A B S T R A C T
Background
Unilateral spatial neglect causes difficulty attending to one side of space. Various rehabilitation interventions have been used but
evidence of their benefit is lacking.
Objectives
To assess whether cognitive rehabilitation improves functional independence, neglect (as measured using standardised assessments),
destination on discharge, falls, balance, depression/anxiety and quality of life in stroke patients with neglect measured immediately
post-intervention and at longer-term follow-up; and to determine which types of interventions are effective and whether cognitive
rehabilitation is more effective than standard care or an attention control.
Search methods
We searched the Cochrane Stroke Group Trials Register (last searched June 2012), MEDLINE (1966 to June 2011), EMBASE (1980
to June 2011), CINAHL (1983 to June 2011), PsycINFO (1974 to June 2011), UK National Research Register (June 2011). We
handsearched relevant journals (up to 1998), screened reference lists, and tracked citations using SCISEARCH.
Selection criteria
We included randomised controlled trials (RCTs) of cognitive rehabilitation specifically aimed at spatial neglect. We excluded studies
of general stroke rehabilitation and studies with mixed participant groups, unless more than 75% of their sample were stroke patients
or separate stroke data were available.
Data collection and analysis
Two review authors independently selected studies, extracted data, and assessed study quality. For subgroup analyses, review authors
independently categorised the approach underlying the cognitive intervention as either ’top-down’ (interventions that encourage
awareness of the disability and potential compensatory strategies) or ’bottom-up’ (interventions directed at the impairment but not
requiring awareness or behavioural change, e.g. wearing prisms or patches).