Effectiveness of device for using interactive and cognitive therapy in the rehabilitation of patients with visuospatial neglect due to cerebral stroke during the post-acute rehabilitation period

Authors

DOI:

https://doi.org/10.26641/2307-0404.2025.3.340763

Keywords:

stroke, visuospatial neglect, rehabilitation, occupational therapy, interactive sensor device Myro, cognitive function, functioning, disability

Abstract

Despite the successes of modern rehabilitation in acute stroke, the effectiveness of existing methods remains limited in patients with visuospatial neglect (VSN). This encourages the search for new methods of occupational therapy interventions, in particular, taking into account the available interactive devices. The aim of this study was to evaluate the impact of the interactive and cognitive rehabilitation device Myro on the state of cognitive functions, visuospatial perception, fine motor skills, gross upper limb functions and limitations of daily activity in patients with neglect due to stroke during the post-acute rehabilitation period. In the study 46 patients were included, 12 women and 34 men, aged 32 to 86 years (mean age was 62.8(12.8) years). All patients were assessed for their visuospatial perception, cognitive function, motor and sensory functions, and activity limitations at the beginning and the end of rehabilitation. In the first stage, during 2023-2024, 18 patients were included in the control group, who were assigned a standardized rehabilitation program. In the second stage, during 2024-2025, 28 patients participated in the main group, who were assigned an author's occupational therapy program using the Myro interactive and cognitive rehabilitation device. All patients received 3 hours of rehabilitation interventions per day for 14 days. The use of the program with an interactive device showed greater effectiveness in restoring gross motor functions of the upper limb, in particular 2.1 times better according to the results of the “Box and Blocks” test (p<0.05), to significantly greater dynamics according to the Barthel Index level (3.3 times, p<0.05). In addition, in the main group, signs of VSN were 27.1% less common at the end of therapy (p<0.05). However, after completing the rehabilitation course there weren’t the advantages of the author's program in terms of the effectiveness of improving cognitive function according to the Montreal Cognitive Test, functioning of the upper limb according to the Fugl-Meyer scale, as well as in terms of restoring fine motor skills of the upper limb according to the “9 pegs” test (p>0.05). Thus, the use of the interactive and cognitive rehabilitation device Myro has shown its effectiveness for the treatment of symptoms of VSN, recovery of gross motor functions and limitations of daily functioning in patients with the consequences of cerebral stroke. However, there is no convincing data on the superior effectiveness of this technique in patients with impaired fine motor skills of the upper limb and cognitive impairment compared to the standard program.

References

Esposito E, Shekhtman G, Chen P. Prevalence of spatial neglect poststroke: a systematic review. Ann Phys Rehabil Med. 2021;64:101459. doi: https://doi.org/10.1016/j.rehab.2020.10.010

Rowe FJ, Hepworth LR, Begoña Coco-Martin M, Gillebert CR, Leal-Vega L, Palmowski-Wolfe A, et al. European Stroke Organisation (ESO) guideline on visual impairment in stroke. Eur Stroke J. 2025 May 22:23969873251314693. doi: https://doi.org/10.1177/23969873251314693

Chen P, Chen CC, Hreha K, Goedert KM, Barrett AM. Kessler Foundation Neglect Assessment Process uniquely measures spatial neglect during activities of daily living. Arch Phys Med Rehabil. 2015 May;96(5):869-876.e1. doi: https://doi.org/10.1016/j.apmr.2014.10.023

Totska A, Nekhanevych O, Korota Y, Mokhna V, Kharchenko V. [The effectiveness of compensatory strategies in the rehabilitation of patients with visuospatial neglect during the post-acute period of stroke rehabi-litation]. Medicni perspektivi. 2025;30(1):127-34. Ukrainian. doi: https://doi.org/10.26641/2307-0404.2025.1.325373

Moore MJ, Vancleef K, Riddoch MJ, Gillebert CR, Demeyere N. Recovery of visuospatial neglect subtypes and relationship to functional outcome six months after stroke. Neurorehabil Neural Repair. 2021;35:823-35. doi: https://doi.org/10.1177/15459683211032977

Overman MJ, Binns E, Milosevich ET, Demeyere N. Recovery of Visuospatial Neglect With Standard Treatment: A Systematic Review and Meta-Analysis. Stroke. 2024 Sep;55(9):2325-39. doi: https://doi.org/10.1161/STROKEAHA.124.046760

National clinical guideline for stroke. Fifth Edition. [Internet]. UK: Royal college of Physycians; 2016. [cited 2025 Apr 29].151 p. Available from: https://www.strokeguideline.org/app/uploads/2023/03/2016-National-Clinical-Guideline-for-Stroke-5th-edition.pdf

Clinical Guidelines for Stroke Management 2017. Summary – Occupational Therapy. Prevent. Treat. Beat [Internet]. [cited 2025 Apr 29]. Available from: https://informme.org.au/en/Guidelines/Clinical-Guidelines-for-Stroke-Management-2017

Bai Z, Zhang J, Zhang Z, Shu T, Niu W. Comparison Between Movement-Based and Task-Based Mirror Therapies on Improving Upper Limb Functions in Patients With Stroke: A Pilot Randomized Controlled Trial. Front Neurol. 2019 Mar 26;10:288. doi: https://doi.org/10.3389/fneur.2019.00288

Dido YuM, Dulo OA. Dynamic of upper limb sensorimotor recovery assessed on the fugl-meyer scale in post-stroke patients with neglect syndrome re-ceiving combined physical therapy and ergotherapy. Wiadomości Lekarskie. 2021;74(4):849-55. doi: https://doi.org/10.36740/WLek202104107

Kwakkel G, Kollen BJ. Predicting activities after stroke: what is clinically relevant? Int J Stroke. 2013;8:25-32.

doi: https://doi.org/10.1111/j.1747-4949.2012.00967.x

Carlsson H, Rosén B, Björkman A, Pessah-Rasmussen H, Brogårdh C. SENSory relearning of the UPPer limb (SENSUPP) after stroke: development and descrip-tion of a novel intervention using the TIDieR checklist. Trials. 2021 Jul 5;22(1):430. doi: https://doi.org/10.1186/s13063-021-05375-6

Tutak JS, Mucha J. A Prototype Mechatronic Device for Upper Limb Rehabilitation and Analysis of Its Functionality. Applied Sciences. 2025;15(12):6613. doi: https://doi.org/10.3390/app15126613

Gibson E, Koh CL, Eames S, Bennett S, Scott AM, Hoffmann TC. Occupational therapy for cognitive impairment in stroke patients. Cochrane Database Syst Rev. 2022 Mar 29;3(3):CD006430. doi: https://doi.org/10.1002/14651858.CD006430.pub3

Nekhanevych O, Griban G, Sekretnyi V, Baku-ridze-Manina V, Kaniuka Ye, Kovalenko T, et al. Pre-dicting the Effectiveness of Physical Therapy in Hockey Players after Cerebral Concussion. International Journal of Human Movement and Sports Sciences. 2023;11(2):316-25. doi: https://doi.org/10.13189/saj.2023.110208

[Standard of medical care for ischemic stroke. Order of the Ministry of Health of Ukraine dated 2024 Jun 20 No 1070]. [Internet]. 2024 [cited 2025 Apr 29]. Ukrainian. Available from: https://moz.gov.ua/uk/decrees/nakaz-moz-ukrayini-vid-20-06-2024-1070-pro-zatverdzhennya-standartu-medichnoyi-dopomogi-ishemichnij-insult

Vratsistas-Curto A, Downie A, McCluskey A, Sherrington C. Trajectories of arm recovery early after stroke: an exploratory study using latent class growth analysis. Ann Med. 2023 Dec;55(1):253-65. doi: https://doi.org/10.1080/07853890.2022.2159062

Ahmed Hassanin M, Aly MG, Atef H, Marques-Sule E, Ahmed GM. Task-oriented training for upper limb functions in patients with multiple sclerosis: Systematic review and meta-analysis. Mult Scler Relat Disord. 2023 May;73:104625. doi: https://doi.org/10.1016/j.msard.2023.104625

Huang YD, Li W, Chou YL, Hung ES, Kang JH. Pendulum test in chronic hemiplegic stroke population: additional ambulatory information beyond spasticity. Sci Rep. 2021;11(1):14769. doi: https://doi.org/10.1038/s41598-021-94108-5

Stroke rehabilitation in adults. NICE guideline [Internet]. 2023 Oct 18 [cited 2025 Apr 29]. Available from: https://www.nice.org.uk/guidance/ng236

Pyrozhkov SI, Riazantseva VV, Motoryn RM, et al. [Statistics]. Kyiv National University of Trade and Economics; 2020. 328 p. Ukrainian. doi: http://doi.org/10.31617/p.knute.2020-164

Husain M, Rorden C. Non-spatially lateralized mechanisms in hemispatial neglect. Nat Rev Neurosci. 2003;4:26-36. doi: https://doi.org/10.1038/nrn1005

Demeyere N, Gillebert CR. Ego- and allocentric visuospatial neglect: dissociations, prevalence, and laterality in acute stroke. Neuropsychology. 2019;33:490-8. doi: https://doi.org/10.1037/neu0000527

Saj A, Verdon V, Vocat R, et al. ‘The anatomy underlying acute versus chronic spatial neglect’ also depends on clinical tests. Brain. 2012;135(Pt 2):e207; author reply e08. doi: https://doi.org/10.1093/brain/awr227

Published

2025-09-29

How to Cite

1.
Totska A, Nekhanevych O, Korota Y, Mokhna V, Logvynenko V. Effectiveness of device for using interactive and cognitive therapy in the rehabilitation of patients with visuospatial neglect due to cerebral stroke during the post-acute rehabilitation period. Med. perspekt. [Internet]. 2025Sep.29 [cited 2025Dec.5];30(3):192-9. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/340763

Issue

Section

THERAPY AND REHABILITATION