Spatial neglect: an exploration of clinical assessment behaviour in stroke rehabilitation

Georgia Fisher, Camila Quel de Oliveira, Peter Stubbs, Emma Power, Matthew Checketts, Alison Porter-Armstrong, David S. Kennedy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Objective: There is a large gap between evidence-based recommendations for spatial neglect assessment and clinical practice in stroke rehabilitation. We aimed to describe factors that may contribute to this gap, clinician perceptions of an ideal assessment tool, and potential implementation strategies to change clinical practice in this area.

Design: Qualitative focus group investigation. Focus group questions were mapped to the Theoretical Domains Framework and asked participants to describe their experiences and perceptions of spatial neglect assessment.

Setting: Online stroke rehabilitation educational bootcamp.

Participants: A sample of 23 occupational therapists, three physiotherapists, and one orthoptist that attended the bootcamp.

Intervention: Prior to their focus group, participants watched an hour-long educational session about spatial neglect.

Main measures: A deductive analysis with the Theoretical Domains Framework was used to describe perceived determinants of clinical spatial neglect assessment. An inductive thematic analysis was used to describe perceptions of an ideal assessment tool and practice-change strategies in this area.

Results: Participants reported that their choice of spatial neglect assessment was influenced by a belief that it would positively impact the function of people with stroke. However, a lack of knowledge about spatial neglect assessment appeared to drive low clinical use of standardised functional assessments. Participants recommended open-source online education involving a multidisciplinary team, with live-skill practice for the implementation of spatial neglect assessment tools.

Conclusions: Our results suggest that clinicians prefer functional assessments of spatial neglect, but multiple factors such as knowledge, training, and policy change are required to enable their translation to clinical practice.
Original languageEnglish
Pages (from-to)688-699
Number of pages12
JournalClinical Rehabilitation
Issue number5
Early online date12 Feb 2024
Publication statusPublished - May 2024

Bibliographical note

Copyright the Author(s) 2024. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • Spatial neglect
  • clinical assessment
  • acquired brain injury
  • allied health
  • implementation science
  • qualitative research


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