Prism Adaptation Training for Treatment of Spatial Neglect During Inpatient Rehabilitation

NCT ID: NCT04977219

Last Updated: 2021-07-26

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 74 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2016-06-01
• Study Completion Date: 2019-12-31

Brief Summary

Left sided spatial neglect is a common yet potentially debilitating phenomena associated with right hemisphere stroke. Heilman defines neglect as "the failure to report, respond, or orient to novel or meaningful stimuli presented to the side opposite of a brain lesion that cannot be attributed to either sensory or motor deficits". Numerous studies have demonstrated the impact of spatial neglect in right hemisphere stroke patients on both rehabilitation outcomes, and subsequent functioning in the community. Given the highly significant negative impact of spatial neglect, numerous treatment approaches have been attempted, yet most lack evidence in terms of efficacy. One promising exception has been prism adaptation training (PAT), which several recent reviews reported improved independence as a benefit of this treatment, both in terms of ameliorating the severity of neglect and demonstrating generalization to important functional behaviors. Still, much remains unknown regarding PAT, and not all studies have shown positive results.

At Sunnyview Rehabilitation Hospital, a number of providers have added PAT to the standard PT, OT and speech that stroke patients receive during their inpatient stay. As part of a process improvement initiative the investigators identified 57 patients that received PAT training between June 2016 and September of 2019. The investigators propose a retrospective case-control study examining the impact of PAT treatment on the rehabilitation outcomes for these patients. Outcome variables to be assessed include the measures of spatial neglect (Catherine Bergego Scale), functional independence measures (FIM), length of hospitalization and discharge destination. The investigators hypothesize that patients who received 4 or more PAT sessions during their inpatient rehabilitation stay will show improvements both in measures of neglect and functional independence as a result of this treatment.

Conditions

Stroke

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: RETROSPECTIVE

Study Groups

Prism Adaptation Training;

Patients who received prism adaptation training for treatment of spatial neglect during their inpatient rehabilitation admission

Prism Adaptation Training

Intervention Type: BEHAVIORAL

Therapists administering PAT followed the protocol developed by the Kessler Foundation (2014).PAT sessions lasted approximately 30 minutes during which patients with left sided neglect don 20 diopter prism goggles deviating their visual field to the right while aiming their finger at a series of visual targets.

Standard Care

Patients who received standard treatment of spatial neglect during their admission

No interventions assigned to this group

Interventions

Prism Adaptation Training

Therapists administering PAT followed the protocol developed by the Kessler Foundation (2014).PAT sessions lasted approximately 30 minutes during which patients with left sided neglect don 20 diopter prism goggles deviating their visual field to the right while aiming their finger at a series of visual targets.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Right hemisphere stroke
• Admitted between 6/2016 & 12/2019

Exclusion Criteria

• Absence of neglect
• Incomplete Catherine Bergego Scale (Less than 7 items scored)
• Evidence of traumatic brain injury
• Brain cancer
• Dementia
• Parkinson's disease
• Alzheimer's disease
• aphasia
• Interrupted hospital admission

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Sunnyview Rehabilitation Hospital

OTHER

Sponsor Role: lead

Responsible Party

Robert Gillen

Clinical Neuropsychologist

Responsibility Role: PRINCIPAL_INVESTIGATOR

References

Gillen RW, Harmon EY, Weil B, Fusco-Gessick B, Novak PP, Barrett AM. Prism Adaptation Treatment of Spatial Neglect: Feasibility During Inpatient Rehabilitation and Identification of Patients Most Likely to Benefit. Front Neurol. 2022 Apr 1;13:803312. doi: 10.3389/fneur.2022.803312. eCollection 2022.

Reference Type: DERIVED

PMID: 35432163 (View on PubMed)

Other Identifiers

21-0505-3

Identifier Type: -

Identifier Source: org_study_id