Physical therapy of higher nerve function disorder: Evaluation and therapy approach

Abstract

Among the higher nerve function disorders due to brain damage, unilateral spatial neglect, mainly caused by right hemisphere damage, is an important clinical issue. Much research into its evaluation and therapeutic approaches have been done since Brain (1941). Various approaches other than the conventional "promoting awareness" have been advocated. As non-cognitive ways, TENS, trunk rotation and prism adaptation are focused on attention. Especially, we studied prism adaptation in relation to wheelchair operation. Furthermore, we report the outline of the Side Mirror Approach, the effect of mirror therapy that has recently come under the spotlight again, on unilateral spatial neglect. In addition, as a related symptom, the primary lesion and the mechanism of Pusher phenomenon (contraversive pushing/ipsilateral pushing) were analyzed symptomatologically, and we propose a basic policy for treatment and improvement methods of sitting balance as a clinical approach.