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Title: Rehabilitation interventions for unilateral neglect after stroke : a systematic review from 1997 through 2012
Authors: Yang, NYH
Zhou, D
Chung, RCK
Li-Tsang, CWP 
Fong, KNK 
Issue Date: 10-May-2013
Source: Frontiers in Human Neuroscience, 10 May 2013, v. 7, 187, p. 1-11
Abstract: A systematic review of the effectiveness of rehabilitation for persons with unilateral neglect (UN) after stroke was conducted by searching the computerized databases from 1997 through 2012. Randomized controlled trials (RCTs) of neglect treatment strategies for stroke patients which used the Behavioral Inattention Test (BIT) as the primary outcome measure were eligible for inclusion. Out of 201 studies initially identified, 12 RCTs covering 277 participants were selected for analysis. All had the same weakness of lower power with smaller samples and limitation in the blindingness of the design. Prism Adaptation (PA) was the most commonly used intervention while continuous Theta-burst stimulation (cTBS) appeared to be a new approach. Meta-analysis showed that for immediate effects, the BIT conventional subscore had a significant and large mean effect size (ES=0.76; 95% CI 0.28-1.23; p=0.002) whereas the BIT total score showed a modestly significant mean ES (ES=0.55; 95% CI 0.16-0.94; p=0.006). No significant mean ES in sensitivity analysis was found for long-lasting effects across all BIT outcomes. PA appeared to be the most effective intervention based on the results of pooled analysis. More rigorous studies should be done on repetitive transcranial magnetic stimulation (rTMS) before it can be concluded that it is a promising treatment for UN.
Keywords: Behavioral inattention test
Rehabilitation
Stroke
Systematic review
Unilateral neglect
Publisher: Frontiers Research Foundation
Journal: Frontiers in Human Neuroscience 
ISSN: 1662-5161
DOI: 10.3389/fnhum.2013.00187
Rights: Copyright: © 2013 Yang, Zhou, Chung, Li-Tsang and Fong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/3.0/), which permits use, distribution and reproduction in other forums, provided the original authors and source are credited and subject to any copyright notices concerning any third-party graphics etc.
The following publication Yang NYH, Zhou D, Chung RCK, Li-Tsang CWP and Fong KNK (2013) Rehabilitation interventions for unilateral neglect after stroke: a systematic review from 1997 through 2012. Front. Hum. Neurosci. 7:187,1-11 is available at https://dx.doi.org/10.3389/fnhum.2013.00187
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