What are the functional outcomes of right hemisphere stroke patients with or without hemi-inattention complications? A critical narrative review and suggestions for further research.

PURPOSE:
There is widespread acceptance that patients demonstrating neglect/hemi-inattention (HI) following right hemisphere stroke (RHS) underachieve functionally compared to their counterparts without neglect. However, empirical evidence for this view needs examination. The purpose of this review is to critically appraise relevant studies that compared outcomes from RHS patients with/without hemi-attention and suggest more robust follow-up research.

METHOD:
Twelve studies published in 1995-2013 were critically reviewed. Two independent reviewers appraised design features including sample representation, assessment and data analysis methods. Strengths and limitations were highlighted.

RESULTS:
Results were largely inconsistent. Considerable heterogeneity within patient groups and across studies complicated interpretation. Evidence suggested average group disparity in scores between patients with and without HI at discharge but the cause of functional disparity could not be attributed specifically to HI from the data and modelling results available.

CONCLUSION:
The relationship between HI status and functional recovery warrants further investigation in studies with stronger methodology to ensure rigour and robustness in the results. Pending further research, HI status should not be regarded as a key predictor of functional recovery or rehabilitation potential in patients with RHSs. This group should continue to receive appropriate therapeutic intervention aimed at maximising their functional recovery post-stroke. Implications for Rehabilitation Findings from this review demonstrate a paucity of evidence to support the presence of hemi-inattention as a key predictor of functional recovery in patients with right hemisphere stroke; as such, practitioners should take this into consideration when planning rehabilitation programmes of their patients. In the initial months following right hemisphere stroke, there are wide-ranging differences in the rate and amount of functional recovery in patients, with and without hemi-inattention. Practitioners should not limit the aspirations of their patients based on the presence or absence of hemi-inattention. This review has identified a number of measurement limitations in commonly employed assessment tools for hemi-inattention and overall functional recovery. As such, practitioners should take the limitations of specific measures into account when interpreting the results contextually and with respect to their patients' situation.

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What are the functional outcomes of right hemisphere stroke patients with or without hemi-inattention complications? A critical narrative review and suggestions for further research
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The influence of visual neglect on stroke rehabilitation.
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Unilateral spatial neglect: relation to rehabilitation outcomes in patients with right hemisphere stroke.
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Functional measures of first-stroke rehabilitation inpatients: usefulness of the Functional Independence Measure total score with a clinical rationale.
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Functional disability and rehabilitation outcome in right hemisphere damaged patients with and without unilateral spatial neglect.
[Arch Phys Med Rehabil. 1999]
Recovery of functional status after right hemisphere stroke: relationship with unilateral neglect.
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Functional disability and rehabilitation outcome in right hemisphere damaged patients with and without unilateral spatial neglect.
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Facilitatory effect of neglect rehabilitation on the recovery of left hemiplegic stroke patients: a cross-over study.
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Visuospatial neglect: underlying factors and test sensitivity.
[Lancet. 1989]
Screening tests are not enough to detect hemineglect.
[Arq Neuropsiquiatr. 2007]
Sensitivity of clinical and behavioural tests of spatial neglect after right hemisphere stroke.
[J Neurol Neurosurg Psychiatry. 2002]
Review Assessment of unilateral neglect.
[Phys Ther. 2003]
Review Evaluating unilateral spatial neglect post stroke: working your way through the maze of assessment choices.
[Top Stroke Rehabil. 2004]
Review Evaluating unilateral spatial neglect post stroke: working your way through the maze of assessment choices.
[Top Stroke Rehabil. 2004]
Review Issues for selection of outcome measures in stroke rehabilitation: ICF activity.
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Review Barthel index for stroke trials: development, properties, and application.
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Review Issues for selection of outcome measures in stroke rehabilitation: ICF activity.
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The role of unilateral spatial neglect in rehabilitation of right brain-damaged ischemic stroke patients: a matched comparison.
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Facilitatory effect of neglect rehabilitation on the recovery of left hemiplegic stroke patients: a cross-over study.
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I have ticked that it does meet REF as far as I am aware as its part of a serial longitudinal research project (undertaken previously for PhD).