Abstract
Background: Unilateral Spatial Neglect (USN) is a disabling feature and a frequent behavioural syndrome in stroke survivors. This study was designed to determine the effects of trunk rotation and limb activation in the management of USN in adult stroke survivors.
Method: Participants were 19 stroke survivors with USN. They were randomly assigned to an intervention group (n=10) and a control group (n=9). All participants took part in conventional physiotherapy protocol thrice a week for four weeks. During the same period, participants in the intervention group also received trunk rotation and limb activation treatment. Cognition, Functional Independence in Activities of Daily Living (ADLs) and severity of USN were assessed using Mini-Mental State Examination (MMSE), Barthel Index (BI) and Behavioural Inattention Test (BIT) respectively.
Results: In the Intervention group, the mean BIT scores increased from 111.20±44.87 to 209.60±13.48, mean BI scores increased from 42.50±29.74 to 74.00±18.07, while MMSE scores increased from 26.60±1.71 to 28.50±1.51. The changes were significant (p<0.05). In the Control group, the mean BIT scores increased from 130.56±32.99 to 195.89±14.59, mean BI scores increased from 81.11±26.67 to 91.67±11.18, while MMSE scores increased from 27.33±1.23 to 28.56±0.53. The changes were significant (p<0.05) except for the BI score. Between-group comparison showed significant post intervention differences in BIT and BI (p < 0.05) scores, but not in MMSE score.
Conclusion: It was concluded that conventional physiotherapy, trunk rotation and limb activation were efficacious in the management of USN in stroke survivors.
Keywords: Stroke, physiotherapy, unilateral spatial neglect, trunk rotation, limb activation.
Résumé
Contexte: La Négligence Spatiale Unilatérale (NSU) est une caractéristique handicapante et un syndrome comportemental fréquent
chez les survivants d’attaque paralytique. Cette étude a été conçue pour déterminer les effets de la rotation du tronc et de l’activation des
membres dans la prise en charge de l’NSU chez les survivants adultesd’attaque paralytique.
Méthode: Les participants étaient 19 survivants d’attaque paralytique avec NSU. Ils ont été répartis au hasard
entre un groupe d’intervention (n = 10) et un groupe témoin (n = 9). Tous les participants ont pris part au
protocole de physiothérapie conventionnelle trois fois par semaine pendant quatre semaines. Au cours de la
même période, les participants au groupe d’intervention ont également reçu une rotation du tronc et un
traitement d’activation des membres. La cognition, l’indépendance fonctionnelle dans les activités de la vie
quotidienne (AVQ) et la gravité de l’NSU ont été évalués à l’aide du Mini- Examen de l’Etat Mental (MEEM),
l’IndexBarthel (IB) et du Test d’InattentionComportemental (TIC) respectivement.
Résultats: Dans le groupe d’Intervention, les scores moyens de TIC ont augmenté de 111.20 ± 44.87 à 209.60 ± 13.48, les scores moyens d’IB ont augmenté de 42.50 ± 29.74 à 74.00 ± 18.07, tandis que les scores de MEEM sont passés de 26.60 ± 1.71 à 28.50 ± 1.51. Les changements étaient significatifs (pd”0,05). Dans le groupe témoin, les scores moyens de BIT ont augmenté de 130,56 ± 32,99 à 195,89 ± 14,59, les scores moyens d’IB ont augmenté de 81,11 ± 26,67 à 91,67 ± 11,18, tandis que les scores de MEEM ont augmenté de 27,33 ± 1,23 à 28,56 ± 0,53. Les changements étaient significatifs (pd”0,05), sauf pour le score IB. La comparaison entre les groupes a montré des différences significatives après l’intervention dans les scores TIC et IB (p <0,05), mais pas dans le score MEEM.
Conclusion: Il a été conclu que la physiothérapie conventionnelle, la rotation du tronc et l’activation des membres étaient efficaces dans la prise en charge de l’NSU chez les survivants d’attaque paralytique.
Mots-clés: Attaque paralytique, physiothérapie, négligence spatiale unilatérale, rotation du tronc, activation des membres.
Correspondence: Dr. O.A. Olawale, Department of Physiotherapy, College of Medicine, University of Lagos, IdiAraba, Lagos, Nigeria. E-mail: oolawale@unilag.edu/ng
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