A team of post-stroke neurorehabilitation experts confirmed that the inclusion of prism adaptive therapy in standard care for patients with post-stroke spatial neglect improved functional and cognitive outcomes according to the measure of independence functional.®.
The article titled “Prism Adaptation Treatment Improves Inpatient Rehabilitation Outcome in Persons with Spatial Neglect: A Retrospective Paired Control Study” was published in Rehabilitation and clinical translation research archives on May XX, 2021.
The authors are Peii Chen, PhD, and Emma Kaplan, BS, of the Center for Stroke Rehabilitation Research at the Kessler Foundation; Nicole Diaz-Segarra, MD, of the Kessler Institute for Rehabilitation; Kimberly Hreha, EdD, OTR / L, University of Texas Medical Branch; and AM Barrett, MD, of the Atlanta VA Health Care System. Dr Chen also has an academic post at Rutgers New Jersey Medical School and Dr Barrett has an academic post at Emory University School of Medicine.
Recent research by Dr. Chen’s group shows that after a stroke, around 30% of people suffer from spatial neglect, a neurological disorder that disrupts a person’s “ internal GPS ” causing them to have difficulty navigating in its environment.
Spatial neglect can also affect people with other types of brain damage. Symptoms include poor balance and navigation as well as obstacles to reading and memory. In addition, spatial neglect slows the progress of rehabilitation and functional recovery, and increases the risk of injury.
Prismatic adaptation therapy shows great promise for therapy for spatial neglect, with some studies indicating that its beneficial effects can last for years. When fitting the prism, people wear glasses equipped with optical prisms that shift their motor movements to the neglected side. Through a ten-session program, individuals regain some ability to function in neglected space.
In this video, Dr. Chen demonstrates the Prism Adaptation Treatment and how it works.
However, prism adaptation therapy has only been tested as an adjunct therapy, with little data available regarding its effectiveness when incorporated into the standard of care for people with spatial neglect.
In this study, researchers analyzed data from patients with spatial neglect in 14 rehabilitation hospitals where the Kessler Foundation Prism Adaptation Treatment (KF-PAT®) was implemented in occupational therapy.
They compared the results of patients who received 8 to 12 daily sessions of prism adaptation treatment to untreated patients. The main measurable outcome was the Functional Independence Measure (FIM®) and the measurable secondary was the discharge destination.
The treated group showed higher scores than the untreated group in terms of full functional independence and cognitive functional independence. This is extremely encouraging evidence that incorporating prism adaptation into the standard of care for people with spatial neglect is beneficial.
Dr Peii Chen, Senior Scientist, Kessler Foundation
The results of the study did not show a significant effect on the rate of return home after discharge, and the authors note that more research on prism adaptation treatment in this population is needed to further clarify how optimize its efficiency.
Chen, P., et al. (2021) Prism fitting therapy improves inpatient rehabilitation outcome in people with spatial neglect: a retrospective paired control study. Rehabilitation and clinical translation research archives. doi.org/10.1016/j.arrct.2021.100130.