specific reference to the phase of recovery.

• Evidence for the long-term use of PA in USN rehabilitation appears to be modest.

Keywords:

• Unilateral spatial neglect
• review
• rehabilitation research
• outcome assessment
• perceptual disorder
• stroke

Acknowledgements

Special thanks to Dr Ajidahun Adedayo and Ms Kedibone Moagi for assisting with the literature search process in this study. Also, we want to profoundly thank Dr Juliet Nwachukwu-Umeonwuka for assisting with the quality assessment of the articles.

Disclosure statement

The Author(s) declare(s) that there is no conflict of interest.

Additional information

Funding

The work was supported for postgraduate degree funding received from the University of Witwatersrand, Faculty of Health Sciences, Medical Endowment Fund.