Hemineglect in stroke patients. Part 2. Rehabilitation techniques and strategies: a summary of recent studies

Hemineglect may complicate recovery of function in stroke patients. Although many studies have demonstrated success in reducing unilateral neglect during or immediately after treatment, longer term carry-over or generalization to untrained tasks has proved more difficult. However, a number of recent studies have shown promise, both in reducing neglect and improving performance in everyday tasks. Strategies found to be particularly useful include sustaining arousal during scanning activities which incorporate attentional cues on the neglected side, and encourage activation of contralesional limbs. Motor imagery techniques have also been effective in reducing neglect and improving everyday function. Other techniques reviewed include a number of specific stimulation strategies, and the reduction of sensory input to the undamaged hemisphere. Unfortunately, these strategies may reduce neglect during stimulation, or for a short time afterwards, but have not been shown to carry-over or to generalize. Practical suggestions are made to enable therapists to incorporate potentially successful strategies into rehabilitation programmes in clinical settings.