Left side neglect occurs after significant damage to the right side of the brain from a stroke, cancer, traumatic brain injury or seizures. Because the part of the brain that controlled the left side of the body is damaged or dead, it is unable to recognize the feedback provided by the nerves along the left side of the body. Mat exercises can be useful in increasing the strength of the left side arm and trunk and increasing awareness of the left side.
Purpose of Intervention
After your brain has been damaged, your recovery can occur in two different ways. Either your damaged brain will reinvigorate and be stimulated again or the other side of your brain will control both sides of your body. This process is reliant usually upon the viability of the damaged tissue, with your brain always preferring to recuperate on the appropriate side rather than to change sides. By providing stimulation such as pressure, touch, weight bearing and visual recognition, you can reeducate your brain to attend to your left side, which will lead to improved functional use of the left side.
Basic Mat Protocol
With left sided neglect, your ability to sit upright will be severely affected. You will lean away from the neglected side and may experience tightness along the right side of your trunk. The foundation for your mat program will begin with simple sitting balance, with your therapist providing sequentially less assistance and verbal cueing and allowing you to sit upright when you can. Forward and backward leans with the therapist's assistance provide your brain with feedback on body location and help to strengthen your weakened trunk muscles.
Weight Bearing
A vital component of left neglect therapy is weight bearing. Not only does weight bearing on your arm strengthen the large muscle groups and target the stabilizer muscles, it also provides pressure through the arm to stimulate brain reactivation. By leaning on your affected arm while it is straight, the movement of your arm bones against your body will encourage your brain to attend to the left side. As you continue to work on arm and trunk strengthening, your therapist will assist you in advanced sideways leans, having you lean to either side until your bent elbow is flush with the mat surface, and then pushing yourself back into the upright position.
Therapeutic Neglect Activities
When you are able to keep your balance consistently on the mat, your therapist will advance your therapy to include dynamic activities while sitting on the mat unsupported. Your therapist may instruct you to locate and stack multiple small cones on top of a table, which will force you to look to and use the left side. With a mirror in front of you, your therapist may have you perform self range of motion to the affected arm and use the visual feedback from the mirror to correct your form.
