The Mobility Assessment Course for the Diagnosis of Spatial Neglect: Taking a Step Forward?
Spatial neglect after stroke can be a challenging syndrome to diagnose under standard neuropsychological assessment. There is now sufficient evidence that those affected might demonstrate neglect behavior in everyday settings despite showing no signs of neglect during common neglect tasks. This disc...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2017-10-01
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| Series: | Frontiers in Neurology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fneur.2017.00563/full |
| _version_ | 1819180241945362432 |
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| author | Megan Grech Tracey Stuart Lindy Williams Celia Chen Tobias Loetscher |
| author_facet | Megan Grech Tracey Stuart Lindy Williams Celia Chen Tobias Loetscher |
| author_sort | Megan Grech |
| collection | DOAJ |
| description | Spatial neglect after stroke can be a challenging syndrome to diagnose under standard neuropsychological assessment. There is now sufficient evidence that those affected might demonstrate neglect behavior in everyday settings despite showing no signs of neglect during common neglect tasks. This discrepancy is attributed to the simplified and unrealistic nature of common pen and paper based tasks that do not match the demanding, novel, and complex environment of everyday life. As such, increasing task demands under more ecologically valid scenarios has become an important method of increasing test sensitivity. The main aim of the current study was to evaluate the diagnostic utility of the Mobility Assessment Course (MAC), an ecological task, for the assessment of neglect. If neglect becomes more apparent under more challenging task demands the MAC could prove to be more diagnostically accurate at detecting neglect than conventional methods, particularly as the time from initial brain damage increases. Data collected by Guide Dogs of SA/NT were retrospectively analyzed. The Receiver Operating Characteristic (ROC) curve, a measure of sensitivity and specificity, was used to investigate the diagnostic utility of the MAC and a series of paper and pencil tests in 67 right hemisphere stroke survivors. While the MAC proved to be a more sensitive neglect test (74.2%) when compared to the Star Cancellation (43.3%) and Line Bisection (35.7%) tests, this was at the expense of relatively low specificity. As a result, the ROC curve analysis showed no statistically discernable differences between tasks (p > 0.12), or between subacute and chronic groups for individual tasks (p > 0.45). It is concluded that, while the MAC is an ecologically valid alternative for assessing neglect, regarding its diagnostic accuracy, there is currently not enough evidence to suggest that it is a big step forward in comparison to the accuracy of conventional tests. |
| first_indexed | 2024-12-22T22:11:13Z |
| format | Article |
| id | doaj.art-e5732fcfb6774d6bb437eac3a45a88da |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-22T22:11:13Z |
| publishDate | 2017-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-e5732fcfb6774d6bb437eac3a45a88da2022-12-21T18:10:53ZengFrontiers Media S.A.Frontiers in Neurology1664-22952017-10-01810.3389/fneur.2017.00563301601The Mobility Assessment Course for the Diagnosis of Spatial Neglect: Taking a Step Forward?Megan Grech0Tracey Stuart1Lindy Williams2Celia Chen3Tobias Loetscher4School of Psychology, Social Work, and Social Policy, University of South Australia, Adelaide, SA, AustraliaGuide Dogs SA/NT, Adelaide, SA, AustraliaSchool of Health Sciences, University of South Australia, Adelaide, SA, AustraliaDepartment of Ophthalmology, Flinders University, Adelaide, SA, AustraliaSchool of Psychology, Social Work, and Social Policy, University of South Australia, Adelaide, SA, AustraliaSpatial neglect after stroke can be a challenging syndrome to diagnose under standard neuropsychological assessment. There is now sufficient evidence that those affected might demonstrate neglect behavior in everyday settings despite showing no signs of neglect during common neglect tasks. This discrepancy is attributed to the simplified and unrealistic nature of common pen and paper based tasks that do not match the demanding, novel, and complex environment of everyday life. As such, increasing task demands under more ecologically valid scenarios has become an important method of increasing test sensitivity. The main aim of the current study was to evaluate the diagnostic utility of the Mobility Assessment Course (MAC), an ecological task, for the assessment of neglect. If neglect becomes more apparent under more challenging task demands the MAC could prove to be more diagnostically accurate at detecting neglect than conventional methods, particularly as the time from initial brain damage increases. Data collected by Guide Dogs of SA/NT were retrospectively analyzed. The Receiver Operating Characteristic (ROC) curve, a measure of sensitivity and specificity, was used to investigate the diagnostic utility of the MAC and a series of paper and pencil tests in 67 right hemisphere stroke survivors. While the MAC proved to be a more sensitive neglect test (74.2%) when compared to the Star Cancellation (43.3%) and Line Bisection (35.7%) tests, this was at the expense of relatively low specificity. As a result, the ROC curve analysis showed no statistically discernable differences between tasks (p > 0.12), or between subacute and chronic groups for individual tasks (p > 0.45). It is concluded that, while the MAC is an ecologically valid alternative for assessing neglect, regarding its diagnostic accuracy, there is currently not enough evidence to suggest that it is a big step forward in comparison to the accuracy of conventional tests.http://journal.frontiersin.org/article/10.3389/fneur.2017.00563/fullassessment of neglectmobilityvisionclinical utilityecological validitysensitivity |
| spellingShingle | Megan Grech Tracey Stuart Lindy Williams Celia Chen Tobias Loetscher The Mobility Assessment Course for the Diagnosis of Spatial Neglect: Taking a Step Forward? Frontiers in Neurology assessment of neglect mobility vision clinical utility ecological validity sensitivity |
| title | The Mobility Assessment Course for the Diagnosis of Spatial Neglect: Taking a Step Forward? |
| title_full | The Mobility Assessment Course for the Diagnosis of Spatial Neglect: Taking a Step Forward? |
| title_fullStr | The Mobility Assessment Course for the Diagnosis of Spatial Neglect: Taking a Step Forward? |
| title_full_unstemmed | The Mobility Assessment Course for the Diagnosis of Spatial Neglect: Taking a Step Forward? |
| title_short | The Mobility Assessment Course for the Diagnosis of Spatial Neglect: Taking a Step Forward? |
| title_sort | mobility assessment course for the diagnosis of spatial neglect taking a step forward |
| topic | assessment of neglect mobility vision clinical utility ecological validity sensitivity |
| url | http://journal.frontiersin.org/article/10.3389/fneur.2017.00563/full |
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