Reintegrating space and object representations in patients with hemispatial neglect: two case studies

Purpose: This article examines the effectiveness of differentiated rehabilitation programmes for patients with two distinct types of hemispatial neglect: body-centred and object-focused. We hypothesized that patients with body-centred neglect would respond to motor-control programmes designed for pa...

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Bibliographic Details
Published in:Disability and rehabilitation 2004-05, Vol.26 (9), p.549-561
Main Authors: Pachalska, Maria, Franczuk, Boguslaw, MacQueen, Bruce Duncan, Talar, Jan
Format: Article
Language:English
Subjects:
Aged
Attention
Cognitive Therapy
Exercise Therapy
Humans
Male
Middle Aged
Neuropsychological Tests
Perceptual Disorders - physiopathology
Perceptual Disorders - rehabilitation
Rehabilitation - methods
Stroke Rehabilitation
Task Performance and Analysis
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Summary:Purpose: This article examines the effectiveness of differentiated rehabilitation programmes for patients with two distinct types of hemispatial neglect: body-centred and object-focused. We hypothesized that patients with body-centred neglect would respond to motor-control programmes designed for patients with limb apraxia, while those with object-focused neglect would require visually oriented therapy. Material and methods: The article describes the rehabilitation of two patients treated by the authors 6 - 9 months after right-hemisphere infarct. Both showed significant left-sided hemispatial neglect: body-centred in one case (patient BC), object-focused in the other (patient OF). A modified AB - BA experimental design was used, where A represents visual training, and B is spatio-motor training. For patient BC, the sequence was A - B; for patient OF, B - A. Neglect was measured using standard tests for neglect and the analysis of drawings made during therapy by both patients. Results: As hypothesized, patient BC showed no progress after conclusion of programme A, while after programme B she showed virtually no lingering neglect. In the case of patient OF, the results were exactly reversed. Conclusions:  Body-centred neglect is essentially a defect in space formation, while object-focused neglect is a disorder of object formation. The patients described here both benefited from neuropsychological therapy for neglect, but not from the same programme.
ISSN:0963-8288
1464-5165
DOI:10.1080/09638280410001663076