Cognition

Postée le 01/12/2022

09:00

Prism Adaptation Treatment for Improving Spatial Neglect and Rehabilitation Outcome

Peii Chen (New York, Usa)

Spatial neglect occurs in 20-40% of individuals with unilateral brain injury, especially stroke. This neuropsychological disorder impedes rehabilitation outcome and slows functional recovery. Several treatments have been developed over the past three decades, but the effectiveness of any given treatment is inconclusive due to the complexity of spatial neglect symptoms and thus underlying neural mechanisms, the lack of standardized treatment protocols, the limitations of research resources to clarify treatment intensity and dosage, and the wide variety of rehabilitation care systems across different countries. While definite effectiveness is still unknown, prism adaptation treatment (PAT) is recommended by multiple guidelines for treating SN based on results of independent clinical trials and meta-analyses. In this lecture, I will briefly introduce how PAT works, demonstrate its effect, offer evidence from my research group, and share experience related to clinical implementation. In particular, I will share the latest findings from a large dataset of 2491 patients’ clinical records. The records came from 16 U.S. rehabilitation hospitals across 11 states. What we found is that receiving more once-daily PAT sessions was associated with greater improvement in spatial neglect as well as rehabilitation outcomes in terms of functional independence. In addition, receiving PAT at a higher frequency (i.e., fewer days between two sessions) for more than 8 sessions predicted better SN improvement. The study provided practice-based evidence that PAT is effective and appropriate in the inpatient rehabilitation setting.