Minami Kodai, Inoue Seigo, Goto Yuto, Jumi Kyohei, Kondo Kunitsugu, Mizuno Katsuhiro, Watanabe Tatsunori
Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, JPN.
Graduate School of Health Sciences, Aomori University of Health and Welfare, Aomori, JPN.
Cureus. 2025 Jun 9;17(6):e85674. doi: 10.7759/cureus.85674. eCollection 2025 Jun.
Interventions to improve activities of daily living (ADL) remain undeveloped for unilateral spatial neglect (USN). This case study examined the effects of combining visual scanning training (VST) and electrical stimulation during walking on ADL for USN. The patient was a 62-year-old right-handed man with dissection and occlusion of the right middle cerebral artery, who was transferred to our hospital on the 11th day from stroke onset. After approximately two months of conventional therapy, he was able to walk without an aid, but frequently overlooked objects and people on the left, requiring assistance. Thereafter, he underwent 14 days of combined VST with transcutaneous electrical nerve stimulation on his left posterior neck muscle during walking in addition to conventional physical therapy. The effectiveness of the intervention was assessed using the Behavior Inattention Test conventional subtest (BIT-c), Catherine Bergego Scale (CBS), and a computer-based assessment of top-down and bottom-up attention. Following the intervention, the BIT-c and CBS scores improved from 141 to 145 and from 11 to 2, respectively, and he rarely overlooked objects while walking. In addition, there was an improvement in attention automatically directed by external stimuli (bottom-up attention). These improvements were maintained at two-week follow-up. These findings suggest that the combined training during walking may have contributed to the improvement of ambulatory ADL in this stroke patient with USN, highlighting its potential relevance for functional independence in similar cases.
针对单侧空间忽视（USN），改善日常生活活动（ADL）的干预措施仍未得到充分发展。本案例研究探讨了在行走过程中结合视觉扫描训练（VST）和电刺激对USN患者ADL的影响。患者为一名62岁右利手男性，患有右大脑中动脉夹层和闭塞，发病后第11天转入我院。经过约两个月的常规治疗，他能够独立行走，但经常忽视左侧的物体和人，需要他人协助。此后，除了常规物理治疗外，他在行走过程中接受了为期14天的VST与经皮电神经刺激相结合的治疗，刺激部位为左侧后颈部肌肉。使用行为疏忽测试常规子测试（BIT-c）、凯瑟琳·贝热戈量表（CBS）以及基于计算机的自上而下和自下而上注意力评估来评估干预效果。干预后，BIT-c和CBS评分分别从141分提高到145分、从11分提高到2分，并且他在行走时很少再忽视物体。此外，由外部刺激自动引导的注意力（自下而上注意力）也有所改善。这些改善在两周的随访中得以维持。这些发现表明，行走过程中的联合训练可能有助于改善这位患有USN的中风患者的行走ADL，凸显了其在类似病例中对功能独立性的潜在意义。
