Posts Tagged hemispatial neglect
Researchers at UK-based University of East Anglia (UEA), in collaboration with Evolv Rehabilitation Technologies, have created a new virtual reality (VR) gaming platform designed to help improve the lives of stroke patients suffering from complex neurological syndromes caused by their stroke.
The new technology, which has been funded by the National Institute for Health Research (NIHR), was recently unveiled at RehabWeek in Toronto.
Around 30% to 50% of stroke survivors experience hemispatial neglect, which leaves people unaware of things located on one side of their body and greatly reduces their ability to live independently.
“A stroke can damage the brain, so that it no longer receives information about the space around one side of the world,” lead researcher Dr Stephanie Rossit, from UEA’s school of Psychology, explains in a media release from UEA.
“If this happens, people may not be aware of anything on one side, usually the same side they also lost their movement. This is called hemispatial neglect.
“These people tend to have very poor recovery and are left with long-term disability. Patients with this condition tell us that it is terrifying. They bump into things, they’re scared to use a wheelchair, so it really is very severe and life-changing.”
Current rehabilitation treatments involve different types of visual and physical coordination tasks (visuomotor) and cognitive exercises, many of which are paper and pen-based.
The new non-immersive VR technology being showcased updates these paper and pen tasks for the digital age – using videogame technology instead, per the release.
“We know that adherence is key to recovery – so we wanted to create something that makes it fun to stick to a rehabilitation task,” Roissit adds.
In one such game, the patient sees a random series of apples, some complete and some with a piece bitten off. The apples vibrate and move to provide greater stimulation to the patient.
“The aim for the patient is to choose the maximum number of complete apples that they see in the quickest time possible,” states David Fried, CEO of Evolv.
“A person with visual neglect would quite often only see a small number of correct targets to the right-hand side of the screen. Therapists can control the complexity of the game by increasing or reducing the number of apples on screen.”
As well as aiding diagnosis, the new game aims to improve rehabilitation by including elements such as scoring and rewards to engage the patient and improve adherence to their treatment.
Fried said: “Traditional rehabilitation treatment is quite monotonous and boring, so this gamification aspect is really important to help people stick with their treatment,” Fried adds.
“Our goal is to use technology to make rehabilitation fun and engaging, and we have applied this to our Spatial Neglect therapy solution. The great thing about it is that it can be used not only in clinics but also in patients’ homes, thereby giving them access to personalized rehabilitation without leaving their living room.”
The team has previously worked with stroke survivors, carers, and clinicians to assess the feasibility, usability, and acceptability of new gaming technology, per the release.
Dr Rossit said: ³This technology has the potential to improve both independence and quality of life of stroke survivors,” Rossit shares.
“This innovative therapy could also improve long-term care after stroke by providing a low-cost, enjoyable therapy that can be self-administered anywhere and anytime, without the need for a therapist to be present on every occasion.”
[Source: University of East Anglia]
[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.
Left neglect, also known as unilateral neglect or hemispatial neglect, is one of the oddest symptoms of a brain injury. It can also be one of the most troublesome symptoms. Left neglect is a deficit that occurs following an injury to the right side of the brain. Due to the injury, the brain has difficulty paying attention to items on the left side. This is generally most apparent in difficulties noticing items visually on the left side. For instance, a survivor with left neglect may bump into frames of doors on the his or her left or miss eating food on the left side of his or her plate. It appears as if he or she is blind to items on the left but this is not a true vision issue. It is an attention issue. The brain is not attending to information on the left. The survivor can have…
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[ARTICLE] Effects of contralesional robot-assisted hand training in patients with unilateral spatial neglect following stroke: a case series study
Background: A reduction of hemispatial neglect due to stroke has been associated with activation of the contralesional hand in the contralesional hemispace. Robot-assisted upper limb training was found to effectively improve paretic arm function in stroke patients. To date no proof of concept of robot-assisted hemispatial neglect therapy has been reported in literature. This study aimed to determine whether robot-assisted left (contralesional) hand activation alone could lead to an improvement in hemispatial neglect following stroke.
Methods: Three stroke patients with right brain injury underwent a 2-week training program of robotic left hand activation with the Gloreha(R) hand rehabilitation glove, which provides repetitive, passive mobilization of the fingers. Outcomes were assessed using the Line Crossing test, the Bells test, the Sentence Reading test, the Saccadic Training, the Sustained Attention to Response Task, and the Purdue Pegboard test.
Results: Changes were observed after treatment as follows. Line Crossing test: all patients showed improved performance (6.7%, 89.5% and 80% increase in lines crossed) with two patients reaching normal performance levels. Bells test: one patient improved performance (50% increase), while one patient showed no change and one patient declined (-10.3% change); no patient reached normal performance levels. Sentence Reading test: all patients showed improved performance (800%, 57.1% and 42.9% increase in number of sentences read) with no patient reaching normal performance level. Saccadic Training: all patients showed improved performance (-62.8%, -15.5% and -9.7% change of the left hemifield reaction time). Sustained Attention to Response Task: all patients showed improved performance (-20.5%, -5.8% and -10% change of the reaction time) with two patients reducing incorrect responses (-42.9% and -73.3%) and one patient increasing them (9.1%). Purdue Pegboard test: all patients showed improved performance (100%, 27.3% and 75% change in the left + right + both hands sub-item score).
Conclusions: Some caution is warranted when interpreting our results, as the responses to the intervention were variable and might have been due to a placebo effect or fluctuating clinical conditions. However, robot-assisted hemispatial neglect therapy might be useful in stroke patients. Larger-scale investigations are needed to confirm our preliminary findings.
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.