G. Noel Squires
© 2015 Meghan Riley
Background and Purpose: Unilateral neglect (ULN) syndrome negatively affects recovery post-stroke and is often associated with falls, longer stays in rehabilitation, and the need for more assistance at discharge. Typical physical therapy treatments include voluntary trunk rotation, visual scanning exercises, mirror therapy, hemispheric activation, sensory awareness training, and lower extremity loading but the efficacy of these treatments is still unclear. The purpose of this case report is to describe multimodal physical therapy (PT) management that includes common PT interventions to alleviate symptoms of ULN and report upon the outcomes of the various treatment methods for rehabilitation of neglect during functional mobility. Case Description: 65 year-old male referred to outpatient PT following diagnosis of right hemispheric basal ganglia bleed presenting with impaired functional mobility primarily due to significant ULN. The patient was treated with the following interventions for 26 visits over 10 weeks: functional training, increased weight bearing activities, hemispheric activation, voluntary trunk rotation, visual scanning, mirror therapy, sensory awareness training, and gait training. Data collection included: 6 Minute Walk Test (6MW Test), gait speed, manual muscle testing (MMT), and level of assistance during functional task analysis. Outcomes: Overall improvement in the patient’s level of assistance with bed mobility and transfers was noted. Patient improved in 6MW Test from 90 ft. preintervention to 185 ft. postintervention reflecting increased functional status and a small meaningful change.19 Patient also improved in gait speed from 0.25 ft/sec preintervention to 0.51 ft/sec postintervention. Discussion: Using multimodal physical therapy management and applying an assortment of interventions developed for the rehabilitation of ULN post-stroke appeared to be beneficial for the patient in increasing awareness of left hemi-side, functional mobility, and status.
Riley, Meghan, "Multimodal Physical Therapy Management Of A Patient With Unilateral Neglect Post-Stroke In An Outpatient Setting: A Case Report" (2015). Case Report Papers. 28.