Influence of unilateral neglect on independence in activities of daily living after stroke

This article summarizes a systematic literature review conducted to establish whether the phenomenon of unilateral neglect (UN) has a substantial impact upon an individual's independence in activities of daily living after stroke. The literature was scrutinized to ensure compatibility with pre-established inclusion criteria and to generate themes for discussion. Consistency of critique methodology was structured through the use of set questions. Findings of the review were more complex than anticipated, not least because of the influence of additional perceptual and cognitive deficits existing alongside UN. Activities conducted outside personal space were found to be less impaired by UN than those within it, despite agreement not being reached over whether neglect can exist in different areas of space. It has also been suggested that load and familiarity have a strong influence upon ability, which leads existing rehabilitation techniques to be brought into question. Inconsistencies are great throughout defining, detecting and treating UN. Decreasing these would go a long way towards improving effective and integrated stroke services, as required by the National Service Framework for Older People. Recommendations have been made for areas in need of research and implications for future practice are discussed.