Walking and wheelchair navigation in patients with left visual neglect

Abstract

Patients with neglect veer to one side when walking or driving a wheelchair, however there is a contradiction in the literature about the direction of this deviation. The study investigated the navigational trajectory of a sample of neglect patients of mixed mobility status in an ecological setting. Fifteen patients with left-sided neglect after right hemisphere stroke were recorded walking or driving a powered wheelchair along a stretch of corridor. Their position in the corridor and the number of collisions was recorded. The results showed that the patients' path was dependent on their mobility status: wheelchair patients with neglect consistently deviated to the left of the centre of the corridor and walking patients with neglect consistently deviated to the right. A further two ambulant patients with neglect were recorded both walking and using the wheelchair to determine whether the differences were task or patient dependent. These two patients also exhibited leftward deviation when driving the wheelchair, but a rightward deviation when walking. These results suggest that the direction of the deviation is task dependent. Further work will be required to identify what features of the two modes of navigation lead to this dissociation.

Keywords:

• Unilateral spatial attention
• Neglect
• Stroke
• Navigation

We would like to thank all the participants who walked and drove up and down the corridor and the hospital staff who were not able to use the corridor during recordings. We also thank the Occupational Therapy Department for identifying potential participants and for assisting with recordings. This study was funded by The Stroke Association