How effective and safe are non-drug treatments for spatial neglect following non-progressive brain injury? A Cochrane Review summary with commentary.

ABSTRACT

BACKGROUND: Around 30% of stroke survivors experience spatial neglect. Spatial neglect hinders rehabilitation outcomes and increases the risk of injury. Non-pharmacological interventions are available, yet their efficacy is unknown. OBJECTIVE: To evaluate the effectiveness of non-pharmacological interventions for spatial neglect (inattention) following stroke and other non-progressive brain injuries. METHODS: A summary of the Cochrane Review by Longley et al. 2020, with comments from a rehabilitation perspective. RESULTS: A total of 43 studies were included in meta-analysis and the quality of evidence was very low for all analyses. The benefits or risks associated with each intervention for spatial neglect including visual treatment, prism adaptation training, body awareness, mental function, movement treatment, non-invasive brain stimulation, electrical stimulation, and acupuncture remain unclear. CONCLUSIONS: Evidence in support or against the treatments is sparse and more rigorous studies are needed to evaluate their efficacy. Clinicians should continue to follow current guidelines when available to meet patients' rehabilitation goals.