Physical Therapy for Extrapersonal Neglect during Walking：Attempt Intervention Using Transcutaneous Electrical Nerve Stimulation and a Smartphone / The Japanese Journal of Rehabilitation Medicine

ABSTRACT

Objective：The purpose of this study was to determine whether combination therapy has an effect on extrapersonal neglect (EP).Methods：The subject, who was capable of walking without the help of a cane or an orthosis, had right brain damage with left unilateral spatial neglect. We used a single-case study (BAB) design, consisting of a 2-week intervention phase, a 2-week baseline phase, and another 2-week intervention phase. The subject was trained seven times a week. Period A (baseline) included normal visual scanning training during walking, while Period B (intervention) included both normal visual scanning training with transcutaneous electrical nerve stimulation (TENS) for neck muscles and video feedback (VF) with a smartphone during walking. The primary outcomes used Behavioral Inattention Test (BIT), and the Catherine Bergego Scale (CBS).Results：Both BIT and CBS improved in Period B. In particular, the CBS sub-items“Collides with people or objects on the left side”and“Experiences difficulty in finding his way towards the left when traveling in familiar places or in the rehabilitation unit”during walking improved, showing improvement in the results of CBS observation scores and anosognosia scores.Conclusion：In this study, we suggested that combination therapy has a beneficial effect on EP and awareness. We also reported the safety and feasibility of the combination therapy.