Interventions for left neglect/inattention
“The Dynavision is a large, computerized light board containing 64 small red square target buttons that light up randomly one at a time. The client searches the board to locate the lighted button. Once located, the client touches the button to extinguish the light. The target button beeps when it is touched and another button is randomly illuminated in a new location on the board. The client attempts to extinguish as many targets as possible during an exercise “run” on the board which lasts either 30 or 60 seconds, or 4 minutes” (Dynavision International).
In a recent study, Warren found evidence for Dynavision‘s effectiveness in rehabilitation in the training of compensatory scanning strategies for visual-field deficit and visual inattention (Klavora & Warren, 1998).
While this would be a great tool to have, costs may be a prohibitive factor for having this in your rehabilitation toolbox.
A cheaper alternative that may serve the same purpose of bringing awareness to the patient’s inattentive/neglected side is by using a laser-pointer.
In a dark room, with the patient standing or sitting, shine the laser pointer in various locations on a wall and have the patient’s tap the laser point. With CVA, you can work on weight-bearing of the hemiparetic side, or use the weak side itself to promote function. After being tapped, immediately move the laser target to another location. Typically, I like to begin in a small area in front, and then expand on the visual field. Although where you shine the laser is not “random”, you can alternate between the left field and right field as you observe their performance. If you suspect left inattention, for example, you can gradually shine the laser pointer more on the left side to promote left-sided awareness.
Variables to consider include:
- Reaction time
- Visual eye scanning pattern
- Head turning
- Sustained attention
- Sitting/standing balance
- UE Coordination
- UE ROM
- UE Strength
May also help to identify:
- Visual field deficit vs. inattention/neglect
Klavora, P. & Warren, M. (1998). Rehabilitation of visuomotor skills in poststroke patients using the Dynavision apparatus. Perceptual Motor Skills 86 (1), 23-30.