Prism Adaptation Training for Treatment of Spatial Neglect During Inpatient Rehabilitation

NCT04977219 | Completed

• 1 other identifier: 21-0505-3
• Study Type: observational
• Target: 74
• Locations: 0 countries
• Sites: N/A

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

Outcome Measures

Primary Outcomes (1)

• Catherine Bergego Scale

  Behavioral measure of unilateral spatial neglect. Scored 0-30. Higher numbers indicate greater severity of spatial neglect.

  Up to 55 days

Secondary Outcomes (3)

• Functional Independence Measure (FIM)

  Up to 55 days

• Length of Stay

  Up to 55 days

• Discharge destination

  Up to 55 days

Study Arms (2)

Prism Adaptation Training;

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

Behavioral: Prism Adaptation Training

Standard Care

Patients who received standard treatment of spatial neglect during their admission

Interventions

Prism Adaptation Training 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.

Prism Adaptation Training;

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Inpatient Rehabilitation Facility (IRF)

You may qualify if:

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

You may not qualify if:

• 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

Sponsors & Collaborators

• Sunnyview Rehabilitation Hospital: lead

Related Publications (1)

• 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.

  PMID: 35432163 DERIVED

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinical Neuropsychologist

Study Record Dates

• First Submitted: July 9, 2021
• First Posted: July 26, 2021
• Study Start: June 1, 2016
• Primary Completion: December 31, 2019
• Study Completion: December 31, 2019
• Last Updated: July 26, 2021

Record last verified: 2021-07

Data Sharing

• IPD Sharing: Will not share