Effects of standing and walking training using a laser pointer based on stimulus-driven attention for behavioural outcome in spatial neglect: A single-case study

Figures & data

Figure 1. Brain images of the study patient. T2-weighted magnetic resonance images of the patient (day 8 from stroke onset).

Figure 2. Experimental study procedure. BIT-c, Behavioural Inattention Test conventional test; CBS, Catherine Bergego Scale; CPT, conventional physical therapy; MPT, modified Posner task.

Figure 3. Standing and walking training using a laser pointer. (A) Standing training by touching when the light of a laser pointer is visible. (B) Standing training by giving an oral signal when the light of the laser pointer is visible. (C) Walking training by giving an oral signal when the light of the laser pointer is visible.

Figure 4. Modified Posner task method. (A) Valid trial, (B) Invalid trial.

Table 1. Therapy time spent in each phase.

	Each phase
	B1	A1	B2	A2
Therapy time
Physical therapy (min)	226	225	164	327
Occupational therapy (min)	227	185	267	163
Speech therapy (min)	102	205	0	204
Total (min)	555	615	431	694
Therapy frequency
Physical therapy (days)	4	4	3	5
Occupational therapy (days)	4	3	4	3
Speech therapy (days)	2	2	0	4
Total (days)	10	9	7	12

Table 2. Results of clinical assessments in each phase.

Variable	Intervention or control phase
	Pre-B1	Post-B1	Post-A1	Post-B2	Post-A2
BIT-c total score (0–146, cut off > 131)	131	137	135	132	131
Line bisection (0–9, cut off > 7)	8	8	9	5*	8
Line cancellation (0–36, cut off > 34)	36	36	35	36	36
Laterality index for line cancellation	0.50	0.50	0.52	0.50	0.50
Star cancellation (0–54, cut off > 51)	54	53	53	52	52
Laterality index for star cancellation	0.50	0.49	0.49	0.48	0.48
Letter cancellation (0–40, cut off > 34)	28	35	33	34	29
Laterality index for letter cancellation	0.51	0.54	0.52	0.50	0.55
Figure and shape copying (0–4, cut off > 3)	3	3	3	3	4
Representational drawing (0–3, cut off > 2)	2	2	2	2	2
AVLT (0–36)	25	−	−	−	26
MMSE-J (0–30)	23	−	−	−	25
FAB (0–18)	11	−	−	−	11

AVLT, Auditory Verbal Learning Test; BIT-c, Behavioural Inattention Test conventional; FAB, Frontal Assessment Battery; MMSE-J, Mini Mental State Examination-Japanese

Laterality index was calculated as the number of erased left side / (number of erased left side + number of erased right side), 0 (contralateral neglect); 0.1 ≤ LI ≤ 0.47 (left-biased inattention); 0.48 ≤ LI ≤ 0.52 (no laterality); 0.53 ≤ LI (right-biased inattention)

* Left deviation was shown in all line bisection tasks

Table 3. Results of the Catherine Bergego Scale (CBS).

Variables	Intervention or control phase
	Pre-B1	Post-B1	Post-A1	Post-B2	Post-A2
Observational assessment
CBS total (0–30)	9	6	6	4	3
1. Grooming	1	1	1	1	0
2. Dressing	0	0	0	0	0
3. Eating	0	0	0	0	0
4. Mouth cleaning	0	0	0	0	0
5. Gaze orientation	1	1	1	0	0
6. Left limb knowledge	0	0	0	0	0
7. Auditory attention	2	1	1	1	1
8. Collisions	2	1	1	1	1
9. Spatial orientation	1	0	0	0	0
10. Finding personal belongings	2	2	2	1	1
CBS-ME (number 2, 6, 7, and 8)	4	2	2	2	2
CBS-PA (number 1, 3, 4, 5, 9, and 10)	5	4	4	2	1
Personal assessment
CBS total	0	0	0	0	0

CBS, Catherine Bergego Scale; CBS-ME, Catherine Bergego Scale motor–intentional; CBS-PA, Catherine Bergego Scale perceptual–attentional.

Figure 5. Results of the modified Posner task. Indicated on the Y-axis are (A) Reaction time (ms) and (B) accuracy (%).

Table 4. Results of the modified Posner task (MPT).

Variable	Intervention or control phase
	Pre-B1	Post-B1	Post-A1	Post-B2	Post-A2
Reaction time (ms)
Valid
Left up	2533.5	1653.3	1713.6	1210.3	1330.1
Left down	2249.9	1205.5	735.8	644.2	915.5
Right up	665.5	614.3	579.6	529.9	519.4
Right down	610.5	610.7	578.9	498.3	526.3
Invalid
Left up	3000.0	2795.3	3000.0	2825.7	2135.0
Left down	3000.0	1923.0	2128.0	903.7	1095.0
Right up	614.0	640.3	629.0	594.0	563.0
Right down	673.3	715.3	652.7	723.0	464.3
Accuracy (%)
Valid
Left up	33.3	75.0	58.3	83.3	91.7
Left down	41.7	91.7	100.0	100.0	91.7
Right up	100.0	100.0	100.0	100.0	100.0
Right down	100.0	100.0	100.0	100.0	100.0
Invalid
Left up	0.0	33.3	0.0	33.3	66.7
Left down	0.0	66.7	66.7	100.0	100.0
Right up	100.0	100.0	100.0	100.0	100.0
Right down	100.0	100.0	100.0	100.0	100.0

Data availability statement

The datasets used during this study are available from the corresponding author on reasonable request.