Sato Masato, Mikami Yukio, Tajima Fumihiro
Department of Rehabilitation, Hashimoto Municipal Hospital, Hashimoto, Wakayama, Japan.
Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan.
Prog Rehabil Med. 2022 Apr 13;7:20220020. doi: 10.2490/prm.20220020. eCollection 2022.
There are no reports on the therapeutic application of perceptive exploration activity in patients with unilateral spatial neglect (USN). This study monitored the course of acute occupational therapy using perceptive exploration activities in a patient with USN who had difficulty in manipulating tools for daily living after a stroke.
A 70-year-old man was admitted to our hospital for conservative treatment of hemiparesis and USN caused by stroke. He was previously diagnosed with cerebral infarction due to middle cerebral artery occlusion. His main symptoms were hemiparesis, egocentric spatial neglect in personal space and peripersonal space, and allocentric neglect, which made it difficult to use tools for daily living. Within 24 h of admission, perceptive exploration activities were initiated as the main therapy in addition to preparatory therapies, such as the facilitation of selective movement of limbs affected by paralysis. These therapies were provided over a 30-day period in 40-min sessions, 5 days a week. This treatment resulted in improved test results for the Fugl-Meyer Assessment, Bisiach's body neglect and anosognosia scales, and the Behavioral Inattention Test. The Functional Independence Measure scores also improved with the improvement of neglect symptoms.
This case study monitored the improvements of egocentric spatial neglect and allocentric neglect during therapy using perceptive exploration activities in a patient with USN who had difficulty manipulating tools for daily living. The effectiveness of the therapy should be confirmed by increasing the sample size in future studies.
目前尚无关于感知探索活动在单侧空间忽视（USN）患者中治疗应用的报道。本研究监测了一名中风后在日常生活中难以操作工具的USN患者，使用感知探索活动进行急性职业治疗的过程。
一名70岁男性因中风导致的偏瘫和USN入院接受保守治疗。他此前被诊断为大脑中动脉闭塞引起的脑梗死。他的主要症状是偏瘫、个人空间和周边个人空间的自我中心空间忽视以及allocentric忽视，这使得他难以在日常生活中使用工具。入院后24小时内，除了诸如促进瘫痪肢体选择性运动等预备治疗外，还启动了感知探索活动作为主要治疗方法。这些治疗在30天内进行，每周5天，每次40分钟。这种治疗使Fugl-Meyer评估、Bisiach身体忽视和疾病感缺失量表以及行为疏忽测试的结果得到改善。随着忽视症状的改善，功能独立性测量得分也有所提高。
本病例研究监测了一名在日常生活中难以操作工具的USN患者，在使用感知探索活动进行治疗期间自我中心空间忽视和allocentric忽视的改善情况。该治疗方法的有效性应在未来研究中通过增加样本量来证实。
