WALKING THROUGH DOORWAYS - AN ANALYSIS OF NAVIGATION SKILLS IN PATIENTS WITH NEGLECT

Neglect can cause problems in navigation in the environment, for instance because patients tend to bump into objects such as doorposts. The aim of this study was to analyse the extent to which neglect affected navigation skills. Nine stroke patients with adequate walking abilities, of whom five had visual neglect, were observed while they walked through an aperture. The width of the passage was varied, and in some trials a coloured strip was attached to either the left or the right side of the aperture in order to increase the salience of that side. Patients with neglect bumped into the sides of the aperture much more often than the patients without neglect or the controls (N = 18). The coloured cue had no effect on the number of collisions. The number of collisions correlated highly with paper and pencil tests of neglect. The results showed that there are differential patterns of performance. Three patients with mild neglect bumped into the left side, and two others with more severe neglect bumped predominantly into the right side. An important indicator of the coupling between perception and action is rotation of the shoulders while passing a narrow aperture. Although the patients were able to do so, they often failed to rotate their shoulders when this was required for a smooth passage, thus indicating an impairment at the level of perception-action coupling. This is even more interesting because patients were very well able to estimate the width of the aperture at the verbal level. The main findings are discussed in terms of contralateral attentional deficit and an ipsilateral release of ''intentional'' processes. Implications for future research are discussed.