The Effect of a Complex Intervention Program for Unilateral Neglect in Patients with Acute-Phase Stroke: A Randomized Controlled Trial

Choi, Hyun-Se; Kim, Deok-Ju; Yang, Young Il

doi:10.24171/j.phrp.2019.10.5.02

Cited by 8 publications

(6 citation statements)

References 31 publications

(37 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast, although previous studies have explored PA in combination with other treatments, most studies have selected therapies with the same bottom-up approach ( 19 , 20 , 48 ). It is notable that the two interventions chosen for the present study stem from the following two different approaches: the “top-down” approach aims to improve perceptual and behavioral biases by acting on disrupted consciousness and thus on higher-level cognitive processes, and the “bottom-up” approach is a physiological approach that aims to influence sensory-motor levels through passive sensory manipulation or visuomotor adaptation.…”

Section: Discussionmentioning

confidence: 99%

“…Based on this, we speculate that combining PA with one approach will yield better results. In previous studies, Saevarsson et al ( 19 ) and Choi et al ( 20 ) combined PA with neck vibration and functional electrical stimulation, respectively, and both showed that the combined intervention better improved USN symptoms. However, the combination of these two studies only increased the number of interventions without mentioning the possible theoretical basis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prism adaptation combined with eye movement training for unilateral spatial neglect after stroke: Study protocol for a single-blind prospective, randomized controlled trial

Yang

Wang

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

BackgroundUnilateral spatial neglect (USN) is a complex neurological syndrome that often reduces rehabilitation outcomes, prolongs patients' hospital stays, and decreases their quality of life. However, the current therapies for USN have varying efficacy. We will explore a new treatment option that combines prism adaptation (PA) with eye movement training (EMT) for the treatment of USN after stroke.MethodsWe will conduct a single-blind, prospective, randomized controlled trial to assess the efficacy of the combined intervention (PA & EMT) on USN in an inpatient rehabilitation setting. The study aims to recruit 88 patients with USN after an ischemic or hemorrhagic stroke. Participants will be randomly assigned to the following four groups: (1) PA group (n = 22), (2) EMT group (n = 22), (3) PA and EMT group (n = 22), and (4) control group (n = 22). All groups will receive 10 sessions of interventions over 2 weeks, 5 times per week. Blinded assessors will conduct a baseline assessment, a post-intervention assessment, and a follow-up assessment (2 weeks post-intervention). The primary outcome measure will use the Behavioral Inattention Test-Conventional Subset (BIT-C) and Catherine Bergego Scale (CBS) to assess the levels of USN. Secondary outcome measures will assess the patient's ability to perform activities of daily living using the Modified Barthel Index (MBI). Patients who completed all treatment and assessment sessions will be included in the final analysis.DiscussionThis study will explore the effects of 10 sessions of combined interventions (PA & EMT) on USN and functional capacity. This study has the potential to identify a new, evidence-based treatment option and provide new ideas for the treatment of USN.Ethics and disseminationThe study protocol has been approved by the Nanchong Central Hospital. Written informed consent will be obtained from all the participants. The results of this study will be disseminated to the public through scientific conferences and a peer-reviewed journal.Trial registrationChiCTR, ChiCTR2100049482. Registered on 2 August 2021, http://www.chictr.org.cn/showproj.aspx?proj=130823.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prism adaptation combined with eye movement training for unilateral spatial neglect after stroke: Study protocol for a single-blind prospective, randomized controlled trial

Yang

Wang

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

show abstract

“…A previous study of 12 stroke patients with unilateral neglect found that a combination therapy with 20 min of PA and NV produced more synergistic intervention effects compared to that of NV alone [ 16 ]. In another study conducted on 30 patients of acute stroke with unilateral neglect, the combined effects of PA and FES were greater than the effects of either intervention alone [ 20 ]. In a study that applied a complex intervention, which combined an eye patch and optokinetic stimulation, positive effects were shown in terms of the reduction in unilateral neglect and improved ADL, compared to the control [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…Compared to the effects of only visual scanning stimulation (VSC), the combination of VSC with transcutaneous electrical nerve stimulation (TENS) exerted greater positive effects for reducing unilateral neglect [ 19 ]. Similarly, compared to the use of either PA or functional electrical stimulation (FES), the combination of PA and FES conferred greater positive effects for symptom reduction [ 20 ]. However, these previous studies were mostly conducted on acute stroke patients, and this limitation hindered the verification of whether the improvement in unilateral neglect was owed to the treatment or whether it was attributable to spontaneous recovery.…”

Section: Introductionmentioning

confidence: 99%

A Complex Intervention Integrating Prism Adaptation and Neck Vibration for Unilateral Neglect in Patients of Chronic Stroke: A Randomised Controlled Trial

Choi

Lee

2022

IJERPH

View full text Add to dashboard Cite

Unilateral neglect in patients of chronic stroke reduces the quality of life and interferes with activities of daily living (ADL). This study aimed to investigate the effects of a complex rehabilitative programme that integrates prism adaptation (PA) and neck vibration (NV) for unilateral neglect in patients of chronic stroke. Thirty-six patients were randomised among the PA + NV group (Group A, n = 12), the NV-only group (Group B, n = 12), and the PA-only group (Group C, n = 12). The intervention was performed for 50 min/day, with five sessions per week, for 4 weeks. Albert’s test and the Catherine Bergego Scale were used to measure the effects of each intervention on unilateral neglect, whereas the modified Barthel Index was used to assess the effect on ADL. All three groups exhibited a reduction in unilateral neglect and an improvement in activities of daily living after the intervention (p < 0.05). Notably, Group A (PA + NV) exhibited a significantly greater level of reduction in unilateral neglect than the other groups (p < 0.05); however, the improvement in ADL did not significantly vary across the three groups (p > 0.05). This novel complex intervention comprising PA + NV is recommended for the rehabilitation, in the clinical setting, of patients of chronic stroke with unilateral neglect.

show abstract

“…On the other hand, the meta-analysis included studies in which the control group received a non-standard treatment intervention, for example, functional electrical stimulation (Choi et al, 2019). Therefore, the overall effect size estimate is not an absolute comparison of prism adaptation to treatment as usual.…”

Section: Introduction 11 Backgroundmentioning

confidence: 99%

No Immediate Treatment Effect of Prism Adaptation for Spatial Neglect: An Inclusive Meta-analysis

Székely¹,

Brink²,

Mitchell³

et al. 2022

Preprint

View full text Add to dashboard Cite

Despite nearly 25 years of research on the topic, there is still no consensus on whether prism adaptation is an effective therapy for visuospatial neglect. We present a meta-analysis from 1998 to 2021 on immediate treatment effects measured by paper-and-pencil clinical tests (BIT-C and cancellation tasks combined), and a standard assessment of neglect in everyday activities (Catherine Bergego Scale). We combined the Behavioural Inattention Test-conventional sub-tests (BIT-C) and cancellation scores into one random effect meta-analytic model, justified by the fact that 89% of the BIT-C score is determined by cancellation tasks. With this approach, we were able to obtain a larger dataset than previous meta-analyses while also including a more specific patient sample: right hemisphere stroke patients with left-sided neglect. We found no evidence for beneficial effects of prism adaptation within our main meta-analytic model (BIT-C/cancellation) where sixteen randomised and non-random controlled trials, altogether including 430 patients for the task of interest, were included. Nor did we find evidence for therapeutic effects as measured by CBS, albeit half as many studies were available for this analysis. The lack of effect was consistent after the removal of influential outliers, when studies with high risk-of-bias were excluded, and when an alternative measure of effect size was considered. These results do not support the routine use of prism adaptation as therapy for spatial neglect.

show abstract

The Effect of a Complex Intervention Program for Unilateral Neglect in Patients with Acute-Phase Stroke: A Randomized Controlled Trial

Cited by 8 publications

References 31 publications

Prism adaptation combined with eye movement training for unilateral spatial neglect after stroke: Study protocol for a single-blind prospective, randomized controlled trial

Prism adaptation combined with eye movement training for unilateral spatial neglect after stroke: Study protocol for a single-blind prospective, randomized controlled trial

A Complex Intervention Integrating Prism Adaptation and Neck Vibration for Unilateral Neglect in Patients of Chronic Stroke: A Randomised Controlled Trial

No Immediate Treatment Effect of Prism Adaptation for Spatial Neglect: An Inclusive Meta-analysis

Contact Info

Product

Resources

About