Impacts of Prism Adaptation Treatment on Spatial Neglect and Rehabilitation Outcome: Dosage Matters

 But you didn't write up and distribute a protocol on this, SO USELESS!

Impacts of Prism Adaptation Treatment on Spatial Neglect and Rehabilitation Outcome: Dosage Matters

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Peii Chen, PhD, Kimberly Hreha, EdD, Chris Gonzalez-Snyder, MBA, MA, ...

First Published June 8, 2022 Research Article Find in PubMed 

https://doi.org/10.1177/15459683221107891

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Abstract

We examined whether number of prism adaptation treatment (PAT) sessions in regular clinical practice would predict spatial neglect (SN) improvement and rehabilitation outcomes. We reviewed clinical records from 16 U.S. rehabilitation hospitals where neurological patients were assessed for SN using the Catherine Bergego Scale (CBS) and if SN was detected, and may have received PAT. Multiple linear regression was used to predict CBS Change (indicating SN improvement) in 520 patients who received PAT while considering age, sex, diagnosis, time post diagnosis, CBS at baseline, neglected side of space, and length of stay. Another set of regression models including the same variables and adding Function Independent Measure (FIM®) at admission was used to predict FIM Gains (indicating rehabilitation outcomes) in 1720 patients receiving PAT or not. We found that greater number of PAT sessions predicted greater CBS Change, especially in patients with moderate-to-severe neglect. Number of PAT sessions also positively correlated with Total FIM, Motor FIM, and Cognitive FIM Gains regardless of SN severity classification at baseline. Furthermore, number of PAT sessions predicted CBS Change and FIM Gains among patients completing ≤8 PAT sessions but not among patients with ≥8 sessions, who however, showed greater CBS Change with increased PAT frequency (i.e., fewer days between two consecutive sessions). Receiving more once-daily PAT sessions predicted greater improvement in SN and rehabilitation outcomes. Receiving PAT at a higher frequency for 8 or more sessions predicted better SN improvement. Thus, dosage matters. The study provides practice-based evidence that PAT is appropriate for inpatient rehabilitation.

Keywords

inpatient rehabilitation, neurorehabilitation, hemispatial neglect, rehabilitation outcomes, occupational therapy

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Kessler Foundation awarded $50,000 grant to study outcomes of new stroke therapy

In case you want to figure out a way to get to use this therapy. Notice that the ASA, NSA and WSO are not involved, shows you their complete lack of influence in stroke.

Kessler Foundation awarded $50,000 grant to study outcomes of new stroke therapy

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Reviewed by James Ives, MPsychSep 11 2018

Kessler Foundation has been awarded a $50,000 grant by the Charles and Ann Serraino Foundation, Inc. The two-year grant will advance the Foundation's practice-based stroke rehabilitation research to advance the diagnosis and treatment of spatial neglect, a hidden disability that complicates recovery after brain injury, especially right brain stroke.

Ten rehabilitation facilities across the U.S. currently implement Kessler Foundation's spatial neglect assessment and treatment protocols, the Kessler Foundation Neglect Assessment Process (KF-NAP™), and the Kessler Foundation Prism Adaptation Treatment (KF-PAT™). Therapy teams at each center are tracking and reporting their use of these tools. This grant enables investigators at Kessler Foundation to analyze the impact of the care processes--whether, across this network of care providers, this rehabilitation may enhance functional recovery.

"Through this support, we will be able to examine the impact of our treatment program on the recovery and independence of stroke survivors, their successfully returning to home, the community, and the workplace," remarked AM Barrett, MD, director of Stroke Rehabilitation Research at Kessler Foundation. "We expect to confirm numerous previous controlled trials that indicated functional benefit of spatial neglect care, and we believe better recovery will translate into improvements across important clinical benchmarks for stroke rehabilitation, including lower fall rates and higher rates of home discharge," noted Dr. Barrett. "Our aim is to present evidence of enhanced quality care and cost-efficacy with the system. If successful, these results can then be leveraged to influence medical systems and third-party payers to adopt prism adaptation therapy as a standard of care for stroke survivors across the country."

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• Penumbra introduces new advancements in stroke thrombectomy aspiration technology

The Charles and Ann Serraino Foundation, Inc., a nonprofit organization based in Hasbrouck Heights, NJ, is dedicated to supporting quality of life for senior citizens. "This gift from the Charles and Ann Serraino Foundation will significantly advance the Foundation's stroke rehabilitation research in the treatment of spatial neglect," said Michele Pignatello, chief development officer of Kessler Foundation. "With this support, senior stroke survivors will gain better access to quality care, which will allow them stay engaged in family life and the community."

"Charles Serraino, who was a former Board member of Kessler Institute, was committed to giving back through accessible and preventative healthcare," remarked Joanne Serraino, President of the Charles and Ann Serraino Foundation. "This grant upholds his vision in providing improved care for seniors who have had a stroke, and ultimately, preserving quality of life. I am happy to partner with an organization that shares the same innovative values as my father, Charles Serraino, and look forward to the future."

Source:

https://kesslerfoundation.org/content/kessler-foundation-receives-grant-study-outcomes-new-stroke-treatment

Prism Adaptation in Rehabilitation? No Additional Effects of Prism Adaptation on Neglect Recovery in the Subacute Phase Poststroke: A Randomized Controlled Trial

In case your doctor failed at getting you 100% recovered you might need this intervention that doesn't even give efficacy ratings or any idea what objective diagnosis might signal use of this. Your doctor is flailing in the dark trying to get you recovered. I bet your doctor knows nothing specific about how to get you recovered. 

Prism Adaptation in Rehabilitation? No Additional Effects of Prism Adaptation on Neglect Recovery in the Subacute Phase Poststroke: A Randomized Controlled Trial

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Antonia F. Ten Brink, MSc¹²

Antonia F. Ten Brink

1University Medical Center Utrecht, Netherlands2De Hoogstraat Rehabilitation, Utrecht, Netherlands
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, Johanna M. A. Visser-Meily, PhD¹²

Johanna M. A. Visser-Meily

1University Medical Center Utrecht, Netherlands2De Hoogstraat Rehabilitation, Utrecht, Netherlands
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, Martijn J. Schut, MSc³

Martijn J. Schut

3Utrecht University, Netherlands
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Mirjam Kouwenhoven, MD²

Mirjam Kouwenhoven

2De Hoogstraat Rehabilitation, Utrecht, Netherlands
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, Anja L. H. Eijsackers, MSc²

Anja L. H. Eijsackers

2De Hoogstraat Rehabilitation, Utrecht, Netherlands
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, Tanja C. W. Nijboer, PhD¹³

Tanja C. W. Nijboer

1University Medical Center Utrecht, Netherlands3Utrecht University, Netherlands
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...

First Published December 1, 2017 Research Article

https://doi.org/10.1177/1545968317744277

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Article Information

Article first published online: December 1, 2017

https://doi.org/10.1177/1545968317744277

Antonia F. Ten Brink, MSc^{1, 2}, Johanna M. A. Visser-Meily, PhD^{1, 2}, Martijn J. Schut, MSc³, Mirjam Kouwenhoven, MD², Anja L. H. Eijsackers, MSc², Tanja C. W. Nijboer, PhD^{1, 3}

¹University Medical Center Utrecht, Netherlands

²De Hoogstraat Rehabilitation, Utrecht, Netherlands

³Utrecht University, Netherlands

Corresponding Author: Tanja C. W. Nijboer, PhD, Department of Experimental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, Netherlands. Email: t.c.w.nijboer@uu.nl

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Abstract

Background. Patients with neglect ignore or respond slower to contralesional stimuli. Neglect negatively influences independence in activities of daily living (ADL). Prism adaptation (PA) is one of the most frequently studied treatments, yet there is little evidence regarding positive effects on neglect behavior in ADL.
Objective. To assess whether PA in the subacute phase ameliorates neglect in situations of varying complexity.
Methods. A total of 70 neglect patients admitted for inpatient stroke rehabilitation received either PA or sham adaptation (SA) for 2 weeks, with full access to standard treatment. There were 7 time-dependent measurements (baseline and 1-4, 6, and 14 weeks after start of treatment). The primary outcome was change of neglect as observed during basic ADL with the Catherine Bergego Scale (CBS). Secondary outcomes were changes in performance on a dynamic multitask (ie, the Mobility Assessment Course [MAC]) and a static paper-and-pencil task (ie, a shape cancellation task [SC]). Results. In all, 34 patients received PA and 35 SA. There were significant time-dependent improvements in performance as measured with the CBS, MAC, and SC (all F > 15.57; P < .001). There was no significant difference in magnitude of improvement between groups on the CBS, MAC, and SC (all F < 2.54; P > .113].
Conclusions. No beneficial effects of PA over SA in the subacute phase poststroke were observed, which was comparable for situations of varying complexity. Heterogeneity of the syndrome, time post–stroke onset, and the content of treatment as usual are discussed. Basic knowledge on subtypes and recovery patterns would aid the development of tailored treatment.

Researchers explore five new avenues for rehabilitation research

Sorry Dr. Barrett, these rehabilitation areas are not where research should be directed. You need to stop the neuronal cascade of death for the best return on recovery.
http://medicalxpress.com/news/2013-11-explore-avenues.html
Because the concept of permanent neurological injury has given way to recognition of the brain's potential for long-term regeneration ad reorganization, rehabilitations strategies are undergoing radical changes. The potential for five new translational interventions was examined in an article published ahead of print on November 13 by Neurology Clinical Practice.

Medical resources are limited, so it is important to focus on areas of greatest potential, according to Dr. Barrett, and strive for advances that translate to effective treatments in the shortest possible timeframes. An emphasis on experience-dependent learning is advised, as well as biological techniques that induce a permissive state for the development of new, optimal, functional brain activation patterns. "The five treatments we identified are based on behavioral (1, 2, 3), or non-invasive physiological stimulation (4, 5)," said Dr. Barrett. "While these have been explored primarily in stroke rehabilitation, they are potentially applicable to other neurological conditions such as brain injury, spinal cord injury and multiple sclerosis."

• Constraint-induced movement therapy, and other intensive, experience-dependent learning, may improve rehabilitation outcomes in people with hemiparesis from stroke and other brain disorders.
• Constraint-induced language therapy, and other methods to stimulate speech and motor output, may improve rehabilitation outcomes in aphasia.
• Prism adaptation therapy, and therapies using virtual feedback and implicitly integrating 3-D motor and perceptual function, may improve function in spatial neglect.
• Transcranial magnetic stimulation may induce a permissive brain state therapeutic for depression and promoting better motor and cognitive recovery.
• Transcranial direct current stimulation might promote better mood, motor and cognitive rehabilitation outcomes, and has an appealing risk/cost profile for feasible future implementation.

Prism adaptation theory in unilateral neglect: motor and perceptual components

If you have this I'm sure your doctor can explain this article.
http://www.frontiersin.org/Journal/10.3389/fnhum.2013.00728/full?utm_source=newsletter&utm_medium=email&utm_campaign=Neuroscience-w46-2013

Styrmir Saevarsson^*

• Clinical Neuropsychology Research Group (EKN), Bogenhausen University Hospital, Munich, Germany

A commentary on
The influence of prism adaptation on perceptual and motor components of neglect: a reply to Saevarsson and Kristjánsson

by Striemer, C. L., and Danckert, J. (2013). Front. Hum. Neurosci. 7:255. doi: 10.3389/fnhum.2013.00255

Dissociating perceptual and motor effects of prism adaptation in spatial neglect
By Striemer, C., and Danckert, J. (2010a). Neuroreport 21, 436–441. doi: 10.1097/WNR.0b013e328338592f

Through a prism darkly: re-evaluating prisms and neglect
By Striemer, C., and Danckert, J. (2010b). Trends Cogn. Sci. 14, 308–316. doi: 10.1016/j.tics.2010.04.001

Striemer and Danckert (2010a) suggest that prism adaptation (PA) has beneficial effects primarily on spatial attention and the motor components of neglect, and that the direct effects on visual neglect are insignificant. The main support for their influential hypothesis (e.g., Saj et al., 2013) comes from their own study (Striemer and Danckert, 2010b), but Saevarsson and Kristjánsson (2013) criticize their interpretations, and call for another possible evaluation of their data. Striemer and Danckert (2013) reply to this criticism; however, there are a number of controversial and fundamental issues that remain unresolved in this debate which future empirical studies need to consider, to explain “how PA remediates symptoms of neglect” (Striemer and Danckert, 2013, p. 2).

Your doctor can read the rest at the link including references.