No abstract

Background:Writing is a human communication tool. No disability behavioral assessment of dysgraphia due to stroke-induced neglect has been conducted in Iran. Objectives: We investigated rehabilitation of dysgraphia in patients with stroke-related neglect in Persian language-specific constructive errors of writing. Methods: All patients were suffering from stroke-induced visual neglect. Five patients were evaluated for dysgraphia in a spontaneous writing task before and after rehabilitation without writing practice for 10 sessions with prism adaption (PA). Dysgraphia was classified into visuospatial omission error, visuospatial destruction error, visuospatial size error, visuospatial tilting error, poor handwriting style, visuospatial distance error, and visuospatial perseveration (addition) error. Neglect was evaluated using the star cancellation test (SCT), and line bisection test (LBT) and activities of daily living (ADL) was assessed by the Barthel index (BI) and the Catherine Bergego scale (CBS). Results: All patients showed significant improvement in dysgraphia (measured using spontaneous writing test), ADL (measured using CBS and BI), and neglect (measured using LBT and SCT) (P < 0.05). Visuospatial destruction errors were the most frequent and visuospatial omission errors were the least frequent errors. Conclusions: PA is a potential effective strategy in stroke rehabilitation of dysgraphia, visuospatial neglect and ADL. Unilateral spatial neglect and rehabilitation improves dysgraphia in Persian language speaking patients with right brain stroke.

Introduction: This study aimed to investigate the influence of neglect and the effect of Prism Adaptation (PA) combined with continuous Theta-Burst Transcranial Magnetic Stimulation (cTBS) on the art constructive errors of painting rehabilitation of stroke patients with neglect. Methods: Fourteen patients with neglect and art constructive errors of painting secondary to stroke were randomly assigned to the rehabilitation group and received PA combined with inhibitory protocol of cTBS over the intact parietal cortex; the control group received PA combined with sham cTBS for 2 weeks in 10 daily sessions. Patients have assessed for art constructive errors of painting in Figure Copying Test (FCT), and Coloring Test (CT) before and after the intervention. Art constructive errors of painting were classified into omission, deformation, size, neglect of warm colors, and perseveration of errors. Neglect was evaluated using the Line Bisection task (LBT), Figure Copying Test (FCT), and Coloring Test (CT). Results: All patients showed significant improvement in art constructive errors of painting (measured using pattern of painting’ errors in Figure Copying Test and Coloring Test), and neglect (measured using LBT, FCT, and CT) (p<0.05). Omission, neglect of warm colors, and deformation were the most frequent errors. Conclusion: Neglect and rehabilitation influences the painting system in stroke patients. Both approaches improved art constructive errors of painting and neglect symptoms.