http://nnr.sagepub.com/content/26/5/463.abstract?etoc
Abstract
Background and Purpose. Compensatory and
restorative treatments have been developed to improve visual field
defects after stroke. However, no controlled
trials have compared these interventions with
standard occupational therapy (OT). Methods. A total of 45
stroke participants with visual field defect admitted for inpatient
rehabilitation were randomized to restorative
computerized training (RT) using computer-based
stimulation of border areas of their visual field defects or to a
computer-based
compensatory therapy (CT) teaching a visual search
strategy. OT, in which different compensation strategies were used to
train
for activities of daily living, served as standard
treatment for the active control group. Each treatment group received 15
single sessions of 30 minutes distributed over 3
weeks. The primary outcome measures were visual field expansion for RT,
visual
search performance for CT, and reading performance
for both treatments. Visual conjunction search, alertness, and the
Barthel
Index were secondary outcomes. Results.
Compared with OT, CT resulted in a better visual search performance, and
RT did not result in a larger expansion of the
visual field. Intragroup pre–post comparisons
demonstrated that CT improved all defined outcome parameters and RT
several,
whereas OT only improved one. Conclusions.
CT improved functional deficits after visual field loss compared with
standard OT and may be the intervention of choice
during inpatient rehabilitation. A larger trial
that includes lesion location in the analysis is recommended.
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