Prism Adaptation Treatment (PAT) for Right Brain Stroke Rehabilitation
VA Office of Research and Development
Summary
After a right brain stroke, \>50% of Veterans experience problems with dressing, eating, self-care or steering their wheelchairs because their ability to move, orient, and respond toward the left side is limited: spatial neglect. Spatial neglect prevents them from functioning independently, and their needs in the hospital and at home are greatly increased. An effective treatment for spatial neglect is 10 days of visuomotor training while wearing optical prisms (PAT), however many clinicians \[fail to diagnose spatial neglect and use this approach. In this study, the investigators will develop a brain scanning test that could objectively identify the Veterans with spatial neglect after stroke who are the best candidates to receive PAT and recover their ability to function. When the research is complete, the investigators expect that brain scans done in the hospital can guide the team to refer Veterans to PAT rehabilitation: improving daily life function\] and quality of life.
Description
Project Summary/Abstract The application addresses the formidable treatment gap for cognitive rehabilitation of spatial neglect (SN), defined as asymmetric orienting, perception, and responding to left space after right brain stroke, causing functional disability. Although Veterans with SN are half as likely to return home, have one-third the community mobility, require 3x as much caregiver supervision, and have longer hospitalizations, increased fall risk and increased rehospitalization compared with similar right brain stroke survivors, a personalized approach to SN rehabilitation is not ava…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Has had a first right brain stroke \>18 years of age * 1-4 months post-diagnosis of right brain stroke * Can sit up, see out of both eyes and point to objects (\>20/50 vision in both eyes) * Can give informed consent to participate Exclusion Criteria: * Has been diagnosed with other chronic, disabling neurological disorder (e.g. multiple sclerosis, Alzheimer Disease) * Has had a clinical left brain stroke or has neuroimaging evidence of prior stroke(s) including the presence of more than two lacunes with diameter greater than 15 mm. * Cannot sit up to be tested and rec…
Interventions
- BehavioralPrism adaptation therapy
The investigators' research and clinical group is the US leader in implementing this intervention for spatial neglect and have brought it to more than 50 clinical centers, hospitals, and treatment organizations.
Locations (4)
- VA Connecticut Healthcare System West Haven Campus, West Haven, CTWest Haven, Connecticut
- Atlanta VA Medical and Rehab Center, Decatur, GADecatur, Georgia
- VA Central Western Massachusetts Healthcare System, Leeds, MALeeds, Massachusetts
- Louis Stokes VA Medical Center, Cleveland, OHCleveland, Ohio