Application of computerised interactive devices for stroke patients with hemispatial neglect.

Background and purpose

Computerised interactive devices provide various treatment options for post-stroke rehabilitation, and may be applicable to treat neuropsychological deficits. This study aimed to identify a single rehabilitation task capable of improving both motor and cognitive functions in stroke patients.

Methods

This prospective randomised controlled trial involved post-stroke patients with hemispatial neglect who were divided into four groups. All groups received conventional treatment. Besides this, the control group made sorter exercises, while the three experimental groups engaged in the following additional activities: exercises with a gravity-supporting exoskeleton; exercises with an upper limb device with sensors on the patient; exercises with an upper limb device with sensors on a touchscreen. All groups used the unaffected side, except the exoskeleton group. Following measures were assessed pre- and post-test: upper limb subsection of the Fugl-Meyer scale (FM-UL), functional independence measure (FIM), line bisection test (LBT), Bells test.

Results

The programme (four weeks, 15 sessions) was completed by 59 post-stroke patients (less than 6 months after stroke). Significant associations were observed between time since stroke onset and improvements in FM-UL (p = .039), and motor (p = .021) and total FIM (p = .034). The motion abilities of the affected upper limb improved regardless of the treated side (p FM-UL = 0.45; p FIM = 0.416; p motor FIM = 0.395; p Bells test = 0.347; p LBT = 0.887). Bells test and LBT showed a strong correlation (-0.593). The effectiveness of the computerised interactive rehabilitation exercises in treating hemispatial neglect was comparable to conventional exercises, improving motor abilities of patients, as well as reducing hemispatial neglect in post-stroke patients.

Conclusion

This form of therapy is effective for both motor and certain cognitive deficits.