Phasic alerting combined with visual spatial training: a novel therapeutic approach for unilateral spatial neglect

Objective: Phasic alerting (PA) is a theory-motivated treatment approach for unilateral spatial neglect (USN). It aims to improve the non-spatial attentional components of the syndrome. The objective of this pilot study was to examine the potential benefit of a novel therapeutic approach, combining PA with Visual Spatial Training for individuals with USN. Method: This pilot study, was conducted with 18 USN stroke patients allocated quasi-randomly to one of 3 groups (each 6 participants): experimental (receiving computerized Visual spatial Training combined with PA), ‘spatial’ control (receiving similar Visual spatial Training without PA), and ‘non-spatial’ control (receiving a similar amount of non-spatial cognitive treatment). Treatment comprised of 10 daily 30-minute sessions. Assessments of USN and function were made at 3 points in time: before and after the intervention period and after 5 weeks. Results: The experimental group showed more than 50% amelioration in distinct measures of neglect during the treatment period. In contrast, the control groups did not show this trend during that period. All groups showed improvement at the follow-up period. However, in most tests the experimental group performed better with moderate effect size values in major USN tests. Conclusion: Visual spatial training combined with PA shows promising results in producing amelioration in USN reflected both in measures of USN and ADLs.