Abstract
Spatial neglect is a devastating disorder in 50–70% of right-brain stroke survivors, who have problems attending to, or making movements towards, left-sided stimuli, and experience a high risk of chronic dependence. Prism adaptation is a promising treatment for neglect that involves brief, daily visuo-motor training sessions while wearing optical prisms. Its benefits extend to functional behaviors such as dressing, with effects lasting 6 months or longer. Because one to two sessions of prism adaptation induce adaptive changes in both spatial-motor behavior (Fortis et al., 2011) and brain function (Saj et al., 2013), it is possible stroke patients may benefit from treatment periods shorter than the standard, intensive protocol of ten sessions over two weeks—a protocol that is impractical for either US inpatient or outpatient rehabilitation. Demonstrating the effectiveness of a lower dose will maximize the availability of neglect treatment. We present preliminary data suggesting that four to six sessions of prism treatment may induce a large treatment effect, maintained three to four weeks post-treatment. We call for a systematic, randomized clinical trial to establish the minimal effective dose suitable for stroke intervention.
Highlights
Spatial neglect is a devastating disorder, affecting 50–70% of individuals surviving righthemisphere stroke (Paolucci et al, 2001; Buxbaum et al, 2004; Nijboer et al, 2013)
Might there be an intermediate number of prism treatment sessions that both produce a lasting effect and can be feasibly administered in the U.S inpatient rehabilitation setting? Below we provide some preliminary data and estimate the effect size associated with an intermediate number of prism treatment sessions
Our analyses suggest that four to six sessions of prisms may induce large treatment effects, lasting three to four weeks
Summary
Spatial neglect is a devastating disorder, affecting 50–70% of individuals surviving righthemisphere stroke (Paolucci et al, 2001; Buxbaum et al, 2004; Nijboer et al, 2013). They experience more in-hospital morbidity (e.g., more falls; Webster et al, 1995; Czernuszenko and Członkowska, 2009; Chen et al, 2015) They experience poorer motor recovery, both during in-patient rehabilitation (e.g., Gillen et al, 2005; Chen et al, 2015) and in the months and years following stroke, even when neglect symptoms are remediated (e.g., Robertson et al, 1997; Nijboer et al, 2014; see Barrett and Muzaffar, 2014, for review). Because these individuals have a profoundly distorted sense of body-spatial relations (Riestra and Barrett, 2013), we might anticipate their problems
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
