Effect of Education on Hemineglect Following Acute Stroke: A Randomised Controlled Trial

Abstract

Introduction: Hemineglect is a condition in which patients are unable to report, respond to, or orient themselves to significant stimuli in the opposite side of space after a brain lesion that cannot be attributed to sensory or motor dysfunction. Patient as well as the caregivers is unaware of the poststroke symptoms. Educating both patients and caregivers about hemineglect is crucial for effective management and support. By providing education, patients gain a better understanding on their condition, its impact on daily life and strategies to cope with it. Caregivers on the other hand can learn how to provide appropriate support, create a supportive environment and assist with rehabilitation exercises. Aim: To determine the effect of education on hemineglect in patients with acute stroke. Materials and Methods: This parallel active controlled, randomised controlled trial with 32 participants who were hospitalised in Justice K.S Hegde Hospital, Mangaluru, Karnataka was conducted between January 2023-January 2024. Allocation was done by sequentially numbered opaque and sealed envelope method. The selected participants were randomly divided into Experimental Group-A (16 participants) and Group-B (control-16 participants). Group-A received education on cueing, environmental modification, shifting of representation of space and regarding sensory and perceptual awareness for 15 minutes once a day along with the standard care and control Group-B (16 participant) recieved the standard care only. Both the groups received standard care treatment for 40 minutes one session per day for five days. The Pre-post intervention evaluation was done for both groups using line bisection test, Catherine Bergego scale and Barthel Index. The collected data were summarised by using the descriptive statistics: frequency, percentage; mean and SD. The independent sample t-test was used to compare the effectiveness (Pre-Post) Line Bisection, Catherine Bergego Scale, and Barthel Index between groups. Results: Line bisection test, Catherine Bergego Scale and Barthel Index for the experimental group were 1.19±0.57, 8.13±2.16, -22.19±12.38, respectively and for the control group were 0.06±0.42, 2.50±2.92, -6.88±6.29. The group comparison of Line Bisection Test, Catherine Bergego Scale and Barthel Index were found to be statistically significant (p<0.001). Conclusion: The study concluded that patient and caregiver education coupled with conventional physical therapy is effective in improving the perceptual awareness and reduction in the presence and severity of hemineglect following acute stroke.

Keywords

• catherine bergego scale
• cerebrovascular accident
• line bisection test
• patient education
• unilateral neglect