Smooth Pursuit Eye Movement Training Promotes Recovery From Auditory and Visual Neglect

Kerkhoff, Georg; Reinhart, Stefan; Ziegler, Wolfram; Artinger, Frank; Marquardt, Christian; Keller, Ingo

doi:10.1177/1545968313491012

Cited by 61 publications

(61 citation statements)

References 41 publications

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“…Therefore, the positive effects found here were specific to visuomotor feedback training and are not simply due to non-specific factors (e.g., amount of training or attention received) or conventional rehabilitation therapy. In addition, even though the effects were found with a relatively small sample size of 20 patients, it is important to note that this sample size is still amongst the largest ever reported in any neglect rehabilitation trial, including very recent studies by Kerkhoff et al (2013Kerkhoff et al ( , 2014 showing promising results of "smooth pursuit" training on samples of 50 and 30 patients respectively, and by Mizuno et al (2011) reporting prism adaptation effects in ADL on a sample of 38 patients.…”

Section: Improvements Associated With Treatmentmentioning

confidence: 93%

Efficacy of home-based visuomotor feedback training in stroke patients with chronic hemispatial neglect

Rossit

Benwell

Szymanek

et al. 2017

Neuropsychological Rehabilitation

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Hemispatial neglect is a severe cognitive condition frequently observed after a stroke, associated with unawareness of one side of space, disability and poor long-term outcome. Visuomotor feedback training (VFT) is a neglect rehabilitation technique that involves a simple, inexpensive and feasible training of grasping-to-lift rods at the centre. We compared the immediate and long-term effects of VFT vs. a control training when delivered in a home-based setting. Twenty participants were randomly allocated to an intervention (who received VFT) or a control group (n = 10 each). Training was delivered for two sessions by an experimenter and then patients self-administered it for 10 sessions over two weeks. Outcome measures included the Behavioural Inattention Test (BIT), line bisection, Balloons Test, Landmark task, room description task, subjective straight-ahead pointing task and the Stroke Impact Scale. The measures were obtained before, immediately after the training sessions and after four-months post-training. Significantly greater short and longterm improvements were obtained after VFT when compared to control training in line bisection, BIT and spatial bias in cancellation. VFT also produced improvements on activities of daily living. We conclude that VFT is a feasible, effective, homebased rehabilitation method for neglect patients that warrants further investigation with well-designed randomised controlled trials on a large sample of patients.

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Section: Improvements Associated With Treatmentmentioning

confidence: 93%

Efficacy of home-based visuomotor feedback training in stroke patients with chronic hemispatial neglect

Rossit

Benwell

Szymanek

et al. 2017

Neuropsychological Rehabilitation

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“…Symptoms often vary from patient to patient due to the heterogeneous nature of visual neglect and its symptoms . The findings from Kerkhoff et al (2013) demonstrated this as effect sizes were greater in those with severe neglect following visual scanning therapy compared to those with mild neglect. Furthermore, these studies excluded patients with any psychological problems such as dementia, limiting the generalizability of the findings from this systematic research review to a specific and potentially very small population.…”

Section: Discussionmentioning

confidence: 82%

“…Two studies (69 participants) used smooth pursuit training (SMT) as an intervention, assessing patient outcomes immediately and two weeks after treatment (Kerkhoff et al, 2013;Kerkhoff et al, 2014). Both studies were of high quality (receiving a PEDro score of 7) using a randomized design where the intervention was administered to patients no more than a month after stroke.…”

Section: Smooth Pursuit Trainingmentioning

confidence: 99%

“…The first study used 5 x 50 minute sessions (total 250 minutes) of SPT with standardized neglect tests as an outcome measure (Kerkhoff et al, 2013). This study reported a significant main effect on paragraph reading (p<.001), significant reductions in rightward bias in both perceptual and motor line bisection tasks (p<.05), and finally a significant reduction in leftward omissions in the single and double digit cancellation tasks (p<.001) compared to baseline performance (pre-intervention).…”

Section: Smooth Pursuit Trainingmentioning

confidence: 99%

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A Systematic Research Review Assessing the Effectiveness of Pursuit Interventions in Spatial Neglect Following Stroke

Hill

Coats

Halstead

et al. 2015

Transl. Stroke Res.

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BACKGOUND: Rehabilitation after stroke is imperative for patients with spatial neglect as it can help improve behavioural, social and cognitive outcomes in these patients, and therefore reduce the financial burden on public health services. The main aim of this review is to investigate the effectiveness of active pursuit eye movements for rehabilitation interventions in patients with spatial neglect following stroke. METHODS:Potential papers for inclusion were gathered by searching key terms in four main databases (AMED, Global Health, Pubmed/Medline and PsychInfo) in addition to screening relevant reference lists. Two reviewers independently selected papers for inclusion based on agreed inclusion criteria (n = 9 with 147 participants). Risk of bias was assessed using the QUADAS-2 tool. RESULTS:All papers reported a statistically significant result in patients who received an intervention which used pursuit eye movements, and this was reported both as a short term (immediate) effect and as a sustained effect up to eight weeks after treatment. These effects were also reported in comparison with interventions using saccadic eye movements. One study also reported increased neural activity in a number of brain regions following pursuit based intervention. CONCLUSIONS:Overall, there is good evidence in support of pursuit intervention used in the rehabilitation of stroke and spatial neglect over and above traditional interventions based on saccadic eye movements. Future research should aim to increase sample sizes, provide information on statistical power, record accurate eye movement responses, and use randomised designs to reduce selection bias.

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“…A further trial aimed to investigate whether or not smooth pursuit therapy is superior to standard scanning therapy (Kerkhoff et al., 2013). The authors reported more improvement following smooth pursuit training in both auditory and visual outcomes.…”

Section: Interventionsmentioning

confidence: 99%

The treatment methods for post‐stroke visual impairment: A systematic review

2017

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AimTo provide a systematic overview of interventions for stroke related visual impairments.MethodA systematic review of the literature was conducted including randomized controlled trials, controlled trials, cohort studies, observational studies, systematic reviews, and retrospective medical note reviews. All languages were included and translation obtained. This review covers adult participants (aged 18 years or over) diagnosed with a visual impairment as a direct cause of a stroke. Studies which included mixed populations were included if over 50% of the participants had a diagnosis of stroke and were discussed separately. We searched scholarly online resources and hand searched articles and registers of published, unpublished, and ongoing trials. Search terms included a variety of MESH terms and alternatives in relation to stroke and visual conditions. Article selection was performed by two authors independently. Data were extracted by one author and verified by a second. The quality of the evidence and risk of bias was assessed using appropriate tools dependant on the type of article.ResultsForty‐nine articles (4142 subjects) were included in the review, including an overview of four Cochrane systematic reviews. Interventions appraised included those for visual field loss, ocular motility deficits, reduced central vision, and visual perceptual deficits.ConclusionFurther high quality randomized controlled trials are required to determine the effectiveness of interventions for treating post‐stroke visual impairments. For interventions which are used in practice but do not yet have an evidence base in the literature, it is imperative that these treatments be addressed and evaluated in future studies.

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Smooth Pursuit Eye Movement Training Promotes Recovery From Auditory and Visual Neglect

Abstract: Repetitive contralesional, smooth pursuit training induces superior, multimodal therapeutic effects in mild and severe neglect.

Cited by 61 publications

References 41 publications

Efficacy of home-based visuomotor feedback training in stroke patients with chronic hemispatial neglect

Efficacy of home-based visuomotor feedback training in stroke patients with chronic hemispatial neglect

A Systematic Research Review Assessing the Effectiveness of Pursuit Interventions in Spatial Neglect Following Stroke

The treatment methods for post‐stroke visual impairment: A systematic review

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