Prism adaptation treatment for spatial neglect post brain tumour removal: A case report

Chen, Peii; Lander, Viktoriya; Noce, Natalia; Hreha, Kimberly

doi:10.1177/1569186120921472

Cited by 6 publications

(8 citation statements)

References 16 publications

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“…Modified from a five-object figure copying test [ 6 ], the Scene Copying Test is a figure copying task consisting of two plants, a house, and two trees arranged in that order left-to-right, printed on the upper half of a page [ 56 ]. The task is to copy the entire “scene” to the lower half of the page.…”

Section: Methodsmentioning

confidence: 99%

Prism adaptation treatment to address spatial neglect in an intensive rehabilitation program: A randomized pilot and feasibility trial

et al. 2021

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Spatial neglect (SN) is a common cognitive disorder after brain injury. Prism adaptation treatment (PAT) is one of the promising interventions for SN albeit inconsistent results from previous studies. We carried out a comparison intervention (PAT vs. Sham) and aimed to evaluate the efficacy of PAT on visuospatial symptoms of SN in an inpatient rehabilitation setting that offered a highly intensive comprehensive brain injury rehabilitation program. A total of 34 patients with moderate-to-severe SN secondary to stroke or traumatic brain injury were randomized to the PAT group and the Sham group (an active control group). Both groups received 10 sessions of treatment, over two weeks, in addition to the rehabilitation therapies provided by their rehabilitation care teams. Outcomes were measured using an ecological instrument (the Catherine Bergego Scale) and paper-and-pencil tests (the Bells Test, the Line Bisection Test and the Scene Copying Test). Patients were assessed at baseline, immediately after treatment, two weeks after treatment, and four weeks after treatment. 23 (67.6%) patients completed treatment and all the assessment sessions and were included in the final analyses using mixed linear modeling. While SN symptoms reduced in both groups, we found no difference between the two groups in the degree of improvement. In addition, the average SN recovery rates were 39.1% and 28.6% in the PAT and Sham groups, respectively, but this discrepancy did not reach statistical significance. Thus, the present study suggests that PAT may contribute little to SN care in the context of a highly intensive inpatient rehabilitation program. Further large-scale investigation is required to uncover the mechanisms underlying PAT and Sham in order to refine the treatment or create new interventions.

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Section: Methodsmentioning

confidence: 99%

Prism adaptation treatment to address spatial neglect in an intensive rehabilitation program: A randomized pilot and feasibility trial

et al. 2021

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“…The prism goggles were used only during PAT (for detailed procedures, see the KF-PAT manual 40 or previous reports). 2 , 42 , 43 PAT was delivered once a day during an OT session, mostly at the beginning of the session. Some sites followed the recommendation of delivering PAT over 10 consecutive days or weekdays (skipping weekends), and others completed as many PAT sessions as possible, depending on individual patients’ condition and length of stay (LOS).…”

Section: Methodsmentioning

confidence: 99%

“…The prevalence of spatial neglect (SN) is approximately 20%-40% among survivors of stroke in acute and postacute inpatient settings and it is more common after right brain damage than left brain damage. 1 SN can also occur in individuals with other types of brain injury 2 , 3 because the disorder results from damage to the neural networks critical to spatial processing and attention control. 4 , 5 Affected individuals typically demonstrate ipsilesional bias and hence pay no or insufficient attention to the contralesional side of space.…”

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confidence: 99%

Prism Adaptation Treatment Improves Inpatient Rehabilitation Outcome in Individuals With Spatial Neglect: A Retrospective Matched Control Study

Chen

Diaz-Segarra

Hreha

et al. 2021

Archives of Rehabilitation Research and Clinical Translation

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Objective To determine whether prism adaptation treatment (PAT) integrated into the standard of care improves rehabilitation outcome in patients with spatial neglect (SN). Design Retrospective matched control study based on information extracted from June 2017-September 2019. Setting Inpatient rehabilitation. Participants Patients from 14 rehabilitation hospitals scoring >0 on the Catherine Bergego Scale (N=312). The median age was 69.5 years, including 152 (49%) female patients and 275 (88%) patients with stroke. Interventions Patients were matched 1:1 by age (±5 years), FIM score at admission (±2 points), and SN severity using the Catherine Bergego Scale (±2 points) and classified into 2 groups: treated (8-12 daily sessions of PAT) vs untreated (no PAT). Main Outcome Measures FIM and its minimal clinically important difference (MCID) were the primary outcome variables. Secondary outcome was home discharge. Results Analysis included the 312 matched patients (156 per group). FIM scores at discharge were analyzed using repeated-measures analyses of variance. The treated group showed reliably higher scores than the untreated group in Total FIM, F =5.57, P =.020, partial η 2 =0.035, and Cognitive FIM, F =19.20, P <.001, partial η 2 =0.110, but not Motor FIM, F =0.35, P =.553, partial η 2 = 0.002. We used conditional logistic regression to examine the odds ratio of reaching MCID in each FIM score and of returning home after discharge. No reliable difference was found between groups in reaching MCID or home discharge. Conclusions Patients with SN receiving PAT had better functional and cognitive outcomes, suggesting that integrating PAT into the standard of care is beneficial. However, receiving PAT may not determine home discharge.

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“…Prism adaptation treatment (PAT; for detailed treatment procedures and mechanisms, see recent reviews) 12 -15 is promising in reducing SN symptoms and improving functional outcomes. 16,17 We conducted a retrospective, matched control study (N = 312) 18 that demonstrated the effectiveness of PAT when embedded in occupational therapy practice on inpatient rehabilitation outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…In the overarching implementation project, 29 therapists were encouraged to assess all neurological patients under their care, with the understanding that SN can occur after different types of brain injury, using the Catherine Bergego Scale (CBS) via the Kessler Foundation Neglect Assessment Process (KF-NAP®). 30,31 Therapists were encouraged to deliver PAT following the Kessler Foundation Prism Adaptation Treatment (KF-PAT®) protocol 13,22 when SN was detected. The primary goal was to train all participating therapists in integrating both KF-NAP and KF-PAT in their practice.…”

Section: Introductionmentioning

confidence: 99%

Impacts of Prism Adaptation Treatment on Spatial Neglect and Rehabilitation Outcome: Dosage Matters

Chen

Hreha

Gonzalez-Snyder³

et al. 2022

Neurorehabil Neural Repair

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We examined whether number of prism adaptation treatment (PAT) sessions in regular clinical practice would predict spatial neglect (SN) improvement and rehabilitation outcomes. We reviewed clinical records from 16 U.S. rehabilitation hospitals where neurological patients were assessed for SN using the Catherine Bergego Scale (CBS) and if SN was detected, and may have received PAT. Multiple linear regression was used to predict CBS Change (indicating SN improvement) in 520 patients who received PAT while considering age, sex, diagnosis, time post diagnosis, CBS at baseline, neglected side of space, and length of stay. Another set of regression models including the same variables and adding Function Independent Measure (FIM®) at admission was used to predict FIM Gains (indicating rehabilitation outcomes) in 1720 patients receiving PAT or not. We found that greater number of PAT sessions predicted greater CBS Change, especially in patients with moderate-to-severe neglect. Number of PAT sessions also positively correlated with Total FIM, Motor FIM, and Cognitive FIM Gains regardless of SN severity classification at baseline. Furthermore, number of PAT sessions predicted CBS Change and FIM Gains among patients completing ≤8 PAT sessions but not among patients with ≥8 sessions, who however, showed greater CBS Change with increased PAT frequency (i.e., fewer days between two consecutive sessions). Receiving more once-daily PAT sessions predicted greater improvement in SN and rehabilitation outcomes. Receiving PAT at a higher frequency for 8 or more sessions predicted better SN improvement. Thus, dosage matters. The study provides practice-based evidence that PAT is appropriate for inpatient rehabilitation.

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Prism adaptation treatment for spatial neglect post brain tumour removal: A case report

Cited by 6 publications

References 16 publications

Prism adaptation treatment to address spatial neglect in an intensive rehabilitation program: A randomized pilot and feasibility trial

Prism adaptation treatment to address spatial neglect in an intensive rehabilitation program: A randomized pilot and feasibility trial

Prism Adaptation Treatment Improves Inpatient Rehabilitation Outcome in Individuals With Spatial Neglect: A Retrospective Matched Control Study

Impacts of Prism Adaptation Treatment on Spatial Neglect and Rehabilitation Outcome: Dosage Matters

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