Tabla I. Características de los pacientes incluidos en el estudio. |
||||
Grupo control |
Grupo experimental |
p |
||
Edad a |
47,20 ± 9,85 |
46,0 ± 10,3 |
0,845 |
|
Sexo (masculino/femenino) |
3 / 3 |
2 / 4 |
1,000 |
|
Tipo de ictus |
Isquémico |
3 (50%) |
5 (83,3%) |
0,545 |
Hemorrágico |
3 (50%) |
1 (16,7%) |
||
Escolaridad |
Estudios primarios |
4 (66,7%) |
1 (16,7%) |
0,080 |
Estudios secundarios |
1 (16,7%) |
5 (83,3%) |
||
Estudios superiores |
1 (16,7%) |
0 |
||
Tiempo transcurrido entre el ictus y el inicio del tratamiento (días) a |
110,0 ± 87,3 |
59,5 ± 26,6 |
0,222 |
|
a Media ± desviación estándar. |
Tabla II. Comparativas intragrupales pre y postratamiento (media ± desviación estándar). |
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Grupo control |
Grupo experimental |
||||||||
Pretratamiento |
Postratamiento |
p |
d de Cohen |
Pretratamiento |
Postratamiento |
p |
d de Cohen |
||
Cancelación de campanas |
11,83 ± 9,20 |
27,00 ± 4,24 |
0,013 a |
2,32 |
15,50 ± 11,06 |
27,00 ± 6,81 |
0,065 |
1,37 |
|
Copia de la figura de Ogden |
3,00 ± 1,10 |
0,67 ± 1,03 |
0,013 a |
–2,40 |
2,17 ± 2,04 |
0,67 ± 1,21 |
0,167 |
–0,98 |
|
Bisección de líneas |
Porcentaje de desviación a la derecha |
33,05 ± 21,97 |
19,70 ± 18,78 |
0,310 |
–0,72 |
26,69 ± 20,90 |
19,15 ± 16,1 |
0,394 |
–0,44 |
Porcentaje de desviación a la izquierda |
–16,44 ± 16,44 |
–10,36 ± 5,11 |
0,818 |
0,55 |
–14,27 ± 8,46 |
–14,45 ± 10,54 |
0,818 |
–0,02 |
|
Líneas omitidas |
7,00 ± 4,29 |
2,00 ± 2,19 |
0,056 |
–1,61 |
4,83 ± 3,87 |
2,00 ± 2,76 |
0,145 |
–0,92 |
|
Baking Tray Task |
Hemicampo izquierdo |
1,00 ± 2,45 |
5,25 ± 3,74 |
0,049 a |
1,47 |
3,08 ± 3,40 |
8,00 ± 7,01 |
0,170 |
0,98 |
Hemicampo derecho |
15,00 ± 2,45 |
10,75 ± 3,74 |
0,049 a |
–1,47 |
12,92 ± 3,40 |
8,00 ± 7,01 |
0,170 |
–0,98 |
|
Lectura de frases |
25,00 ± 15,81 |
38,50 ± 6,06 |
0,183 |
1,24 |
36,17 ± 7,94 |
41,83 ± 2,40 |
0,326 |
1,06 |
|
Catherine Bergego Scale |
Autoadministrada |
10,47 ± 3,52 |
7,50 ± 8,41 |
0,376 |
–0,51 |
9,15 ± 3,36 |
11,00 ± 6,60 |
0,809 |
0,39 |
Heteroadministrada |
11,34 ± 7,85 |
12,07 ± 7,99 |
1,000 |
0,10 |
13,68 ± 6,81 |
11,24 ± 6,70 |
0,747 |
–0,40 |
|
Diferencias entre la puntuación del familiar y la del paciente |
0,87 ± 9,23 |
4,57 ± 5,86 |
0,468 |
0,52 |
4,53 ± 7,18 |
0,24 ± 5,52 |
0,378 |
–0,73 |
|
a Diferencias significativas p < 0,05. |
Rehabilitation of anosognosia in patients with unilateral visuospatial neglect Introduction. Patients with unilateral visuospatial neglect secondary to a stroke are usually unaware of the fact that their perception and exploration of contralesional space are deficient. This clinical phenomenon, know as anosognosia, directly conditions the rehabilitation process and prolongs its duration to a significant extent, while also making it more difficult for the patient to adhere to it. Aim. To assess the efficacy of a specific rehabilitation programme for the treatment of anosognosia in patients presenting with unilateral visuospatial neglect. Patients and methods. Twelve patients with a stroke in the right hemisphere were divided into two groups. The experimental group received 15 sessions of computerised cognitive therapy along with 15 sessions of specific rehabilitation for anosognosia. The control group underwent 15 sessions of computerised cognitive treatment. All of them were administered, before and after treatment, a battery of tests to evaluate visuospatial attention. The level of functionality was evaluated by means of the Catherine Bergego Scale. Results. After the intervention, the control group showed statistically significant psychometric differences. The same did not occur with the experimental group. No differences were obtained in the pre- and post-treatment intergroup comparisons, or in the psychometric measures or on the functional scale. Conclusions. Further research is needed to help us improve the treatment of anosognosia in patients with unilateral visuospatial neglect. Some methodological recommendations emerge from the limitations identified in this study. Key words. Anosognosia. Cognitive rehabilitation. Hemispatial neglect. Neuropsychological rehabilitation. Stroke. Treatment. |