Lasting improvements in left spatial neglect following a protocol combining neck-muscle vibration and voluntary arm movements: a case-study

Abstract

Purpose: Beyond promising experimental results of sensory passive stimulations in spatial cognition disorders, some questions still remain regarding interests of these stimulations during the daily activities in neglect. The aim of this case-study was to evaluate the effects of a protocol combining left neck-muscle vibration with daily simple movements, like arm pointing movements, on perceptivo-locomotor deficits in a left spatial neglect patient.

Materials and methods: Two neuropsychological tests, one subjective straight-ahead pointing (SSA) test and one wheelchair navigation test were carried out before the combination protocol, immediately after, 1 h later, and 24 h later.

Results: The results showed a reduction of neglect spatial bias following the protocol lasted at least 24 h in all the tests (except for the SSA test due to the unavailability of the pointing device).

Conclusions: The range of improvements in the symptoms of spatial neglect suggests that this therapeutic intervention based on the combining neck-muscle vibration to voluntary arm movements could be a useful treatment for this condition. One of future investigation axes should be the development of a vibratory tool in order to facilitate the combining this proprioceptive stimulation to daily activities.

Implications for rehabilitation

• Spatial neglect is a perplexing neuropsychological syndrome, affecting different domains of spatial cognition and impacting also the functional domain.

• The treatments based on neck-muscle vibration are simple to use, non-invasive and requires none active participation of patient.

• A therapeutic intervention based on the combining left neck-muscle vibration and voluntary arm movements in a left-spatial-neglect show a lasting reduction of symptoms especially in daily activities.

• The combination of treatments based on the Bottom–Up approach opens innovative perspectives in rehabilitation.

Keywords:

• Neglect
• combination protocol
• neck-muscle vibration
• voluntary arm movement
• egocentred perception
• Bottom–Up approach

Acknowledgements

We are sincerely grateful to J. Robertson for the translation to English and to F. Clanché, R. Weinland, and E. Bernard for their helpful technical assistance. We would like to give special thanks to Ph. P. Perrin and C. Cian. Fundi

Disclosure statement

The authors declare that they have no conflict of interest.

Additional information

Funding

This work was supported by and received a grant from the Région Lorraine and by the Université de Lorraine, France (Contrat d'objectifs avec les Etablissements d'Enseignement Supérieur et de Recherche Lorrains – Exercice 2015).