The Effects of Continuous vs. Intermittent Prism Adaptation Protocols for Treating Visuospatial Neglect: A Randomized Controlled Trial
Visuospatial neglect may interfere with activities of daily living (ADL). Prism adaptation (PA) is one treatment option and may involve two components: recalibration (more strategic) and realignment (more implicit). We examined whether recalibration or realignment is the driving force in neglect reh...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:a0f25235e2df4c2b96829cbfaf57f5c12021-11-19T04:52:45ZThe Effects of Continuous vs. Intermittent Prism Adaptation Protocols for Treating Visuospatial Neglect: A Randomized Controlled Trial1664-229510.3389/fneur.2021.742727https://doaj.org/article/a0f25235e2df4c2b96829cbfaf57f5c12021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.742727/fullhttps://doaj.org/toc/1664-2295Visuospatial neglect may interfere with activities of daily living (ADL). Prism adaptation (PA) is one treatment option and may involve two components: recalibration (more strategic) and realignment (more implicit). We examined whether recalibration or realignment is the driving force in neglect rehabilitation using PA. In a randomized controlled trial with two recruitment series and a cross-over design, 24 neglect patients were allocated to a continuous (PA-c) or intermittent (PA-i) PA procedure. During the PA-c condition, goggles were worn without doffing. In the PA-i condition, patients donned goggles twice (first series of patients) or three times (second series) during training to induce more recalibrations. Primary outcome parameters were performance (omissions) on the Apples Cancellation Test and ADL scores. To assess the efficacy of the PA treatment, we compared effect sizes of the current study with those from three groups from previous studies at the same rehabilitation unit: (1) a passive treatment with a similar intensity, (2) a placebo treatment with a similar intensity, and (3) a PA treatment with fewer therapy sessions. Treatment conditions did not significantly predict scores on primary and most secondary outcome parameters. However, the spontaneous ipsilesional body orientation improved only in patients receiving the PA-i condition and this improvement also appeared in patients showing a strong after-effect (irrespective of condition). Effect sizes for the Apples Cancellation Test and the Functional Independence Measure were larger for both PA treatment protocols than the historical control groups. We conclude that more recalibrations during an intermittent PA treatment may have a beneficial effect on spontaneous body orientation but not on other aspects of neglect or on ADL performance.Clinical Trial Registration: German Clinical Trials Register, identifier: DRKS00018813, DRKS00021539.Jannik Florian ScheffelsJannik Florian ScheffelsSona KorabovaSona KorabovaPaul ElingAndreas KastrupHelmut HildebrandtHelmut HildebrandtFrontiers Media S.A.articleneglectrehabilitationprism adaptationrecalibrationrealignmentintermittent trainingNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021) |
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neglect rehabilitation prism adaptation recalibration realignment intermittent training Neurology. Diseases of the nervous system RC346-429 |
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neglect rehabilitation prism adaptation recalibration realignment intermittent training Neurology. Diseases of the nervous system RC346-429 Jannik Florian Scheffels Jannik Florian Scheffels Sona Korabova Sona Korabova Paul Eling Andreas Kastrup Helmut Hildebrandt Helmut Hildebrandt The Effects of Continuous vs. Intermittent Prism Adaptation Protocols for Treating Visuospatial Neglect: A Randomized Controlled Trial |
| description |
Visuospatial neglect may interfere with activities of daily living (ADL). Prism adaptation (PA) is one treatment option and may involve two components: recalibration (more strategic) and realignment (more implicit). We examined whether recalibration or realignment is the driving force in neglect rehabilitation using PA. In a randomized controlled trial with two recruitment series and a cross-over design, 24 neglect patients were allocated to a continuous (PA-c) or intermittent (PA-i) PA procedure. During the PA-c condition, goggles were worn without doffing. In the PA-i condition, patients donned goggles twice (first series of patients) or three times (second series) during training to induce more recalibrations. Primary outcome parameters were performance (omissions) on the Apples Cancellation Test and ADL scores. To assess the efficacy of the PA treatment, we compared effect sizes of the current study with those from three groups from previous studies at the same rehabilitation unit: (1) a passive treatment with a similar intensity, (2) a placebo treatment with a similar intensity, and (3) a PA treatment with fewer therapy sessions. Treatment conditions did not significantly predict scores on primary and most secondary outcome parameters. However, the spontaneous ipsilesional body orientation improved only in patients receiving the PA-i condition and this improvement also appeared in patients showing a strong after-effect (irrespective of condition). Effect sizes for the Apples Cancellation Test and the Functional Independence Measure were larger for both PA treatment protocols than the historical control groups. We conclude that more recalibrations during an intermittent PA treatment may have a beneficial effect on spontaneous body orientation but not on other aspects of neglect or on ADL performance.Clinical Trial Registration: German Clinical Trials Register, identifier: DRKS00018813, DRKS00021539. |
| format |
article |
| author |
Jannik Florian Scheffels Jannik Florian Scheffels Sona Korabova Sona Korabova Paul Eling Andreas Kastrup Helmut Hildebrandt Helmut Hildebrandt |
| author_facet |
Jannik Florian Scheffels Jannik Florian Scheffels Sona Korabova Sona Korabova Paul Eling Andreas Kastrup Helmut Hildebrandt Helmut Hildebrandt |
| author_sort |
Jannik Florian Scheffels |
| title |
The Effects of Continuous vs. Intermittent Prism Adaptation Protocols for Treating Visuospatial Neglect: A Randomized Controlled Trial |
| title_short |
The Effects of Continuous vs. Intermittent Prism Adaptation Protocols for Treating Visuospatial Neglect: A Randomized Controlled Trial |
| title_full |
The Effects of Continuous vs. Intermittent Prism Adaptation Protocols for Treating Visuospatial Neglect: A Randomized Controlled Trial |
| title_fullStr |
The Effects of Continuous vs. Intermittent Prism Adaptation Protocols for Treating Visuospatial Neglect: A Randomized Controlled Trial |
| title_full_unstemmed |
The Effects of Continuous vs. Intermittent Prism Adaptation Protocols for Treating Visuospatial Neglect: A Randomized Controlled Trial |
| title_sort |
effects of continuous vs. intermittent prism adaptation protocols for treating visuospatial neglect: a randomized controlled trial |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/a0f25235e2df4c2b96829cbfaf57f5c1 |
| work_keys_str_mv |
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