human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND In a r and omized controlled type Ib study , the effectiveness of three different forms of therapy for the treatment of visual neglect was assessed by comparing therapy outcomes in three groups of patients after cerebrovascular accidents . METHODS A control group received only st and ard exploration training , whilst the second and third group received exploration training combined with either contralateral transcutaneous electrical nerve stimulation ( TENS ) or optokinetic stimulation ( OKS ) respectively . RESULTS It was found that exploration training alone result ed in no improvement on both st and ard neglect tests ( NTs ) and everyday-relevant measures of reading and writing performance . In contrast , the groups receiving TENS or OKS showed significant improvements in both sets of measures with the difference that for the TENS group the improvement in NT scores at the end of therapy had disappeared 1-week later . However , both treatments result ed in significant improvements in reading and writing which were still present upon retesting 1-week after the end of therapy . CONCLUSION Both methods can be recommended for neglect therapy and are superior to exploration therapy alone Prism adaptation has been shown to alleviate the symptoms of unilateral spatial neglect following stroke in single case and small group studies . The purpose s of this single blinded pilot r and omised controlled trial were to determine the feasibility of delivering prism adaptation treatment in a clinical ly valid sample and to assess its impact on self-care . Thirty seven right hemisphere stroke patients with unilateral spatial neglect were r and omised into either prism adaptation ( using 10 dioptre , 6 degree prisms ) or sham treatment ( using plain glasses ) groups . Treatment was delivered each weekday for two weeks . Pointing accuracy , without vision of the finger , was recorded each day before treatment . Outcome was measured , by blinded assessors , four days and eight weeks after the end of treatment using the Catherine Bergego Scale ( CBS ) and the conventional neuropsychological tests from the Behavioural Inattention Test ( BIT ) . Thirty four patients received treatment : 16 with prisms , 18 sham .  Mean compliance was 99 % and 97 % , respectively . Over the treatment days only the prism treated group showed increased leftward bias in open loop pointing to targets on a touch screen . However , despite the group level changes in pointing behaviour no overall effect of the treatment on self-care or BIT were found Feedback of  eye movements  was evaluated as a treatment for visual neglect in right hemisphere stroke patients . Patients with visual neglect identified on the Behavioural Inattention Test ( BIT ) were r and omly allocated to two groups . One group ( n = 9 ) was treated for 2 h 40 min a week for 4 weeks , by wearing glasses which provided a reminder bleep if patients failed to move their eyes to the left in a 15 s interval . The control group ( n = 9 ) received no treatment for their  visual inattention  . Comparison of the groups after 4 weeks treatment and a further 4 weeks follow-up showed no significant difference either in eye movements or on the BIT . However , there was a trend towards a difference between eye movements in the two groups at 8 weeks , suggesting treatment may have influenced eye movements without changing neglect Purpose . The goal of this study was to determine whether non immersive interactive virtual environments are an effective medium for training individuals who suffer from Unilateral Spatial Neglect ( USN ) as a result of a right hemisphere stroke , and to compare it to a st and ard computer visual scanning training . Method . Participants included 19 patients with right hemisphere stroke in two groups , 11 in an experimental group were given computer desktop-based Virtual Reality ( VR ) street crossing training and 8 in a control group who were given computer based visual scanning tasks , both for a total of twelve sessions , 9 hours total , over four weeks . Measures included : 1 . St and ard USN assessment s , paper and pencil and ADL checklist ; 2 . Test on the VR street program ; and 3 . Actual street crossing videotaped . Testing was performed pre and post intervention . Results . The VR group achieved on the USN measures results that equaled those achieved by the control group treated with conventional visual scanning tasks . They improved more on the VR test and they did better on some measures of the real street crossing . Conclusions . Despite several limitations in this study the present results support the effectiveness of the VR street program in the treatment of participants with USN , and further development of the program Objective To investigate the effect of virtual reality training on unilateral spatial neglect in stroke patients . Method Twenty-four stroke patients ( 14 males and 10 females , mean age=64.7 ) who had unilateral spatial neglect as a result of right hemisphere stroke were recruited . All patients were r and omly assigned to either the virtual reality ( VR ) group ( n=12 ) or the control group ( n=12 ) . The VR group received VR training , which stimulated the left side of their bodies . The control group received conventional neglect therapy such as visual scanning training . Both groups received therapy for 30 minutes a day , five days per week for three weeks . Outcome measurements included star cancellation test , line bisection test , Catherine Bergego scale ( CBS ) , and the Korean version of modified Barthel index ( K-MBI ) . These measurements were taken before and after treatment . Results There were no significant differences in the baseline characteristics and initial values between the two groups . The changes in star cancellation test results and CBS in the VR group were significantly higher than those of the control group after treatment . The changes in line bisection test score and the K-MBI in the VR group were not statistically significant . Conclusion This study suggests that virtual reality training may be a beneficial therapeutic technique on unilateral spatial neglect in stroke patients The aim of this r and omised , double-blind study was to investigate the therapeutic effectiveness of left-h and electrical stimulation for patients with post-stroke left visuo-spatial neglect . This approach was hypothesised to enhance activation of the right hemisphere attention system and to improve visual exploration of extrapersonal space .  Participants ( n = 40 ) in the study were in a relatively early stage of recovery from their first right hemisphere stroke , and were r and omly assigned to the experimental ( E ) or control ( C ) group . Group E received conventional visual scanning training combined with electrostimulation of the left h and , while Group C received scanning training with sham stimulation . Their visuo-spatial neglect was assessed twice , prior to the rehabilitation programme and on its completion , using cancellation tests and a letter-reading task . The effect of electrostimulation on hemineglect was assessed following a single administration and after a month-long rehabilitation programme . Although the immediate effect of stimulation was poor , after a month-long rehabilitation period we found significantly greater improvement in Group E patients than in Group C patients . Interestingly , the presence of hemisensory loss did not weaken the observed effect . Therefore , we cl aim that contralesional h and stimulation combined with visual scanning was a more effective treatment for hemineglect rehabilitation than scanning training alone Objective : To investigate the effectiveness of voluntary trunk rotation and half-field eye-patching to treat patients with unilateral neglect in stroke . Design : Pre — post , day 60 follow-up , single-blinded r and omized controlled trial . Setting : Single-centre inpatient rehabilitation hospital . Subjects : Sixty subacute patients with right hemisphere stroke having unilateral neglect within eight weeks post stroke consented to participate between November 2003 and July 2005 . They were r and omly assigned to three comparison groups . Interventions : Nineteen patients received daily experimental training in voluntary trunk rotation ( TR ) for 1 hour five times a week for 30 days . Twenty patients received the same kind of treatment together with half-field eye-patching ( TR + EP ) . Fifteen patients in the control group received conventional training with the same contact time . Main outcome measures : Patients were assessed on days 0 , 30 and 60 using the Behavioural Inattention Test , the Clock Drawing Test , and the Functional Independence Measure . Results : No significant differences between voluntary trunk rotation ( TR ) , voluntary trunk rotation and half-field eye-patching ( TR + EP ) and controls were found in functional performance and neglect measures at day 30 ( P = 0.042—0.994 ) and follow-up ( P = 0.052—0.911 ) at P = 0.005 using Bonferroni correction . Conclusions : The results of this study do not support the use of voluntary trunk rotation alone or with half-field eye-patching to improve functional performance or reduce unilateral neglect in subacute patients with stroke Background . Rehabilitation of the severely affected paretic arm after stroke represents a major challenge , especially in the presence of sensory impairment . Objective . To evaluate the effect of a therapy that includes use of a mirror to simulate the affected upper extremity with the unaffected upper extremity early after stroke . Methods . Thirty-six patients with severe hemiparesis because of a first-ever ischemic stroke in the territory of the middle cerebral artery were enrolled , no more than 8 weeks after the stroke . They completed a protocol of 6 weeks of additional therapy ( 30 minutes a day , 5 days a week ) , with r and om assignment to either mirror therapy ( MT ) or an equivalent control therapy ( CT ) . The main outcome measures were the Fugl-Meyer subscores for the upper extremity , evaluated by independent raters through videotape . Patients also underwent functional and neuropsychological testing . Results . In the subgroup of 25 patients with distal plegia at the beginning of the therapy , MT patients regained more distal function than CT patients . Furthermore , across all patients , MT improved recovery of surface sensibility . Neither of these effects depended on the side of the lesioned hemisphere . MT stimulated recovery from hemineglect . Conclusions . MT early after stroke is a promising method to improve sensory and attentional deficits and to support motor recovery in a distal plegic limb Purpose . The right half-field eye-patching technique has been reported to be effective in reducing unilateral neglect ( UN ) and improving functional ability in stroke patients . This study investigated the efficacy of conventional treatment with right half-field eye patching in treating subacute stroke patients with UN  , using a r and omised controlled trial . Method . Thirty-five in patients with subacute stroke were recruited and r and omised into intervention and control groups . The patients in the intervention group received 4 weeks of conventional occupational therapy with modified right half-field eye-patching . Those in the control group received 4 weeks of conventional treatment only . Assessors , who were blind to the treatments , assessed the groups using the Behavioural Inattention Test ( BIT ) and the Functional Independence Measure ( FIM ) on admission and at 4 weeks . Results . Patients treated with right half-field eye-patching had significantly ( p = 0.046 ) higher BIT gain ( mean = 25.06 , SD = 30.81 ) than those treated with the conventional treatment ( mean = 8.29 , SD = 10.35 ) . There was no significant difference ( p = 0.467 ) in FIM gain between patients in both groups . Conclusions . Right half-field eye-patching improved stroke patients ' impairment level in terms of UN , but the potential benefits in impairment tests were not confirmed by improvements in function Most systematic review s rely substantially on the assessment of the method ological quality of the individual trials . The aim of this study was to obtain consensus among experts about a set of generic core items for quality assessment of r and omized clinical trials ( RCTs ) . The invited participants were experts in the field of quality assessment of RCTs . The initial item pool contained all items from existing criteria lists . Subsequently , we reduced the number of items by using the Delphi consensus technique . Each Delphi round comprised a question naire , an analysis , and a feedback report . The feedback report included staff team decisions made on the basis of the analysis and their justification . A total of 33 international experts agreed to participate , of whom 21 completed all question naires . The initial item pool of 206 items was reduced to 9 items in three Delphi rounds . The final criteria list ( the Delphi list ) was satisfactory to all participants . It is a starting point on the way to a minimum reference st and ard for RCTs on many different research topics . This list is not intended to replace , but rather to be used alongside , existing criteria lists OBJECTIVE Assessment of a new rehabilitation method for  unilateral neglect syndrome ( UNS ) , using a specific device ( Bon Saint Come 's device ) that associates exploratory reconditioning with voluntary trunk rotation . DESIGN Study 1 , r and omized control trial during 2 months ; study 2 , nonr and omized control trial during 2 months . SETTING Neurorehabilitation units in private and public center . PATIENTS In study 1 , 22 consecutive patients with UNS result ing from recent stroke ( < 3 months ) were r and omly assigned to an Experimental Group ( 11 patients ) or to a Control Group ( 11 patients ) . The 2 groups were very similar in terms of general and neurological data . In study 2 , 5 consecutive patients with chronic UNS result ing from an old stroke ( > 6 months ) showing the same characteristics were included . INTERVENTION In study 1 , patients in Group E followed the experimental program 1 hour a day for 1 month ( 20 hours ) and Group C followed usual neurorehabilitation during the same time . In study 2 , every patient followed the experimental program 1 hour a day for 1 month ( 20 hours ) . MAIN OUTCOME MEASURES Assessment in both studies was done at day 0 , day 30 , and day 60 using a battery of UNS tests ( Albert , Scheckenberg , bell ) and an activities of daily living ( ADL ) test ( the Functional Independence Measure [ FIM ] ) . Mean scores of each test were compared between the 2 groups with the Wilcoxon nonparametric test . RESULTS In study 1 all UNS test results and the FIM improved significantly more in Group E than in Group C. In Group E , UNS disappeared in 5 patients and improved in 6 . In Group C , UNS disappeared in 1 patient , improved in 4 , and was unchanged in 6 . In Study 2 , UNS remitted in 2 patients , improved in 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND In a r and omized controlled type Ib study , the effectiveness of three different forms of therapy for the treatment of visual neglect was assessed by comparing therapy outcomes in three groups of patients after cerebrovascular accidents . METHODS A control group received only st and ard exploration training , whilst the second and third group received exploration training combined with either contralateral transcutaneous electrical nerve stimulation ( TENS ) or optokinetic stimulation ( OKS ) respectively . RESULTS It was found that exploration training alone result ed in no improvement on both st and ard neglect tests ( NTs ) and everyday-relevant measures of reading and writing performance . In contrast , the groups receiving TENS or OKS showed significant improvements in both sets of measures with the difference that for the TENS group the improvement in NT scores at the end of therapy had disappeared 1-week later . However , both treatments result ed in significant improvements in reading and writing which were still present upon retesting 1-week after the end of therapy . CONCLUSION Both methods can be recommended for neglect therapy and are superior to exploration therapy alone Prism adaptation has been shown to alleviate the symptoms of unilateral spatial neglect following stroke in single case and small group studies . The purpose s of this single blinded pilot r and omised controlled trial were to determine the feasibility of delivering prism adaptation treatment in a clinical ly valid sample and to assess its impact on self-care . Thirty seven right hemisphere stroke patients with unilateral spatial neglect were r and omised into either prism adaptation ( using 10 dioptre , 6 degree prisms ) or sham treatment ( using plain glasses ) groups . Treatment was delivered each weekday for two weeks . Pointing accuracy , without vision of the finger , was recorded each day before treatment . Outcome was measured , by blinded assessors , four days and eight weeks after the end of treatment using the Catherine Bergego Scale ( CBS ) and the conventional neuropsychological tests from the Behavioural Inattention Test ( BIT ) . Thirty four patients received treatment : 16 with prisms , 18 sham .  Mean compliance was 99 % and 97 % , respectively . Over the treatment days only the prism treated group showed increased leftward bias in open loop pointing to targets on a touch screen . However , despite the group level changes in pointing behaviour no overall effect of the treatment on self-care or BIT were found Feedback of  eye movements  was evaluated as a treatment for visual neglect in right hemisphere stroke patients . Patients with visual neglect identified on the Behavioural Inattention Test ( BIT ) were r and omly allocated to two groups . One group ( n = 9 ) was treated for 2 h 40 min a week for 4 weeks , by wearing glasses which provided a reminder bleep if patients failed to move their eyes to the left in a 15 s interval . The control group ( n = 9 ) received no treatment for their  visual inattention  . Comparison of the groups after 4 weeks treatment and a further 4 weeks follow-up showed no significant difference either in eye movements or on the BIT . However , there was a trend towards a difference between eye movements in the two groups at 8 weeks , suggesting treatment may have influenced eye movements without changing neglect Purpose . The goal of this study was to determine whether non immersive interactive virtual environments are an effective medium for training individuals who suffer from Unilateral Spatial Neglect ( USN ) as a result of a right hemisphere stroke , and to compare it to a st and ard computer visual scanning training . Method . Participants included 19 patients with right hemisphere stroke in two groups , 11 in an experimental group were given computer desktop-based Virtual Reality ( VR ) street crossing training and 8 in a control group who were given computer based visual scanning tasks , both for a total of twelve sessions , 9 hours total , over four weeks . Measures included : 1 . St and ard USN assessment s , paper and pencil and ADL checklist ; 2 . Test on the VR street program ; and 3 . Actual street crossing videotaped . Testing was performed pre and post intervention . Results . The VR group achieved on the USN measures results that equaled those achieved by the control group treated with conventional visual scanning tasks . They improved more on the VR test and they did better on some measures of the real street crossing . Conclusions . Despite several limitations in this study the present results support the effectiveness of the VR street program in the treatment of participants with USN , and further development of the program Objective To investigate the effect of virtual reality training on unilateral spatial neglect in stroke patients . Method Twenty-four stroke patients ( 14 males and 10 females , mean age=64.7 ) who had unilateral spatial neglect as a result of right hemisphere stroke were recruited . All patients were r and omly assigned to either the virtual reality ( VR ) group ( n=12 ) or the control group ( n=12 ) . The VR group received VR training , which stimulated the left side of their bodies . The control group received conventional neglect therapy such as visual scanning training . Both groups received therapy for 30 minutes a day , five days per week for three weeks . Outcome measurements included star cancellation test , line bisection test , Catherine Bergego scale ( CBS ) , and the Korean version of modified Barthel index ( K-MBI ) . These measurements were taken before and after treatment . Results There were no significant differences in the baseline characteristics and initial values between the two groups . The changes in star cancellation test results and CBS in the VR group were significantly higher than those of the control group after treatment . The changes in line bisection test score and the K-MBI in the VR group were not statistically significant . Conclusion This study suggests that virtual reality training may be a beneficial therapeutic technique on unilateral spatial neglect in stroke patients The aim of this r and omised , double-blind study was to investigate the therapeutic effectiveness of left-h and electrical stimulation for patients with post-stroke left visuo-spatial neglect . This approach was hypothesised to enhance activation of the right hemisphere attention system and to improve visual exploration of extrapersonal space .  Participants ( n = 40 ) in the study were in a relatively early stage of recovery from their first right hemisphere stroke , and were r and omly assigned to the experimental ( E ) or control ( C ) group . Group E received conventional visual scanning training combined with electrostimulation of the left h and , while Group C received scanning training with sham stimulation . Their visuo-spatial neglect was assessed twice , prior to the rehabilitation programme and on its completion , using cancellation tests and a letter-reading task . The effect of electrostimulation on hemineglect was assessed following a single administration and after a month-long rehabilitation programme . Although the immediate effect of stimulation was poor , after a month-long rehabilitation period we found significantly greater improvement in Group E patients than in Group C patients . Interestingly , the presence of hemisensory loss did not weaken the observed effect . Therefore , we cl aim that contralesional h and stimulation combined with visual scanning was a more effective treatment for hemineglect rehabilitation than scanning training alone Objective : To investigate the effectiveness of voluntary trunk rotation and half-field eye-patching to treat patients with unilateral neglect in stroke . Design : Pre — post , day 60 follow-up , single-blinded r and omized controlled trial . Setting : Single-centre inpatient rehabilitation hospital . Subjects : Sixty subacute patients with right hemisphere stroke having unilateral neglect within eight weeks post stroke consented to participate between November 2003 and July 2005 . They were r and omly assigned to three comparison groups . Interventions : Nineteen patients received daily experimental training in voluntary trunk rotation ( TR ) for 1 hour five times a week for 30 days . Twenty patients received the same kind of treatment together with half-field eye-patching ( TR + EP ) . Fifteen patients in the control group received conventional training with the same contact time . Main outcome measures : Patients were assessed on days 0 , 30 and 60 using the Behavioural Inattention Test , the Clock Drawing Test , and the Functional Independence Measure . Results : No significant differences between voluntary trunk rotation ( TR ) , voluntary trunk rotation and half-field eye-patching ( TR + EP ) and controls were found in functional performance and neglect measures at day 30 ( P = 0.042—0.994 ) and follow-up ( P = 0.052—0.911 ) at P = 0.005 using Bonferroni correction . Conclusions : The results of this study do not support the use of voluntary trunk rotation alone or with half-field eye-patching to improve functional performance or reduce unilateral neglect in subacute patients with stroke Background . Rehabilitation of the severely affected paretic arm after stroke represents a major challenge , especially in the presence of sensory impairment . Objective . To evaluate the effect of a therapy that includes use of a mirror to simulate the affected upper extremity with the unaffected upper extremity early after stroke . Methods . Thirty-six patients with severe hemiparesis because of a first-ever ischemic stroke in the territory of the middle cerebral artery were enrolled , no more than 8 weeks after the stroke . They completed a protocol of 6 weeks of additional therapy ( 30 minutes a day , 5 days a week ) , with r and om assignment to either mirror therapy ( MT ) or an equivalent control therapy ( CT ) . The main outcome measures were the Fugl-Meyer subscores for the upper extremity , evaluated by independent raters through videotape . Patients also underwent functional and neuropsychological testing . Results . In the subgroup of 25 patients with distal plegia at the beginning of the therapy , MT patients regained more distal function than CT patients . Furthermore , across all patients , MT improved recovery of surface sensibility . Neither of these effects depended on the side of the lesioned hemisphere . MT stimulated recovery from hemineglect . Conclusions . MT early after stroke is a promising method to improve sensory and attentional deficits and to support motor recovery in a distal plegic limb Purpose . The right half-field eye-patching technique has been reported to be effective in reducing unilateral neglect ( UN ) and improving functional ability in stroke patients . This study investigated the efficacy of conventional treatment with right half-field eye patching in treating subacute stroke patients with UN  , using a r and omised controlled trial . Method . Thirty-five in patients with subacute stroke were recruited and r and omised into intervention and control groups . The patients in the intervention group received 4 weeks of conventional occupational therapy with modified right half-field eye-patching . Those in the control group received 4 weeks of conventional treatment only . Assessors , who were blind to the treatments , assessed the groups using the Behavioural Inattention Test ( BIT ) and the Functional Independence Measure ( FIM ) on admission and at 4 weeks . Results . Patients treated with right half-field eye-patching had significantly ( p = 0.046 ) higher BIT gain ( mean = 25.06 , SD = 30.81 ) than those treated with the conventional treatment ( mean = 8.29 , SD = 10.35 ) . There was no significant difference ( p = 0.467 ) in FIM gain between patients in both groups . Conclusions . Right half-field eye-patching improved stroke patients ' impairment level in terms of UN , but the potential benefits in impairment tests were not confirmed by improvements in function Most systematic review s rely substantially on the assessment of the method ological quality of the individual trials . The aim of this study was to obtain consensus among experts about a set of generic core items for quality assessment of r and omized clinical trials ( RCTs ) . The invited participants were experts in the field of quality assessment of RCTs . The initial item pool contained all items from existing criteria lists . Subsequently , we reduced the number of items by using the Delphi consensus technique . Each Delphi round comprised a question naire , an analysis , and a feedback report . The feedback report included staff team decisions made on the basis of the analysis and their justification . A total of 33 international experts agreed to participate , of whom 21 completed all question naires . The initial item pool of 206 items was reduced to 9 items in three Delphi rounds . The final criteria list ( the Delphi list ) was satisfactory to all participants . It is a starting point on the way to a minimum reference st and ard for RCTs on many different research topics . This list is not intended to replace , but rather to be used alongside , existing criteria lists OBJECTIVE Assessment of a new rehabilitation method for  unilateral neglect syndrome ( UNS ) , using a specific device ( Bon Saint Come 's device ) that associates exploratory reconditioning with voluntary trunk rotation . DESIGN Study 1 , r and omized control trial during 2 months ; study 2 , nonr and omized control trial during 2 months . SETTING Neurorehabilitation units in private and public center . PATIENTS In study 1 , 22 consecutive patients with UNS result ing from recent stroke ( < 3 months ) were r and omly assigned to an Experimental Group ( 11 patients ) or to a Control Group ( 11 patients ) . The 2 groups were very similar in terms of general and neurological data . In study 2 , 5 consecutive patients with chronic UNS result ing from an old stroke ( > 6 months ) showing the same characteristics were included . INTERVENTION In study 1 , patients in Group E followed the experimental program 1 hour a day for 1 month ( 20 hours ) and Group C followed usual neurorehabilitation during the same time . In study 2 , every patient followed the experimental program 1 hour a day for 1 month ( 20 hours ) . MAIN OUTCOME MEASURES Assessment in both studies was done at day 0 , day 30 , and day 60 using a battery of UNS tests ( Albert , Scheckenberg , bell ) and an activities of daily living ( ADL ) test ( the Functional Independence Measure [ FIM ] ) . Mean scores of each test were compared between the 2 groups with the Wilcoxon nonparametric test . RESULTS In study 1 all UNS test results and the FIM improved significantly more in Group E than in Group C. In Group E , UNS disappeared in 5 patients and improved in 6 . In Group C , UNS disappeared in 1 patient , improved in 4 , and was unchanged in 6 . In Study 2 , UNS remitted in 2 patients , improved in 
    Output:
    