NCT07519317

Brief Summary

Several interventions exist for remediation of spatial neglect, but they have mixed evidence. Optokinetic stimulation is a bottom-up intervention; in other words, it is a stimulus-driven process, with Level A (strongest) evidence, and is recommended in clinical practice guidelines such as the American Heart Association's stroke guidelines. The studies currently published all use varing doses (number of sessions a week), did not assess the impact on mobility and risk of falls, and have not been implemented in the home setting. It is imperative to understand how to successfully implement this intervention at home, and learn how it will impact mobility in order to better support a large population of individuals living with chronic spatial neglect and who face barriers to accessing care because they require caregiver support to leave the home. This will be done using both qualitative and quantitative methods.

Trial Health

65
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Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
90

participants targeted

Target at P50-P75 for not_applicable

Timeline
23mo left

Started Sep 2026

Typical duration for not_applicable

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

April 2, 2026

Completed
7 days until next milestone

First Posted

Study publicly available on registry

April 9, 2026

Completed
5 months until next milestone

Study Start

First participant enrolled

September 1, 2026

Expected
1.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 1, 2028

4 months until next milestone

Study Completion

Last participant's last visit for all outcomes

August 1, 2028

Last Updated

June 11, 2026

Status Verified

April 1, 2026

Enrollment Period

1.6 years

First QC Date

April 2, 2026

Last Update Submit

June 9, 2026

Conditions

Keywords

spatial neglect; optokinetic stimulation; stroke

Outcome Measures

Primary Outcomes (1)

  • The Mobility Assessment Course

    Evaluates a person's mobility, using visual search multitask, to assess neglect, and its relation with existing neglect tasks. The change in score from pre- to post-treatment is the primary outcome measure of the study. For this assessment, the focus on side-to side spatial imbalance (the total score is the difference between targets found on the right versus the left side). There are 40 targets (20 on each side). Lower total score indicates a poorer performance (0-40). The mean control asymmetry= 0.75 (SD=0.81), and if the asymmetry score is greater or equal to 2.78, neglect is present.

    20 minutes

Secondary Outcomes (3)

  • Health-ITUES

    10 minutes

  • Stroke Assessment of Fall Risk

    10 minutes

  • Caregiver Burden Scale

    10 minutes

Other Outcomes (3)

  • The Oxford Cognitive Screen

    15 minutes

  • Catherine Bergego Scale via the Kessler Foundation Neglect Assessment Process

    45 minutes

  • Aphasia Rapid Test

    3 minutes

Study Arms (2)

Treatment Group 1

ACTIVE COMPARATOR

3 50-minute sessions of optokinetic stimulation over 7-9 days

Behavioral: Optokinetic stimulation

Treatment Group 2

ACTIVE COMPARATOR

5 50-minute sessions of optokinetic stimulation over 7-9 days

Behavioral: Optokinetic stimulation

Interventions

Visual scanning (repeated eye movements) from one side of the computer to the neglected side of space. The target is 30 to 70 dots, randomly displayed (of all colors, size: 2- 4 cm) on a dark background on a computer screen.

Treatment Group 1Treatment Group 2

Eligibility Criteria

Age60 Years - 110 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • first and unilateral right brain damage stroke, confirmed by medical records,
  • time post stroke \>6 months,
  • moderate to severe SN, classified using the Catherine Bergego Scale (CBS) via the Kessler Foundation Neglect Assessment Process (KF-NAP),
  • over age of 60 years, and
  • IGD noted either on the KF-NAP or neuroimaging from medical records.

You may not qualify if:

  • history of multiple strokes or neurological incidents (e.g., traumatic brain injury, seizures, or brain tumor),
  • unable to communicate through spoken English, screened using the Aphasia Rapid Test (ART), as instructions for treatment and assessment tasks will be provided verbally in English,
  • cognitive impairment as defined by the Blind-MoCA,
  • dependent in mobility- walking or wheelchair via medial chart,
  • legally blind per medical chart,
  • home located out of a 50-mile radius from Duke University, making it too costly for the frequent home visits, and
  • no IGD present.
  • a current care partner (defined as someone providing care and assistance) of a stroke survivor living with SN,
  • English speaker,
  • the stroke survivor they are caring for has been enrolled into the study.
  • not a care partner currently,
  • can't speak English,
  • the stroke survivor didn't consent

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular Diseases

Study Officials

  • Kimberly Hreha, EdD, OTR/L

    Duke University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Kimberly Hreha, EdD, OTR/L

CONTACT

Cassandra (CJ) Rhodes, MS, ATC

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Randomized clinical trial with both qualitative and quantitative methods.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 2, 2026

First Posted

April 9, 2026

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

April 1, 2028

Study Completion (Estimated)

August 1, 2028

Last Updated

June 11, 2026

Record last verified: 2026-04

Data Sharing

IPD Sharing
Will not share