Kinaesthetic ability training improves unilateral neglect and functional outcome in patients with stroke: A randomized control trial
Sehim Kutlay, Aysun Genç, Haydar Gök, Derya Öztuna, Ayşe A. Küçükdeveci
Department of Physical Medicine and Rehabilitation, Ankara University Faculty of Medicine, Ankara, Turkey. E-mail: firstname.lastname@example.org
Objective: To investigate the effects of kinaesthetic ability training with the Kinesthetic Ability Trainer (KAT) on unilateral neglect and functional outcomes in stroke patients.
Study design: An assessor-blinded, randomized controlled, clinical trial.
Methods: A total of 64 stroke patients with unilateral neglect (mean age 61 (standard deviation (SD) 12) years, 60.4% male, mean time since stroke 6.4 (SD 10.4) months, left hemiplegia 92.5%) were randomly assigned to a conventional rehabilitation programme (control group, n = 32) or KAT plus a conventional rehabilitation programme (KAT group, n = 32) for 4 weeks. Patients were assessed with the Behavioral Inattention Test (BIT) and Functional Independence Measure (FIM) before and after therapy.
Results: Both groups showed significant improvements in all subscales of the BIT (conventional and behavioural) (p < 0.001) and the FIM motor scale (p < 0.001) after therapy. Recovery from neglect was assessed, based on the BIT cut-off scores. The recovery rate for behavioural BIT was 40% in the KAT group and 17.9% in the control group (p = 0.07), whereas recovery rates according to the conventional BIT were 16% and 10.7% in the KAT and control groups, respectively.
Conclusion: Kinaesthetic ability training provides clinically meaningful improvement in stroke patients with unilateral neglect. It may be useful as an adjunctive therapy for rehabilitation in these patients.
Unilateral neglect that is failure to respond to stimuli from the contrlateral space is a challenging for patients undergoing rehabilitation. Patients with unilateral neglect usually have decreased awareness of the deficit which limits activities of daily living. While some signs of unilateral neglect spontaneously improved within a few weeks following stroke, most patients with unilateral neglect need various treatment modalities. In this study, we used kinaesthetic ability training as an adjunctive treatment to conventional rehabilitation programme in stroke patients with unilateral neglect. Kinaesthetic ability training provides improvement in patients with neglect. It may be useful for neglect rehabilitation.