Bowen A, Lincoln N B, Dewey M
Human Communication and Deafness, Faculty of Education, University of Manchester, Oxford Road, Manchester, UK, M13 9PL.
Cochrane Database Syst Rev. 2002(2):CD003586. doi: 10.1002/14651858.CD003586.
Unilateral spatial neglect is a failure to attend to one side of space. Various strategies have been used to treat these problems but evidence of their benefit has been lacking.
To determine the effects of cognitive rehabilitation for spatial neglect following stroke as measured on impairment and disability level assessments, and destination on discharge from hospital. To determine whether any effects persist at follow-up assessment.
We searched the Cochrane Stroke Group Trials Register (last searched February 2001), MEDLINE (1966-December 2000), EMBASE (1980-February 2001), CINAHL (1983-January 2001), PSYCLIT and CLINPSYCH (1974-February 2001). We handsearched relevant journals, screened reference lists from relevant articles and tracked citations using SCISEARCH.
Controlled trials of cognitive rehabilitation for spatial neglect in stroke. Studies with mixed patient groups were excluded unless more than 75% of their sample were stroke patients or separate stroke data were available for stroke patients.
Two reviewers independently selected trials, extracted data, and assessed trial quality.
We included 15 studies with 400 participants. A large number of different outcome measures were reported. Only six studies included a measure of disability and only four (111 participants) investigated persisting effects on any outcome. There was evidence that cognitive rehabilitation resulted in significant and persisting improvements in performance on impairment level assessments, although this varied depending on the test used. There was insufficient evidence to confirm or exclude an effect of cognitive rehabilitation at the level of disability or on destination following discharge from hospital.
REVIEWER'S CONCLUSIONS: There is some evidence that cognitive rehabilitation for spatial neglect improves performance on some impairment level tests but its effect on disability is unclear. Further well-designed RCTs are warranted as well as basic research to develop valid outcome measures.
单侧空间忽视是指对空间一侧的注意力缺失。已采用多种策略来治疗这些问题，但缺乏其有效性的证据。
确定认知康复对中风后空间忽视的影响，通过损伤和残疾水平评估以及出院目的地来衡量。确定在随访评估中是否有任何效果持续存在。
我们检索了Cochrane中风组试验注册库（最后检索时间为2001年2月）、MEDLINE（1966年 - 2000年12月）、EMBASE（1980年 - 2001年2月）、CINAHL（1983年 - 2001年1月）、PSYCLIT和CLINPSYCH（1974年 - 2001年2月）。我们手工检索了相关期刊，筛选了相关文章的参考文献列表，并使用SCISEARCH追踪了引文。
中风后空间忽视的认知康复对照试验。除非超过75%的样本为中风患者或可获得中风患者的单独中风数据，否则排除混合患者组的研究。
两名评审员独立选择试验、提取数据并评估试验质量。
我们纳入了15项研究，共400名参与者。报告了大量不同的结局指标。只有6项研究纳入了残疾测量，只有4项研究（111名参与者）调查了对任何结局的持续影响。有证据表明，认知康复在损伤水平评估中导致了显著且持续的表现改善，尽管这因所使用的测试而异。没有足够的证据来确认或排除认知康复在残疾水平或出院后目的地方面的影响。
有一些证据表明，针对空间忽视的认知康复可改善某些损伤水平测试中的表现，但其对残疾的影响尚不清楚。需要进一步设计良好的随机对照试验以及基础研究来开发有效的结局指标。
