Department of Rehabilitation Medicine, Saitama International Medical Center, Saitama Medical University, Hidaka, Japan.
Eur Neurol. 2010;63(3):170-5. doi: 10.1159/000286517. Epub 2010 Feb 20.
Unilateral spatial neglect (USN) is one of the major behavioral disturbances in patients with cerebral lesions and often impairs the patients' independence in activities of daily living (ADL). Although many studies have addressed the mechanism and assessment of USN, there have been only few reports on rehabilitation strategies for patients with USN. The present study examined whether family participation can contribute to an improvement in USN following an acute stroke.
This study compared the improvement at 3 weeks among patients treated with conventional exercise sessions and a program including the participation of family members. The study followed 34 stroke patients with hemiparesis and USN. Twenty had family participation in their therapy. The severity of USN was measured using the Behavioral Inattention Test (BIT) and a laterality index (LI). Mobility was assessed using the Rivermead Mobility Index (RMI), and ADL were assessed using the Barthel index.
The results showed a relationship between BIT score improvement and family participation, and the BIT score improvement reflected the LI improvement. The RMI and BIT scores showed that ADL improved more with than without family participation.
Family participation improved not only the mobility but also USN, suggesting that it can make important contributions to acute stroke rehabilitation.
单侧空间忽略（USN）是脑损伤患者的主要行为障碍之一，常导致患者日常生活活动（ADL）的独立性受损。尽管许多研究都探讨了 USN 的机制和评估，但针对 USN 患者的康复策略的报道却很少。本研究探讨了家庭参与是否有助于急性脑卒中后 USN 的改善。
本研究比较了接受常规运动治疗和包括家庭成员参与的方案治疗的患者在 3 周时的改善情况。研究纳入了 34 名偏瘫合并 USN 的脑卒中患者。其中 20 名患者的治疗中包含家庭成员的参与。采用行为忽视测验（BIT）和侧化指数（LI）评估 USN 的严重程度。采用 Rivermead 移动指数（RMI）评估移动能力，采用 Barthel 指数评估 ADL。
结果显示，BIT 评分的改善与家庭参与之间存在相关性，且 BIT 评分的改善反映了 LI 的改善。RMI 和 BIT 评分表明，家庭参与组的移动能力和 USN 改善情况均优于无家庭参与组。
家庭参与不仅改善了移动能力，还改善了 USN，这表明家庭参与对急性脑卒中康复具有重要作用。
