Ludwig Maximilian University, Munich, Germany.
Neurorehabil Neural Repair. 2013 Feb;27(2):142-52. doi: 10.1177/1545968312457826. Epub 2012 Sep 11.
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.
The authors investigated a novel feedback-based perceptual training procedure for the rehabilitation of patients after stroke.
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 over 4 weeks of treatment. Visual line-orientation discrimination and visuospatial and visuoconstructive tasks were assessed before and after training.
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.
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.
中风后右侧或更罕见的左侧顶颞叶损伤的患者可能存在严重的视空间障碍，这会影响日常生活活动（ADL）和长期预后。临床研究表明，系统的知觉训练可以改善这些障碍。健康人群的知觉学习研究表明，空间线方向知觉的快速改善具有部分向未训练线方向的转移。
作者研究了一种新的基于反馈的知觉训练程序，用于中风后患者的康复。
在一项非对照试验中，13 名患者在中风后 12 至 28 周内表现出线方向和相关视空间任务的严重缺陷，接受了 4 周治疗的重复基于反馈的计算机化视觉线方向训练。在训练前后评估了视觉线定向辨别以及视空间和视构建任务。
作者发现：（a）13 名参与者的训练和非训练空间定向测试均迅速改善，部分达到正常水平；（b）在 2 个月随访时，获得的改善稳定；（c）2 名参与者的训练效果在未训练眼出现眼间转移，提示这种知觉改善的中枢后交叉点位置；（d）改善程度向相关空间任务（如水平书写、模拟时钟阅读和视构建能力）的分级转移，但与视觉表现无关的测量无转移。
这些结果表明，基于反馈的知觉定向训练作为中风后康复的一部分，对视空间缺陷的治疗诱导改善具有潜在作用。
