Prism Adaptation in Rehabilitation? No Additional Effects of Prism Adaptation on Neglect Recovery in the Subacute Phase Poststroke

Antonia F. Ten Brink, Johanna M A Visser-Meily, Martijn J. Schut, Mirjam Kouwenhoven, Anja L H Eijsackers, Tanja C.W. Nijboer

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)
34 Downloads (Pure)

Abstract

Background. Patients with neglect ignore or respond slower to contralesional stimuli. Neglect negatively influences independence in activities of daily living (ADL). Prism adaptation (PA) is one of the most frequently studied treatments, yet there is little evidence regarding positive effects on neglect behavior in ADL. Objective. To assess whether PA in the subacute phase ameliorates neglect in situations of varying complexity. Methods. A total of 70 neglect patients admitted for inpatient stroke rehabilitation received either PA or sham adaptation (SA) for 2 weeks, with full access to standard treatment. There were 7 time-dependent measurements (baseline and 1-4, 6, and 14 weeks after start of treatment). The primary outcome was change of neglect as observed during basic ADL with the Catherine Bergego Scale (CBS). Secondary outcomes were changes in performance on a dynamic multitask (ie, the Mobility Assessment Course [MAC]) and a static paper-and-pencil task (ie, a shape cancellation task [SC]). Results. In all, 34 patients received PA and 35 SA. There were significant time-dependent improvements in performance as measured with the CBS, MAC, and SC (all F > 15.57; P .113]. Conclusions. No beneficial effects of PA over SA in the subacute phase poststroke were observed, which was comparable for situations of varying complexity. Heterogeneity of the syndrome, time post–stroke onset, and the content of treatment as usual are discussed. Basic knowledge on subtypes and recovery patterns would aid the development of tailored treatment.
Original languageEnglish
Pages (from-to)1017-1028
Number of pages12
JournalNeurorehabilitation and Neural Repair
Volume31
Issue number12
Early online date1 Dec 2017
DOIs
Publication statusPublished - 1 Dec 2017

Keywords

  • Catherine Bergego Scale
  • clinical trial
  • hemispatial neglect
  • Mobility Assessment Course
  • prism adaptation
  • rehabilitation
  • stroke
  • treatment

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