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.

Journal article


Stein, M. 2016. 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. Disability and Rehabilitation. 38 (4), pp. 315-28. https://doi.org/10.3109/09638288.2015.1037865
AuthorsStein, M.
Abstract

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.

KeywordsFunctional outcomes; Hemi-inattention; Modelling; Neglect; Right hemisphere; Stroke
Year2016
JournalDisability and Rehabilitation
Journal citation38 (4), pp. 315-28
PublisherTaylor & Francis
ISSN1464-5165
Digital Object Identifier (DOI)https://doi.org/10.3109/09638288.2015.1037865
Official URLhttps://doi.org/10.3109/09638288.2015.1037865
Publication dates
Online20 Apr 2015
Publication process dates
Accepted01 Apr 2015
Deposited09 Mar 2020
Output statusPublished
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What are the functional outcomes of right hemisphere stroke patients with or wit...
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
Taylor & Francis Open Select. 2016 Feb 13; 38(4)315
What are the functional outcomes of right hemisphere stroke patients with or wit...
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.
Disabil Rehabil. 2016;38(4):315-28. doi: 10.3109/09638288.2015.1037865. Epub 2015 Apr 20.
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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.
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Review Evaluating unilateral spatial neglect post stroke: working your way through the maze of assessment choices.
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Review Evaluating unilateral spatial neglect post stroke: working your way through the maze of assessment choices.
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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).

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Mechanised orthosis for children with neurological disorders (MOTION) - Evaluation of training packages
Hatzidimitriadou, E., Stein, M., Moore, J., Apps, J. and Kanderakis, T. 2023. Mechanised orthosis for children with neurological disorders (MOTION) - Evaluation of training packages. Canterbury Canterbury Christ Church University.
Mechanised orthosis for children with neurological disorders (MOTION) - Assessment of training needs of professionals and parents in bionic rehabilitation final report on survey and interviews of health care professionals and parents of children with CP
Hatzidimitriadou, E., Apps, J., Stein, M. and Moore, J. 2023. Mechanised orthosis for children with neurological disorders (MOTION) - Assessment of training needs of professionals and parents in bionic rehabilitation final report on survey and interviews of health care professionals and parents of children with CP. Canterbury Canterbury Christ Church University.
The experiences and perceptions of healthcare professionals regarding assistive technology training: A systematic review
Manship, S., Hatzidimitriadou, E., Moore, J., Stein, M., Towse, D. and Smith, R. 2023. The experiences and perceptions of healthcare professionals regarding assistive technology training: A systematic review. Assistive Technology. https://doi.org/10.1080/10400435.2023.2219294
EMPOWERing older people and their communities to manage their own CARE (EMPOWERCARE): Evaluation study of a social innovation initiative across four European countries
Hatzidimitriadou, E., Wright, T., Stirrup, V., Kuzbit, P., Thompson, T., DeBraal, P, Burton, C., Price, A., Stein, M., Wells, G., Manship, S., Martin, A. and Chung, P. 2022. EMPOWERing older people and their communities to manage their own CARE (EMPOWERCARE): Evaluation study of a social innovation initiative across four European countries. International Journal of Integrated Care. https://doi.org/10.5334/ijic.ICIC22333
A national survey of UK healthcare professionals regarding their knowledge, experiences and training needs of assistive technology (AT)​
Morris, R., Hatzidimitriadou, E., Manship, S., Stein, M., Parkin, C., Achille-Fauveau, S. and Laval, D. 2021. A national survey of UK healthcare professionals regarding their knowledge, experiences and training needs of assistive technology (AT)​.
Online training in ‘assistive technology for posture and mobility’ for healthcare professionals​
Stein, M., Hatzidimitriadou, E., Manship, S., Morris, R., Gallien, P., Petit, A., Achille-Fauveau, S., Laval, D. and Menard, L. 2021. Online training in ‘assistive technology for posture and mobility’ for healthcare professionals​.
Training of professionals in assistive technologies: pedagogic issues and strategies (Formation des professionnels aux technologies d’assistance: Enjeux et stratégies pédagogiques)
Menard, L., Achille-Fauveau, S., Laval Quesney, D., Petit, A., Hatzidimitriadou, E., Stein, M., Manship, S., Morris, R. and Gallien, P. 2021. Training of professionals in assistive technologies: pedagogic issues and strategies (Formation des professionnels aux technologies d’assistance: Enjeux et stratégies pédagogiques).
Novel robotic assistive technologies: choosing appropriate training for healthcare professionals
Ménard, L., Petit, A., Leblong, E., Stein, M., Hatzidimitriadou, E., Khemmar, R., Manship, S., Morris, R., Ragot, N. and Gallien, P. 2020. Novel robotic assistive technologies: choosing appropriate training for healthcare professionals. Modelling, Measurement and Control C. 81 (1-4), pp. 43-48. https://doi.org/10.18280/mmc_c.811-408
How is carer strain related to the recovery of stroke survivors with right hemisphere dysfunction? Implications for practice
Stein, M. and Reynolds, F. 2020. How is carer strain related to the recovery of stroke survivors with right hemisphere dysfunction? Implications for practice. Disability and Rehabilitation. 44 (5), pp. 693-701. https://doi.org/10.1080/09638288.2020.1775311
The contribution of new technologies and robotics in assistive technology for disability: What training is required for healthcare professionals? (L'apport des Nouvelles Technologies et de la Robotique dans les Aides Techniques de Compensation du Handicap: Quelle formation pour les professionnels de santé?)
Menard, L., Petit, A., Leblong, E., Khemmar, R., Hatzidimitriadou, E., Manship, S., Stein, M., Morris, R., Ragot, N. and Gallien, P. 2020. The contribution of new technologies and robotics in assistive technology for disability: What training is required for healthcare professionals? (L'apport des Nouvelles Technologies et de la Robotique dans les Aides Techniques de Compensation du Handicap: Quelle formation pour les professionnels de santé?).
Promoting resilience in occupational therapy rducation, a scoping literature review
Stein, M., Chung, P., Clark, N. and Holt, N. 2019. Promoting resilience in occupational therapy rducation, a scoping literature review .