Prism adaptation treatment to address spatial neglect in an intensive rehabilitation program: A randomized pilot and feasibility trial
Abstract
Spatial neglect (SN) is 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 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 SN patients were randomized to the PAT group and the Sham PAT 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) specific to SN.
Patients were assessed at baseline, immediately after treatment, two weeks after treatment, and four weeks after treatment. A total of 23 patients 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 PAT 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 investigation is required to uncover the mechanisms underlying PAT and Sham PAT in order to refine the treatment or create new interventions.