Kim Dong Chan, Park Junghyeon, Kim Min Wook
Department of Rehabilitation Medicine, Eunpyeong St. Marys' Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul 03312, Republic of Korea.
Department of Rehabilitation Medicine, Incheon St. Marys' Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea, 56, Dongsu-ro, Bupyeong-gu, Incheon 21431, Republic of Korea.
Brain Sci. 2025 Aug 23;15(9):906. doi: 10.3390/brainsci15090906.
: Anosognosia for hemiplegia (AHP) is a multifaceted syndrome in which stroke survivors fail to recognize motor impairments. Although AHP has significant clinical implications, rehabilitation strategies have remained fragmented and underexplored. This systematic review aimed to critically evaluate rehabilitation interventions for AHP published between 2006 and 2025, categorize intervention types, and assess clinical outcomes to inform future research and practice. : A structured search was conducted in the PubMed and PsycINFO databases on 31 March 2025, using predefined keywords related to stroke, anosognosia, and rehabilitation. The eligible studies included randomized controlled trials, case-control studies, and case studies. Following title, abstract, and full-text screening, nine studies focusing on rehabilitation interventions for AHP were selected and analyzed. : The interventions reviewed included sensorimotor recalibration techniques, neuromodulatory approaches, error-based cognitive training, and self-observation in video replay strategies. Interventions emphasizing motor intention monitoring, error correction, and self-observation were more consistently associated with durable improvements in motor awareness than neglect-based spatial interventions were. However, many studies were limited by small sample sizes and a lack of standardized outcome measures. Assessment methodologies vary widely, highlighting the need for multidimensional theory-driven evaluation tools. : Effective rehabilitation for AHP requires strategies targeting disrupted self-monitoring and agency mechanisms, rather than spatial realignment alone. The video self-observation and error-based learning paradigms show particular promise. Future research should focus on controlled trials, longitudinal tracking, and the integration of individualized, mechanism-specific rehabilitation models to optimize outcomes for stroke survivors with AHP.
偏瘫失认症（AHP）是一种多方面的综合征，中风幸存者无法识别运动障碍。尽管AHP具有重大的临床意义，但康复策略仍然零散且未得到充分探索。本系统评价旨在严格评估2006年至2025年间发表的针对AHP的康复干预措施，对干预类型进行分类，并评估临床结果，以为未来的研究和实践提供参考。2025年3月31日，在PubMed和PsycINFO数据库中进行了结构化搜索，使用了与中风、失认症和康复相关的预定义关键词。符合条件的研究包括随机对照试验、病例对照研究和病例研究。经过标题、摘要和全文筛选，选择并分析了9项关注AHP康复干预措施的研究。所审查的干预措施包括感觉运动重新校准技术、神经调节方法、基于错误的认知训练以及视频回放策略中的自我观察。与基于忽视的空间干预措施相比，强调运动意图监测、错误纠正和自我观察的干预措施与运动意识的持久改善更一致地相关。然而，许多研究受到样本量小和缺乏标准化结局测量的限制。评估方法差异很大，突出了对多维理论驱动评估工具的需求。对AHP进行有效的康复需要针对自我监测和能动性机制受损的策略，而不仅仅是空间调整。视频自我观察和基于错误的学习范式显示出特别的前景。未来的研究应专注于对照试验、纵向跟踪，以及整合个性化、针对特定机制的康复模型，以优化患有AHP的中风幸存者的结局。
