[ARTICLE] Efficacy of home-based visuomotor feedback training in stroke patients with chronic hemispatial neglect – Full Text

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 long-term 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, home-based rehabilitation method for neglect patients that warrants further investigation with well-designed randomised controlled trials on a large sample of patients.

Continue —> Efficacy of home-based visuomotor feedback training in stroke patients with chronic hemispatial neglect: Neuropsychological Rehabilitation: Vol 0, No 0

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Figure 3 of 5 Figure 3. (A) Lesion map for individual patients. B-C) Lesion overlap map summarising the degree of involvement for each voxel in the intervention (B; N = 8) and control (C; N = 5) groups. Lesions were identified by a clinical neurologist (K.M.), who was blind to the design, group assignment and purpose of the study. Lesions were mapped onto 11 axial slices of a T1-weighted template, corresponding to the MNI z coordinates of −24, −16, −8, 0, 8, 16, 24, 32, 40, 50, 60 mm using identical or closest matching transverse slices for each patient using MRIcro software package (Rorden & Brett, 2000 Rorden, C., & Brett, M. (2000). Stereotaxic display of brain lesions. Behavioural Neurology, 12, 191–200. doi: 10.1155/2000/421719 [CrossRef], [PubMed], [Web of Science ®] ). Due to technical difficulties at the clinical facility, we were able to obtain and map digital brain scans for 13 patients only (6 MRIs and 7 CTs) as the remaining digital brain scans were either lost or corrupted. Please note however, that all brain scan reports were available and confirmed the presence of a stroke and its location for all our patients. The range of colour scale derives from the absolute number of patient lesions involved in each voxel.

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