Dosage of prism adaptation treatments in a hospital setting

image: Kessler Foundation researchers have developed tools based on prism adaptation to assess and treat spatial neglect, an often overlooked consequence of stroke.
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Credit: Kessler Foundation/Jody Banks

Eastern Hanover, NJ. September 7, 2022. A team of stroke researchers found that the dosage of Prism Adaptive Therapy was correlated with improvement in post-stroke spatial neglect as well as rehabilitation outcomes. Their findings appeared in Neurorehabilitation and neural repair in the article, “Impacts of prism adaptation treatment on spatial neglect and recovery result: Dosage Matters”, (DOI: 10.1177/15459683221107891) published online June 8, 2022. The authors are Peii Chen, PhD, Kimberley Hreha, EdD, Chris Gonzalez-Snyder, MBA, MA, Timothy Rich, PhD, Robert W. Gillen, PhD, Devan Parrott, PhD, and AM Barrett, MD.

Spatial neglect, a common cause of functional disability after stroke and other types of brain injury, is a consequence of damage to neural networks that process spatial information and attentional control. A third of stroke survivors suffer from spatial neglect, which increases their risk of prolonged hospitalization, injury, poor motor recovery and discharge to long-term care facilities. Prism Adaptive Treatment (PAT) has shown promise in reducing symptoms of spatial neglect and improving rehabilitation outcomes, but further research was needed to determine the optimal frequency and number of sessions needed to improve outcomes. results.

To gain insight, clinical records were collected from a network of 16 rehabilitation hospitals in 11 states, staffed by occupational therapists trained in the assessment of spatial neglect (Kessler Foundation Neglect Assessment Process, KF-NAP®) and treatment (Kessler Foundation Prism Adaptation Therapy, KF-PAT®). The sample included 2,415 patients; 520 patients had Catherine Bergego scores (CBS via KF-NAP) before and after PAT; and 1,720 had FIM® (Functional Independence Measure) scores at admission/discharge, including 715 with PAT data and 349 with CBS and FIM data.

“We found that more once-daily PAT sessions were correlated with greater improvement in spatial neglect,” said lead author Dr. Chen, senior researcher at the Center for Stroke Rehabilitation Research. of the Kessler Foundation. “Additionally, more PAT sessions showed greater beneficial impacts on rehabilitation, as measured by functional gains from admission to discharge. And the frequency of PAT sessions was also a factor,” a- she added, “with those who received more than eight sessions with fewer days between sessions achieving even greater improvement. Thus, dosage, defined as the number of PAT sessions, matters. Our study supports the implementation implementation of PAT in rehabilitative care for spatial neglect, with the goal of maximizing functional recovery and minimizing caregiver burden.

Based on these findings, the team advises starting PAT early during rehabilitation to allow patients to receive higher doses of therapy. Further analyzes will examine the impact of timing of therapy during inpatient rehabilitation on outcomes, and whether outcomes differ between right-sided and left-sided spatial neglect. Future studies are needed to assess the long-term impact of PAT and whether patients may benefit from an additional PAT session after discharge.

Learn more about the clinical tools developed for the assessment and treatment of spatial neglect at the Kessler Foundation Learning Center (kflearn.org)

For more information on ongoing stroke research studies, visit Studies | Kesler Foundation

Funding: Kessler Foundation, Wallerstein Foundation for Geriatric Improvement and Charles and Ann Serraino Foundation

Visit the Kessler Foundation Learning Center (kflearn.org) for information on tools for diagnosing and treating spatial neglect.

About the Kessler Foundation Center for Stroke Rehabilitation Research:

Research studies cover all areas of post-stroke dysfunction, including cognitive deficits and mobility impairments. Stroke researchers also mentor students, resident physicians, and postdoctoral fellows in translational neuroscience of rehabilitation. Cognitive research emphasizes hidden disabilities after stroke, including impairments in functional vision (spatial bias and spatial neglect) and reading deficits. Related research focuses on risk factors for delirium and medication adherence. Mobility research, in partnership with the Mobility and Rehabilitation Engineering Research Center, focuses on the application of new technologies for the functional restoration of the upper and lower limbs. Stroke research receives funding from federal, state, and private sources. The scientists have faculty appointments at Rutgers New Jersey Medical School.

About the Kessler Foundation:

The Kessler Foundation, a leading disability non-profit organization, is a world leader in rehabilitation research that aims to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disorders caused by diseases and brain damage. and the spinal cord. The Kessler Foundation is the national leader in funding innovative programs that expand employment opportunities for people with disabilities.

For more information on ongoing stroke rehabilitation research at the Kessler Foundation, visit Studies | Kesler Foundation.

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To interview Dr. Chen, contact:

Carolann Murphy, [email protected]

Deb Hauss, [email protected]

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Pei Chen, Ph.D.

Dr. Chen, senior researcher at the Kessler Foundation Stroke Rehabilitation Center. She directs the Attention, Consciousness, and Spatial Abilities Laboratory, which focuses on new approaches for treating cognitive deficits caused by stroke, brain injury, and other neurological conditions.

Using prism glasses to treat someone with post-stroke spatial neglect

Kessler Foundation researchers have developed tools based on prism adaptation to assess and treat spatial neglect, an often overlooked consequence of stroke.


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