Evaluation of a test battery for hemineglect in elderly stroke patients for use by therapists in clinical practice.

Hemineglect is not a single entity, and the syndrome has a number of sensory and motor manifestations. The purpose of this study was a) to measure performance of healthy elderly subjects on a battery of validated tests for hemineglect in order to establish appropriate cut-off scores and b) to assess performance of a large sample of elderly stroke patients in a rehabilitation unit, using the same battery. Tests were selected to identify rate of occurrence of hemineglect in visuo-spatial, representational, pre-motor and personal modalities. The battery was administered to 107 patients with right or left sided brain damage and 43 age-matched controls. Results showed that 39.2% right-sided brain damage), were 'neglecters', scoring below cut-off in one or more tests. Star Cancellation and Line Bisection showed the highest relative sensitivity for visuo-spatial neglect (76.4%) 'Baking Tray Task', the 'Exploratory Motor Task', and utilisation of common objects test for personal neglect are additionally suggested for use in the clinical situation. 'Copying a Daisy' and clock-drawing are not recommended due to low sensitivity and subjectivity in scoring respectively.