ABSTRACT

This review aimed to examine the bottom-up and top-down rehabilitation intervention effectiveness based on the functional outcome measure as immediate effect and long-term effect for unilateral spatial neglect conditions. The RCT studies were collected by searching in three databases J-Stage, PubMed, and PEDro from 2008 through 2018. The studies which used the following instruments: BI, CBS, FMA, and FIM, as the functional outcome with the PEDro score of six and above, were eligible for inclusion. A total of 492 participants in 13 studies included from 291 studies initially identified. The meta-analysis for overall ES revealed that BI and CBS had a significant mean of SMD = 0.65 (95% CI, 0.23–1.07; p = 0.003; I² = 65%), and SMD = −0.23 (95% CI, −0.45 to −0.01; p = 0.04; I² = 35%) respectively, while FMA and FIM had an insignificant mean of SMD = 0.14 (95% CI, −0.08–0.37; p = 0.22; I² = 0%), and SMD = −0.22 (95% CI, −0.69–0.25; p = 0.37; I² = 0%) respectively. Based on the results, although indicated the heterogeneity representation across studies, it showed that the top-down intervention approach of high-frequency rTMS was more effective in enhancing the functional abilities and ADL of unilateral spatial neglect patients on the immediate effects but not necessarily in the long-term effects.

摘要

本综述旨在检验基于功能结果测量的自下而上和自上而下的康复干预效果，作为单方面空间忽视条件的即时效应和长期效应。从 2008 年到 2018 年，通过在 J-Stage、PubMed 和 PEDro 三个数据库中搜索来收集 RCT 研究。这些研究使用以下工具：BI、CBS、FMA 和 FIM，作为 PEDro 评分为 6 的功能结果及以上，有资格入选。13 项研究的 492 名参与者来自最初确定的 291 项研究。总体 ES 的荟萃分析显示，BI 和 CBS 的 SMD = 0.65（95% CI，0.23–1.07；p  = 0.003；I ²  = 65%）和 SMD = -0.23（95% CI， -0.45 至 -0.01；p  = 0.04；I ²  = 35%)，而 FMA 和 FIM 的 SMD = 0.14 (95% CI, -0.08–0.37; p  = 0.22; I ²  = 0%) 和 SMD = -0.22 (95% CI)的平均值不显着, -0.69–0.25; p  = 0.37; I ²  = 0%)。根据结果​​，虽然表明了研究之间的异质性表示，但表明高频 rTMS 自上而下的干预方法在增强单侧空间忽视患者的功能能力和 ADL 的即时效果方面更有效，但不一定在的长期影响。