http://nnr.sagepub.com/content/27/2/142.abstract?etoc
Abstract
Background. Patients with right or more
rarely left parietotemporal lesions after stroke may have profound
visuospatial disorders that
impair activities of daily living (ADL) and
long-term outcome. Clinical studies indicate improvements with
systematic training
of perception. Studies of perceptual learning in
healthy persons suggest rapid improvements in perceptual learning of
spatial
line orientation with partial transfer to
nontrained line orientations. Objective. The authors investigated a novel feedback-based perceptual training procedure for the rehabilitation of patients after stroke.
Methods. In an uncontrolled trial, 13
participants showing profound deficits in line orientation and related
visuospatial tasks within
12 to 28 weeks of onset performed repetitive
feedback-based, computerized training of visual line orientation over4
weeks
of treatment. Visual line-orientation
discrimination and visuospatial and visuoconstructive tasks were
assessed before and
after training. Results. The authors found (a) rapid improvements in trained but also in nontrained spatial orientation tests in all 13 participants, partially up to a
normal level; (b) stability of the obtained improvements at 2-month follow-up; (c) interocular transfer of training effects to the nontrained eye in 2 participants suggesting a central, postchiasmatic locus
for this perceptual improvement; and (d)
graded transfer of improvements to related spatial tasks, such as
horizontal writing, analog clock reading, and visuoconstructive
capacities but no transfer to unrelated measures of
visual performance. Conclusions. These results suggest the potential for treatment-induced improvements in visuospatial deficits by feedback-based, perceptual
orientation training as a component of rehabilitation after stroke.
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