Abstract
It is known that the presence of hemispatial neglect is one complication of stroke that causes a greater functional impairment and burden on the patient. Objective measurement of this deficit is an important part of the process of identifying the level of impairment, and being able to then dig deeper for an assessment measure to better realize the level of the deficit. This case report comparison of the line cancellation test and the star cancellation test aims to provide insight on how the clinician may tailor their choice of the most appropriate screening tool for neglect. Methods. The Case Report is based on a patient that was seen at Naples Community Hospital, all information was obtained during a single treatment session. He was a middle-aged Croatian male, professional bodybuilder. He presented post right MCA embolus with left sided deficits, and a left hemispatial neglect. During the session, he completed 3 different objective measures in varying testing positions, with uniform verbal directions and prompts. Results. All objective measures were able to be completed. The results of the line cancellation test were abnormal when compared with the previous test scenarios on patients with similar deficits. The difference was that this patient performed better on the line cancellation when in standing (considered the more challenging, i.e. multitasking position). Discussion. A normal response for many patients, on all 3 shown outcome measures, was to perform more poorly (by crossing less items, or marking off further from midline) in the standing position. The assumption for this response was that a patient is more comfortable in a seated position, and can focus more attention to the task, or measure, at hand. It was thought that standing would be difficult, enhancing the patients neglected visual field, causing them to perform more poorly. This patients’ interesting case has given rise to considerations for more detailed talks on how concepts in neuroplasticity, specifically salience and specificity, can affect performance on these measures.