OBJECTIVE. We determined whether listening to excerpts of classical music ameliorates unilateral neglect (UN) in stroke patients. METHOD. In this within-subject study, we recruited and separately tested 16 UN patients with a right-hemisphere stroke under three conditions within 1 wk. In each condition, participants were asked to complete three subtests of the Behavioral Inattention Test while listening to classical music, white noise, or nothing. All conditions and the presentation of the tests were counterbalanced across participants. Visual analog scales were used to provide self-reported ratings of arousal and mood. RESULTS. Participants generally had the highest scores under the classical music condition and the lowest scores under the silence condition. In addition, most participants rated their arousal as highest after listening to classical music. CONCLUSION. Listening to classical music may improve visual attention in stroke patients with UN. Future research with larger study populations is necessary to validate these findings.

OBJECTIVE. We investigated the effect of constraint-induced therapy (CIT) plus eye patching (EP), CIT alone, and conventional treatment on functional performance, eye movement, and trunk–arm kinematics in stroke patients with neglect syndrome. METHOD. Twenty-four participants were recruited and randomly allocated to three intervention groups. All participants received intervention 2 hr/day, 5 days/wk, for 3 wk. Outcome measures included the Catherine Bergego Scale, eye movement, and trunk–arm kinematic analysis. RESULTS. The CIT + EP and CIT groups demonstrated larger improvements in functional performance than the control group. The CIT group showed better performance with left fixation points than the CIT+EP group and shorter reaction time than the control group. The CIT + EP group improved more in preplanned control and leftward trunk shift than the other two groups. CONCLUSION. CIT + EP and CIT were more effective interventions than conventional treatment of patients with neglect syndrome in daily functional performance.

Objectives. The purpose of this study was to determine the reliability and validity of a Draw-A-Man Test in measuring personal neglect in patients with right brain stroke. Method. Draw-A-Man Test was administered to 51 persons with right cerebrovascular accident (CVA) and 110 age-matched persons without brain insult. A categorical classification was developed based on the man drawn in the test. Participants who showed homogeneous bilateral representation of body parts were considered to not have personal neglect, whereas those who showed unilateral body parts were considered to have personal neglect. The completed tests were used to blindly categorize the persons with and without personal neglect according to the above definition by two raters for calculating interrater reliability. The Klein-Bell ADL (Activities of Daily Living) Scale was also administered to the participants with right CVA to validate the Draw-A-Man Test. Results. This dichotomy—bilateral representation versus unilateral representation—showed a high percentage of agreement between two raters. Rater A classified all 110 “normal” participants as being without personal neglect and classified 13 of the 51 participants with stroke as having personal neglect. Participants demonstrating personal neglect showed significantly poorer ADL performance than did those without personal neglect. ADL performance was also found to be significantly related to somatosensation, motor status of the impaired limbs, and muscle strength of the sound limbs. However, even after controlling the effect of these variables by partial correlation, personal neglect was still highly related to ADL performance. Conclusion. The Draw-A-Man Test is a reliable and valid tool for discriminating clients with personal neglect from those without.

Unilateral neglect is a common neurological syndrome resulting from right-hemisphere strokes and has important prognostic value for functional outcome. This article identifies three approaches to neglect rehabilitation that are based on right-hemispheric activation mechanisms: (a) the lateralized task approach, (b) the controlled sensory stimulation approach, and (c) the limb activation approach. Their theoretical bases, experimental findings, and practical implications for neglect remediations are discussed. Meta-analytic procedures were used to critically review and statistically combine the results from potentially relevant studies, including 9 group design studies and 22 single-subject studies. An overall mean effect size r of .77 was found for the group design studies. For the studies with individual subjects as units of analysis, an overall mean r of .89 was obtained. This review provided empirical support for intervention in cases of unilateral neglect on the basis of brain activation mechanisms. Some appropriate areas for further research include evaluating treatment efficacy against functional criteria, refining intervention procedures in keeping with the advances in brain activation research, and identifying the optimal conditions for promoting generalized training.

Objectives. The Behavioral Inattention Test (BIT) is a standardized assessment for unilateral visual neglect. It comprises six conventional and nine behavioral subtests. The purpose of this study was to add to the validation of the behavioral subtests. Method. Forty Israeli subjects with right cerebrovascular accident (CVA), from both day center and hospital settings, were evaluated on three measures: the BIT, performance tasks, and a checklist of activities of daily living (ADL). Results. Seven of the nine BIT behavioral subtests differentiated significantly between subjects with visual neglect and those without neglect; six of the nine subtests correlated significantly with parallel performance tasks or ADL checklist items. Conclusion. These results support the construct and predictive validity of most of the BIT behavioral subtests as functional measures of unilateral neglect, thus, the BIT is recommended for use by occupational therapists. Inclusion of a relative score for right and left omissions within the BIT is recommended.

Objectives. Neglect in vertical and radial directions is rarely evaluated systematically in patients with brain damage. Method and Results. Using the line bisection task, we confirmed that some patients with unilateral brain damage manifest vertical or radial spatial neglect. In fact, patients with severe left horizontal neglect tend to have severe vertical neglect. Conclusion. Because vertical and radial neglect may affect the ability to perform functional daily activities, occupational therapists need to address the existence of vertical and radial neglect when evaluating and training patients with brain damage.