Search training for people with visual field loss after stroke: A cohort study

Abstract

BackgroundPeople with visual field loss after stroke often experience difficulties in everyday activities. The purpose of this study was to assess the acceptability of search training as used within occupational therapy and the feasibility of possible measures for use in a future trial. Methods:Nine participants took part in a goal oriented intervention that was delivered three times a week for three weeks. Patient reports of acceptability and outcomes using the Visual Function Questionnaire-25 (VFQ-25) were collected. Participants' room search behaviour before and after the intervention was recorded using a head worn camera. Results:Eight participants completed nine treatment visits. All participants reported improved awareness and attention to the blind side during activities following the intervention. 7/8 participants change scores on VFQ-25 exceeded 6 points. Patterns of head-direction behaviour and overall room search times were variable across patients; markedly improved performance was only evident in the most severely affected participant. Conclusions:The intervention was acceptable. The VFQ-25 is a feasible measure for assessing patient reported outcomes. While the room search was informative about individuals' behaviour, more sophisticated methods of gaze tracking would allow search processes to be determined in real world activities that are relevant to patients' goals.

Biomechanical adaptation to post-stroke visual field loss: a systematic review

“…The amplitudes of saccades into the BHF were smaller than into the SHF, for both left- and right-sided sHH. Turton et al (2018) [ 65 ] Cohort study n = 9HH ( n = 7, 1 right, 6 left) Quadrantanopia ( n = 1) Partial visual field loss with macular involvement ( n = 1) Ischemic stroke ( n = 6) Haemorrhage ( n = 3) Adults Participants received an intensive course of scanning and search training using various process activities and occupations. Training lasted 1 h, three times a week for 3 weeks Head movement Head yaw and pitch Increased searching on blind side, from head movement, following intervention (for n = 3 of 9) Wood et al (2011) [ 66 ] Case-control study n = 60 HH ( n = 22, 5 right, 17 left) Quadrantanopia ( n = 8) Healthy controls ( n = 30) Cerebrovascular accident ( n = 12) Tumour ( n = 2) AVM ( n = 2) Congenital brain abnormality ( n = 1) Trauma ( n = 5) Adults N/A The driving performance of each participant was assessed under in-traffic conditions along 6.3 miles of non-interstate driving in residential and commercial areas of a city.…”

“…Head movements were recorded in eight studies by means of a head-mounted binocular infrared video pupil tracker [ 44 , 51 , 55 ], a high-resolution accelerometer [ 63 ], digital head-worn video camera [ 65 , 66 ], a low-torque potentiometer [ 67 ] or a remote infrared system [ 45 ]. Shoulder movements were recorded in two studies by means of a video camera [ 51 , 66 ].…”

“…Head movements were recorded in eight studies ( n = 221) [ 44 , 45 , 51 , 55 , 63 , 65 – 67 ]. Examining the head movement parameters during various visual tasks (e.g.…”

“…For rehabilitation purposes, Turton et al [ 65 ] assessed the acceptability of search training for people with visual field loss after stroke and reported increased searching on the blind side, from head movement, following the intervention.…”

Scanning training for rehabilitation of visual field loss due to stroke: Identifying and exploring training tools in use

“…Although there is a lack of conclusive evidence of effectiveness of scanning training, it is a promising technique (Pollock et al., 2011). Occupational therapists typically teach broad, horizontal scanning movements during practice of relevant ADL (Turton, 2014). Scanning training may also be administered using devices or tools, including computer-based or paper-based exercises (Pollock et al., 2011).…”