Abstract
Aim: Controversy exists as to whether prism adaptation improves the symptoms of neglect. The purpose of this review is to investigate the efficacy of prism adaptation techniques in the rehabilitation of neglect. Methods: A literature review was conducted using the search engines Pubmed, Medline, Embase, Ovid, Google scholar and http://pcwww.liv.ac.uk/~rowef/index_files/Page646.htm. Study and review abstracts from the literature search were analysed and marked for inclusion if they contained the following terms in reference to visual neglect: ‘visual inattention’, ‘visual neglect’, ‘stroke’, ‘cerebro-vascular accident’, ‘rehabilitation’ and ‘prism adaptation’. Only journals written in English with full text access were included in this review. Results: Neglect is now known as a multi-component disorder and recent studies have suggested using a combination therapy approach for the rehabilitation of neglect. There have been promising reports when prism adaptation has been used in combination with other methods of rehabilitation. However, there is not yet an adequate amount of evidence to definitively guide rehabilitation and thus additional research is advocated. Conclusion: Although negative results have been reported, the majority of studies advocate the use of prism adaptation. However, there is not yet enough evidence to incorporate prism adaptation into the clinical rehabilitation programme for neglect patients. Further studies need to concentrate on the clinical significance of improvements in neglect symptoms and the extent to which improvements extend to the everyday lives of patients.
Highlights
Visual inattention, known as neglect, has been reported to be one of the most common visual difficulties caused by stroke
This condition usually follows a right-sided lesion of the Correspondence and offprint requests to: Kirsty Lavery, Orthoptic Department, Wycombe General Hospital, Queen Alexandra Road, High Wycombe, Bucks HP11 2TT. e-mail: kirsty.lavery@ buckshealthcare.nhs.uk parietal lobe, it may be caused by a left sided lesion and involvement of any one of various brain structures.[3]
Prism adaptation had no positive effect on neglect in daily living assessed by the Catherine Bergego Scale (CBS) or the behavioural inattention test (BIT) despite a cumulative effect on pointing bias being evident during the treatment programme
Summary
Known as neglect, has been reported to be one of the most common visual difficulties caused by stroke. The incidence has been reported to be as high as 90%1 and as low as 8%.2. This condition usually follows a right-sided lesion of the Correspondence and offprint requests to: Kirsty Lavery, Orthoptic Department, Wycombe General Hospital, Queen Alexandra Road, High Wycombe, Bucks HP11 2TT. E-mail: kirsty.lavery@ buckshealthcare.nhs.uk parietal lobe, it may be caused by a left sided lesion and involvement of any one of various brain structures.[3] It results in the patient being unaware of one side of their environment, the side contralateral to the lesion. One study has reported a 43% partial recovery of patients during a 2-week period and a complete recovery was observed in 9% of patients.[8]
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