The Effect of Visual Scanning Exercises Integrated Into Physiotherapy in Patients With Unilateral Spatial Neglect Poststroke

Wyk, A. Van; Eksteen, Carina A.; Rheeder, Paul

doi:10.1177/1545968314526306

Cited by 32 publications

(31 citation statements)

References 33 publications

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“…These authors reported the geometric mean and 95% confidence interval (CI) at baseline and the end of each week of the treatment period. The expected geometric mean of the Barthel Index value at onset was 45 ( 12 ) and an improvement in the change from baseline at 2 weeks for the combination of VSE integrated with task-specific activities group (experimental group) compared with the task-specific activities group (control group) is 36 which is 0.214 on the logarithmic (base 10) scale. From the reported 95% CI for the geometric mean, a SD of 0.179 on the log scale was calculated.…”

Section: Methods and Analysismentioning

confidence: 97%

“…Recruitment and assessment of patients will be done in each of the rehabilitation centers in a consecutive sequence based on the number of patients in a particular center at a given time until an adequate and representative sample group ( n = 100) for the trial has been reached. An adequate and representative sample size required for phase 1 of the study was calculated based on a relatively small, but similar study ( 12 ). These authors reported the geometric mean and 95% confidence interval (CI) at baseline and the end of each week of the treatment period.…”

Section: Methods and Analysismentioning

confidence: 99%

“…Based on this information, a sample of at least 30 patients per group will have 90% power to detect the clinical relevant change when testing at the 0.05 level of significance. If testing was one-sided (VRT, VSE, and task-specific activities), based on the published results of the previous study ( 12 ), a sample of 30 patients per group will be required. Hence, to achieve a sample size of 30 patients per group, the cross-sectional part of the study (phase 1) will need to enrol at least 100 patients in the sub-acute phase.…”

Section: Methods and Analysismentioning

confidence: 99%

“…Results of a matched-pair randomized controlled trial conducted by Van Wyk et al ( 12 ) indicated that visual scanning exercises (VSE) with saccadic eye movement training during task-specific activities for patients with USN following a stroke resulted in significant improvement on impairment and functional activity level after 4 weeks of rehabilitation. However, the authors realized that although the intervention focused on the visual system (VSE integrated with task-specific activities), the visual system also functions in intimate integration with the vestibular system and the somatosensory (proprioceptive, cutaneous, and joint receptors) systems in maintaining postural orientation and stability during functional movement.…”

Section: Introductionmentioning

confidence: 99%

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A Cross-sectional Survey and Cross-sectional Clinical Trial to Determine the Prevalence and Management of Eye Movement Disorders and Vestibular Dysfunction in Post-Stroke Patients in the Sub-Acute Phase: Protocol

et al. 2016

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IntroductionVisual impairment, specifically eye movement disorders and vestibular dysfunction may have a negative influence on the functional recovery in post-stroke patients. This type of sensory dysfunction may further be associated with poor functional outcome in patients’ post-stroke.MethodsIn phase 1, a cross-sectional survey (n = 100) will be conducted to determine the prevalence of eye movement disorders and vestibular dysfunction in patients who sustained a stroke. A cross-sectional clinical trial (n = 60) will be conducted during phase 2 of the study to determine the effect of the combination of vestibular rehabilitation therapy (VRT) and visual scanning exercises (VSE) (experimental group) integrated with task-specific activities compared with the effect of task-specific activities as an intervention (control group) on patients who present with eye movement impairment and central vestibular dysfunction post-stroke. An audiologist will assess (a) visual acuity (static and dynamic), (b) nystagmus, (c) saccadic eye movements, (d) smooth pursuit eye movements, (e) vestibulo-ocular reflex, and (f) saccular, utricular, and vestibular nerve function. An independent physiotherapist will assess (1) cognitive function, (2) residual oculomotor visual performance, (3) visual–perceptual system, (4) functional balance, (5) gait, (6) functional ability, (7) presence of anxiety and/or depression, and (8) level of participation in physical activity.Ethics and disseminationEthics approval has been obtained from the Ethics Committee of the Faculty of Health Sciences at the University of Pretoria (UP) (374/2015). The study will be submitted as fulfillment for the PhD degree at UP. Dissemination will include submission to peer-reviewed professional journals and presentation at congresses. Training of rehabilitation team members on the integration of VSE and VRT into task-specific activities in rehabilitation will be done if the outcome of the experimental group’s functional performance is clinically and statistically significantly better than the control group on the Barthel Index.Trial RegistrationPan African Clinical Trials Registry (PACTR201509001223262).

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Section: Methods and Analysismentioning

confidence: 97%

Section: Methods and Analysismentioning

confidence: 99%

Section: Methods and Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Cross-sectional Survey and Cross-sectional Clinical Trial to Determine the Prevalence and Management of Eye Movement Disorders and Vestibular Dysfunction in Post-Stroke Patients in the Sub-Acute Phase: Protocol

et al. 2016

Self Cite

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“…In patients with spatial neglect, spontaneous saccadic eye movements or head movements are restricted to the ipsilesional visual hemifield and may rarely cross midline (Zoltan, 1996 ; Chaikin, 2007 ). Visual scanning training expands these movements into the contralesional space by repeatedly using cues, such as “point your right (unimpaired) hand to the left side” or “look to the left.” Recent studies have shown that visual scanning exercises increase perceptual processing (Where networks) in neglect patients, thereby leading to better visual function and ability to perform activities of daily living (van Wyk et al, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Midline Body Actions and Leftward Spatial “Aiming” in Patients with Spatial Neglect

Chaudhari

Pigott

Barrett

2015

Front. Hum. Neurosci.

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Spatial motor–intentional “Aiming” bias is a dysfunction in initiation/execution of motor–intentional behavior, resulting in hypokinetic and hypometric leftward movements. Aiming bias may contribute to posture, balance, and movement problems and uniquely account for disability in post-stroke spatial neglect. Body movement may modify and even worsen Aiming errors, but therapy techniques, such as visual scanning training, do not take this into account. Here, we evaluated (1) whether instructing neglect patients to move midline body parts improves their ability to explore left space and (2) whether this has a different impact on different patients. A 68-year-old woman with spatial neglect after a right basal ganglia infarct had difficulty orienting to and identifying left-sided objects. She was prompted with four instructions: “look to the left,” “point with your nose to the left,” “point with your [right] hand to the left,” and “stick out your tongue and point it to the left.” She oriented leftward dramatically better when pointing with the tongue/nose, than she did when pointing with the hand. We then tested nine more consecutive patients with spatial neglect using the same instructions. Only four of them made any orienting errors. Only one patient made >50% errors when pointing with the hand, and she did not benefit from pointing with the tongue/nose. We observed that pointing with the tongue could facilitate left-sided orientation in a stroke survivor with spatial neglect. If midline structures are represented more bilaterally, they may be less affected by Aiming bias. Alternatively, moving the body midline may be more permissive for leftward orienting than moving right body parts. We were not able to replicate this effect in another patient; we suspect that the magnitude of this effect may depend upon the degree to which patients have directional akinesia, spatial Where deficits, or cerebellar/frontal cortical lesions. Future research could examine these hypotheses.

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Non-pharmacological interventions for spatial neglect or inattention following stroke and other non-progressive brain injury

Longley

Hazelton

Heal

et al. 2021

Cochrane Database of Systematic Reviews

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The Effect of Visual Scanning Exercises Integrated Into Physiotherapy in Patients With Unilateral Spatial Neglect Poststroke

Cited by 32 publications

References 33 publications

A Cross-sectional Survey and Cross-sectional Clinical Trial to Determine the Prevalence and Management of Eye Movement Disorders and Vestibular Dysfunction in Post-Stroke Patients in the Sub-Acute Phase: Protocol

A Cross-sectional Survey and Cross-sectional Clinical Trial to Determine the Prevalence and Management of Eye Movement Disorders and Vestibular Dysfunction in Post-Stroke Patients in the Sub-Acute Phase: Protocol

Midline Body Actions and Leftward Spatial “Aiming” in Patients with Spatial Neglect

Non-pharmacological interventions for spatial neglect or inattention following stroke and other non-progressive brain injury

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