neglect in patients with stroke have been confirmed, the
effects were a little bit different depending on the clinical
measures5)
. The result of this study showed that no signifi-
cant difference between the groups was found in the SCT,
but there was statistically significant difference between two
groups in the LBT. From this puzzling result, it can be con-
ceivable that the LBT and SCT test are qualitatively different
tasks that evoke different spatial processing mechanism. The
LBT requires the subjects to focus on the horizontal extent
of one single specific object. On the other hand, the SCT
requires the subjects to scan randomly structured multiple
object arrays. Therefore, attention in SCT is more related
to visuospatial exploration of different and successive loca-
tions on the display21)
.
Several studies have found that stroke patients often ori-
ent their bodies and heads toward the side of their lesion
even when there is no evidence of unilateral neglect20, 22)
.
These findings suggest that focus on remediation of gaze
and scanning alone is unlikely to be the most effective way
to improve visual attention in patients with stroke. Mental
practice may represent an alternative approach or also a con-
tribution to the conventional rehabilitation. Also the com-
bination of mental practice and conventional occupational
therapy may generally be the most promising approach.
Limitation of this study includes: First, in this study, the
effects of mental practice on unilateral neglect were not mea-
sureable by all employed neglect tests. One reason might be
due to the fact that some neuropsychological tests such as
the copying and drawing tasks are less sensitive than SCT
and that the scoring of these tasks is also less objective23)
.
Second, this study used a written examination only for the
assessment of unilateral neglect. Since there are many cases
of unilateral neglect clinically in the patient’s daily life in
spite of normal performance in the written examination24)
,
Azouvi et al.25)
reported that behavioral assessment showed
higher sensitivity when it was together with a written ex-
amination, rather than when a written examination was used
alone.
The long-term follow-up effects of mental practice were
not identified by this study. Therefore, further controlled
studies with lager sample sizes and longer interventions are
needed to clarify the clinical benefits of mental practice as
a rehabilitation approach for stroke patients with unilateral
neglect.