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Unilateral neglect syndrome rehabilitation by trunk rotation and scanning training
Wiart L, Come AB, Debelleix X, Petit H, Joseph PA, Mazaux JM, Barat M
Archives of Physical Medicine and Rehabilitation 1997 Apr;78(4):424-429
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: Assessment of a new rehabilitation method for unilateral neglect syndrome (UNS), using a specific device (Bon Saint Come's device) that associates exploratory reconditioning with voluntary trunk rotation. DESIGN: Study 1, randomized control trial during 2 months; study 2, nonrandomized control trial during 2 months. SETTING: Neurorehabilitation units in private and public center. PATIENTS: In study 1, 22 consecutive patients with UNS resulting from recent stroke (< 3 months) were randomly assigned to an experimental group (11 patients) or to a control group (11 patients). The 2 groups were very similar in terms of general and neurological data. In study 2, 5 consecutive patients with chronic UNS resulting from an old stroke (> 6 months) showing the same characteristics were included. INTERVENTION: In study 1, patients in group E followed the experimental program 1 hour a day for 1 month (20 hours) and group C followed usual neurorehabilitation during the same time. In study 2, every patient followed the experimental program 1 hour a day for 1 month (20 hours). MAIN OUTCOME MEASURES: Assessment in both studies was done at day 0, day 30, and day 60 using a battery of UNS tests (Albert, Scheckenberg, bell) and an activities of daily living (ADL) test (the Functional Independence Measure (FIM)). Mean scores of each test were compared between the 2 groups with the Wilcoxon nonparametric test. RESULTS: In study 1 all UNS test results and the FIM improved significantly more in group E than in group C. In group E, UNS disappeared in 5 patients and improved in 6. In group C, UNS disappeared in 1 patient, improved in 4, and was unchanged in 6. In study 2, UNS remitted in 2 patients, improved in 2 patients, and was unchanged in 1. CONCLUSION: The Bon Saint Come method seems to significantly improve recent and chronic UNS, as well as ADL function. These encouraging results could have resulted from a synergistic effect of spatial reconditioning and voluntary trunk rotation. It must be assessed by a new study with more patients.

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