Effects of Prism Adaptation for Unilateral Spatial Neglect After Stroke: A Systematic Review and Meta-Analysis.

Abstract

The aim of the study was to assess effects of prism adaptation on unilateral spatial neglect poststroke. Searching databases and referring to randomized controlled trial until December 30, 2019. There were two reviewers who searched some key words such as unilateral spatial neglect and prism adaptation, and only randomized controlled trial was included. There were two evaluators who screened literature and data regarding research design, treatment plan, etc. Assessment tool recommended in Cochrane Reviewers' Handbook 5.1.0 was adopted to assess the risks of bias of randomized controlled trial, and Revman 5.3 software was used for meta-analysis. Mean differences and 95% of confidence intervals were calculated, and heterogeneity was assessed through I2 statistics. Eight randomized controlled trials were included, involving 244 patients of which 130 in experimental group and 114 in control group. According to meta-analysis results, prism adaptation group scored significantly higher than control group in improving Behavioral Inattention Test (mean difference = 8.99, 95% confidence interval = 0.93 to 17.06, P = 0.03) and Star Cancellation Test (mean difference = 3.04, 95% confidence interval = 0.19 to 5.88, P = 0.04). However, there was no significant statistical difference in Catherine Bergego Scale between groups (mean difference = -0.30, 95% confidence interval = -1.83 to 1.23, P = 0.70). The long-term follow-up visits (over 1 mo) appeared no statistical difference in Behavioral Inattention Test scores between the patients of two groups (mean difference = 8.93, 95% confidence interval = -1.98 to 19.84, P = 0.1). Prism adaptation can improve neglect symptoms of patients with unilateral spatial neglect after stroke temporarily.