Limb activation effects in hemispatial neglect

Objective: To assess the efficacy of passive and active limb movement to improve visual scanning in patients with hemispatial neglect. Design: Before-after trial: behavioral analyses of a case series. Setting: Stroke rehabilitation unit in a tertiary care hospital. Participants: Nine individuals with right-hemisphere stroke (mean time poststroke, 19.5mo) and left-sided neglect, as assessed by the Sunnybrook Bedside Neglect Battery. Intervention: Active left limb movement (button push; n=3) or passive left limb movement (n=8) with functional electric stimulation (FES) administered during visual scanning testing. Main Outcome Measures: Performance on visual scanning tests involving naming of letters and numbers. Results: Both active and passive movement significantly improved target detection on the left side, but not on the right side, on the visual scanning task. Positive results were seen in 2 of 3 active movement patients and 6 of 8 passive movement patients. Conclusions: Both active and FES-stimulated passive movements are potential techniques for the treatment of hemispatial neglect.