Rightward orienting bias, wheelchair maneuvering, and fall risk

Webster, J. C.; Roades, Laurie A.; Morrill, Belinda; Rapport, Lisa J.; Abadee, Payandeh S.; Sowa, Marian; Dutra, Robin L.; Godlewski, M. Catherine

doi:10.1016/s0003-9993(95)80068-9

Cited by 73 publications

(42 citation statements)

References 12 publications

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“…It should be emphasized that the number of left-sided omissions should not be considered the sole marker of VN, but the pattern of visual scanning should also be taken into consideration (Azouvi et al, 2006). Webster et al (1995) reported that rightward bias in clinical tasks in right hemisphere patients was associated with an increased risk of wheelchair accidents. In our study we found a significant correlation between starting point in the star cancellation task and BI in VN patients, suggesting that residual VN has a possible impact on daily functioning.…”

Section: Discussionmentioning

confidence: 99%

“…Latent residual VN that is not detectable in repeated tasks of VN may continue to cause difficulties in everyday life. It seems that patients with mild VN are able to anticipate their skewed spatial orientation and to compensate for VN in structured and predictable circumstances (Jehkonen et al, 2000), but novel situations are enough to result in failures and accidents (Webster et al, 1995). Several clinical studies based on paper-and-pencil tasks (e.g., Appelros, Nydevik, Karlsson, Thorwalls, & Seiger, 2004;Cassidy, Lewis, & Gray, 1998;Jehkonen et al, 2000) have shown that VN typically resolves over time as measured by the number of omissions.…”

Section: Introductionmentioning

confidence: 99%

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Recovery From Visual Neglect After Right Hemisphere Stroke: Does Starting Point in Cancellation Tasks Change After 6 Months?

Kettunen¹,

Nurmi²,

Dastidar³

et al. 2012

The Clinical Neuropsychologist

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In the acute phase of stroke, patients with left visual neglect (VN) automatically orient to the right hemispace. This study examined the presence of rightward bias after right hemisphere stroke within 10 days of stroke onset and after 6 months. Our sample comprised 43 patients and 49 healthy controls. Presence of VN was evaluated with the six conventional subtests of the Behavioral Inattention Test (BITC). Starting points were determined in three BITC cancellation tasks by measuring the distance between the starting point and the median line of the stimulus sheet in centimeters. Activities of daily living (ADL) were assessed with the Barthel Index. At baseline VN patients showed more robust rightward bias than patients without VN. The magnitude of rightward bias decreased clearly in the VN patients at follow-up. A favorable ADL outcome was observed in 90% of the patients with VN and in all of the patients without VN. The magnitude of rightward bias differed clearly between the patient groups and controls. Our result implies that VN was likely to have improved as measured by BITC sum scores, but symptoms of rightward attention bias were still detected. We therefore suggest that, for clinical purposes, it is important that attention bias is measured accurately after right hemisphere stroke.Keywords: Rightward bias; Recovery; Stroke; Visual neglect. INTRODUCTIONVisual neglect (VN) is a disabling disorder that frequently occurs after right hemisphere stroke (Bowen, McKenna, & Tallis, 1999;Ringman, Saver, Woolson, Clarke, & Adams, 2004), suggesting a special role for the right hemisphere in spatial attention (Halligan, Fink, Marshall, & Vallar, 2003; Heilman, Watson, & Valenstein, 2003;Shulman et al., 2010). Neglect refers to failure to report, respond, or orient to stimuli on the contralesional side of space that cannot be accounted for by primary sensory or motor deficits (Halligan, Cockburn, & Wilson, 1991; Heilman et al., 2003;Robertson & Halligan, 1999). One prominent theory of this asymmetry in VN is that the left hemisphere controls shifts of attention in the rightward direction, while the right hemisphere controls shifts of attention in either direction (Mesulam, 1981). In the acute phase of stroke, patients with left visual neglect (VN) automatically orient to the right hemispace. This study examined the presence of rightward bias after right hemisphere stroke within 10 days of stroke onset and after 6 months. Our sample comprised 43 patients and 49 healthy controls. Presence of VN was evaluated with the six conventional subtests of the Behavioral Inattention Test (BITC). Starting points were determined in three BITC cancellation tasks by measuring the distance between the starting point and the median line of the stimulus sheet in centimeters. Activities of daily living (ADL) were assessed with the Barthel Index. At baseline VN patients showed more robust rightward bias than patients without VN. The magnitude of rightward bias decreased clearly in the VN patients at follow-up. A favorable ADL outcome was...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Recovery From Visual Neglect After Right Hemisphere Stroke: Does Starting Point in Cancellation Tasks Change After 6 Months?

Kettunen¹,

Nurmi²,

Dastidar³

et al. 2012

The Clinical Neuropsychologist

View full text Add to dashboard Cite

show abstract

“…Fifth, tasks assessing navigation are needed. Although most clinicians would likely agree that the ability to safely navigate in a complex environment is crucial to everyday life, a recent literature search revealed only one report of an obstacle-course measure of wheelchair mobility (Webster, Roades, et al, 1995;Webster, Cottam, et al, 1989). More importantly, the obstacle-course measure accurately predicted frequency of falls.…”

Section: New Directionsmentioning

confidence: 99%

Cognitive Rehabilitation Interventions for Neglect and Related Disorders: Moving from Bench to Bedside in Stroke Patients

Barrett

Buxbaum

Coslett

et al. 2006

Journal of Cognitive Neuroscience

118

101

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Abstract& The spatial neglect syndrome, defined by asymmetric attention and action not attributed to primary motor or sensory dysfunction and accompanied by functional disability, is a major cause of post-stroke morbidity. In this review, we consider the challenges and obstacles facing scientific researches wishing to evaluate the mechanisms and effectiveness of rehabilitation interventions. Spatial neglect is a heterogeneous disorder, for which consensus research definitions are not currently available, and it is unclear which of the deficits associated with the syndrome causes subsequent disability. We review current opinion about methods of assessment, suggest a rational approach to selecting therapies which requires further study, and make systems-level and theoretical recommendations for building theory. We lastly review some creative questions for consideration in future research. &

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“…patients disproportionately collide with objects on their unattended left side (Punt, Kitadono, Hulleman, Humphreys, & Riddoch, 2008Qiang, Sonoda, Suzuki, Okamoto, & Saitoh, 2005;Turton et al, 2009;Webster et al, 1989;Webster, Rapport, Godlewski, & Abadee, 1994;Webster et al, 1995). Studies examining veering trajectories, however, have shown mixed results.…”

mentioning

confidence: 99%

Deviating to the right: Using eyetracking to study the role of attention in navigation asymmetries

Robertson

Forte

Nicholls

2014

Atten Percept Psychophys

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The ability to navigate accurately through the environment and avoid obstacles is essential for effective interactions with the environment. It is therefore surprising that systematic rightward errors are observed when neurologically intact participants navigate through doorways-most likely due to the operation of biases in spatial attention. These rightward errors may arise due to the operation of an extinction-like process, whereby participants overattend to the left doorpost and collide with the right one. Alternatively, rightward biases might reflect a bisection bias, such that the extrapersonal nature of the aperture causes participants to misbisect the aperture slightly to the right of true center. Because eye movements and spatial attention are closely related, in this study we used eyetracking to test the extinction and bisection models in a remote wheelchair navigation task. University students (n = 16) made rightward errors when navigating the wheelchair through a doorway, and fixated more frequently toward the right side of the aperture throughout the trial. These results are inconsistent with an extinction-based theory of navigation asymmetry, which predicts a leftward bias in eye position due to participants overattending to the left side of the doorway. Instead, the observed rightward bias in eye movements strongly supports a bisection-based theory of navigation asymmetry, whereby participants mentally "mark" the midpoint of a doorway toward the right and then head toward that point, resulting in rightward deviations. The rightward nature of participants' navigation errors and eye positions is consistent with the existence of a rightward attentional bias for extrapersonal stimuli.

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Rightward orienting bias, wheelchair maneuvering, and fall risk

Cited by 73 publications

References 12 publications

Recovery From Visual Neglect After Right Hemisphere Stroke: Does Starting Point in Cancellation Tasks Change After 6 Months?

Recovery From Visual Neglect After Right Hemisphere Stroke: Does Starting Point in Cancellation Tasks Change After 6 Months?

Cognitive Rehabilitation Interventions for Neglect and Related Disorders: Moving from Bench to Bedside in Stroke Patients

Deviating to the right: Using eyetracking to study the role of attention in navigation asymmetries

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