Impact of visuospatial neglect post-stroke on daily activities, participation and informal caregiver burden: A systematic review

Martine S Bosma; Tanja C W Nijboer; Monique A A Caljouw; Wilco P Achterberg

doi:10.1016/j.rehab.2019.05.006

Impact of visuospatial neglect post-stroke on daily activities, participation and informal caregiver burden: A systematic review

Ann Phys Rehabil Med. 2020 Jul;63(4):344-358. doi: 10.1016/j.rehab.2019.05.006. Epub 2019 Jun 11.

Authors

Martine S Bosma¹, Tanja C W Nijboer², Monique A A Caljouw³, Wilco P Achterberg³

Affiliations

¹ Department of public health and primary care, Leiden university medical center, Post zone V0-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands; Zorggroep Florence, Laan van Vredenoord 1, 2289 DA, Rijswijk, The Netherlands. Electronic address: m.kant-bosma@lumc.nl.
² Center of excellence for rehabilitation medicine, UMC Utrecht brain center, university medical center Utrecht, and De Hoogstraat rehabilitation, Utrecht, The Netherlands; Utrecht university, department of experimental psychology, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.
³ Department of public health and primary care, Leiden university medical center, Post zone V0-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.

PMID: 31200080
DOI: 10.1016/j.rehab.2019.05.006

Abstract

Objectives: Visuospatial neglect (VSN) is a common cognitive disorder after stroke. The primary aim of this systematic review was to provide an overview of the impact of VSN in 3 aspects: (1) activities of daily living (ADL), (2) participation, and (3) caregiver burden. The second aim was to investigate the differences in studies focusing on populations with mean age<65 versus≥65 years.

Methods: PubMed, EMBASE, Web of Science, Cochrane Library, Emcare, PsychINFO, Academic Search Premier and CENTRAL were searched systematically. Quality was assessed with the Mixed Methods Appraisal Tool.

Results: Of the 115 included studies, 104 provided outcomes on ADL, 15 on participation (4 studies with mean age≥65), and 2 on caregiver burden (1 study with mean age≥65). Quality assessment yielded scores ranging from 0 to 100%. VSN had a negative impact on ADL (i.e., independence during ADL and performance in self-care, household tasks, reading, writing, walking, wheelchair navigation) and participation (i.e., driving, community mobility, orientation, work). The impact of VSN on fulfilling social roles was unclear. VSN had a negative effect on caregiver burden. We found no clear age-related differences.

Conclusions and implications: VSN has a negative impact not only on patients' independence but particularly on the performance of ADL. Despite the far fewer studies of VSN as compared with ADL, VSN also seems to hamper participation and increase caregiver burden, but further research is needed. Because of the large impact, VSN should be systematically and carefully assessed during rehabilitation. A considerable number of different instruments were used to diagnose VSN. Diagnosing VSN at more than one level [function (i.e., pen-and-paper test), activities, and participation] is strongly recommended. Consensus is needed on how to assess VSN and its negative impact for research and rehabilitation practice.

Systematic review registration no: PROSPERPO Registration No. CRD42018087483.

Keywords: Activities of daily living; Caregiver burden; Participation; Stroke; Unilateral neglect; Visuospatial neglect.

Publication types

Systematic Review

MeSH terms

Activities of Daily Living / psychology
Aged
Aged, 80 and over
Caregiver Burden / psychology*
Female
Humans
Male
Middle Aged
Patient Participation / psychology*
Perceptual Disorders / etiology
Perceptual Disorders / rehabilitation*
Self Care / psychology
Spatial Processing
Stroke / psychology*
Stroke Rehabilitation / psychology*