Limb activation effects in hemispatial neglect.

OBJECTIVE To assess the efficacy of passive and active limb movement to improve visual scanning in patients with hemispatial neglect. DESIGN Before-after trial: behavioral analyses of a case series. SETTING Stroke rehabilitation unit in a tertiary care hospital. PARTICIPANTS Nine individuals with right-hemisphere stroke (mean time poststroke, 19.5 mo) and left-sided neglect, as assessed by the Sunnybrook Bedside Neglect Battery. INTERVENTION Active left limb movement (button push; n=3) or passive left limb movement (n=8) with functional electric stimulation (FES) administered during visual scanning testing. MAIN OUTCOME MEASURES Performance on visual scanning tests involving naming of letters and numbers. RESULTS Both active and passive movement significantly improved target detection on the left side, but not on the right side, on the visual scanning task. Positive results were seen in 2 of 3 active movement patients and 6 of 8 passive movement patients. CONCLUSIONS Both active and FES-stimulated passive movements are potential techniques for the treatment of hemispatial neglect.