Mizuno Katsuhiro, Tsujimoto Kengo, Tsuji Tetsuya
Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan.
Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Brain Sci. 2021 Mar 9;11(3):347. doi: 10.3390/brainsci11030347.
Rehabilitation for unilateral spatial neglect (USN) using prism adaptation (PA) is one of the most widely used methods, and the effectiveness of PA is well-evidenced. Although the effect of PA generalized various neglect symptoms, the effectiveness for some aspects of neglect is not fully proven. The Catherine Bergego Scale (CBS) was developed to identify problems with the activities of daily living (ADL) caused by USN. The CBS is composed of 10 observation assessments and a self-assessment questionnaire. To assess the self-awareness of USN, the anosognosia score is calculated as the difference between the observational scores and the self-assessment scores. To investigate how PA affects ADL and self-awareness in subacute USN patients during rehabilitation, we analyzed each item of the CBS and self-awareness from a randomized, controlled trial (RCT) that we previously conducted (Mizuno et al., 2011).
A double-masked randomized, controlled trial was conducted to evaluate the effects of a 2-week PA therapy on USN in 8 hospitals in Japan. We compared each item of the CBS, anosognosia score, and absolute value of the anosognosia score between the prism group and the control group.
Two of ten items (gaze orientation and exploration of personal belongings) were significantly improved in the prism group compared with those in the control group. The absolute value of the anosognosia score was significantly improved by PA.
Improvement of oculomotor exploration by PA may generalize the behavioral level in a daily living environment. This study suggested that PA could accelerate the self-awareness of neglect during subacute rehabilitation.
使用棱镜适应（PA）对单侧空间忽视（USN）进行康复治疗是应用最广泛的方法之一，且PA的有效性有充分证据。尽管PA对各种忽视症状均有效果，但对忽视某些方面的有效性尚未得到充分证实。凯瑟琳·贝热戈量表（CBS）旨在识别由USN导致的日常生活活动（ADL）问题。CBS由10项观察评估和一份自我评估问卷组成。为评估USN的自我意识，失认症得分计算为观察得分与自我评估得分之差。为研究PA在康复过程中如何影响亚急性USN患者的ADL和自我意识，我们对之前进行的一项随机对照试验（RCT）（水野等人，2011年）中的CBS各项及自我意识进行了分析。
在日本的8家医院进行了一项双盲随机对照试验，以评估为期2周的PA治疗对USN的效果。我们比较了棱镜组和对照组之间CBS的各项、失认症得分以及失认症得分的绝对值。
与对照组相比，棱镜组10项中的两项（注视方向和个人物品探索）有显著改善。PA使失认症得分的绝对值有显著改善。
PA改善眼动探索可能会推广到日常生活环境中的行为水平。本研究表明，PA可加速亚急性康复期间对忽视的自我意识。
