Department of Health Services Research, University of Liverpool, Liverpool, UK.
Department of Orthoptics, Salford Royal NHS Foundation Trust, Manchester, UK.
Brain Behav. 2018 Aug;8(8):e01041. doi: 10.1002/brb3.1041. Epub 2018 Jul 13.
To provide a systematic overview of the factors that influence how a person adapts to visual field loss following stroke.
A systematic review was undertaken (data search period 1861-2016) inclusive of systematic reviews, randomized controlled trials, controlled trials, cohort studies, observational studies, and case controlled studies. Studies including adult subjects with hemifield visual field loss, which occured as a direct consequence of stroke, were included. Search terms included a range of MESH terms as well as alternative terms relating to stroke, visual field loss, visual functions, visual perception, and adaptation. Articles were selected by two authors independently, and data were extracted by one author, being verified by the second. All included articles were assessed for risk of bias and quality using checklists appropriate to the study design.
Forty-seven articles (2,900 participants) were included in the overall review, categorized into two sections. Section one included seventeen studies where the reviewers were able to identify a factor they considered as likely to be important for the process of adaptation to poststroke visual field loss. Section two included thirty studies detailing interventions for visual field loss that the reviewers deemed likely to have an influence on the adaptation process. There were no studies identified which specifically investigated and summarized the factors that influence how a person adapts to visual field loss following stroke.
There is a substantial amount of evidence that patients can be supported to compensate and adapt to visual field loss following stroke using a range of strategies and methods. However, this systematic review highlights the fact that many unanswered questions in the area of adaptation to visual field loss remain. Further research is required on strategies and methods to improve adaptation to aid clinicians in supporting these patients along their rehabilitation journey.
系统综述影响脑卒中后视野缺损患者适应能力的相关因素。
系统检索了 1861 年至 2016 年期间发表的系统综述、随机对照试验、对照试验、队列研究、观察性研究和病例对照研究,纳入了成人半视野视野缺损患者的研究,这些患者的视野缺损是由脑卒中直接引起的。检索词包括一系列 MeSH 术语以及与脑卒中、视野缺损、视觉功能、视觉感知和适应相关的替代术语。由两名作者独立选择文章,由一名作者提取数据,并由另一名作者进行验证。所有纳入的文章均使用适用于研究设计的检查表进行了偏倚风险和质量评估。
共有 47 篇文章(2900 名参与者)纳入了总体综述,分为两部分。第一部分纳入了 17 项研究,其中综述者能够确定他们认为可能对适应脑卒中后视野缺损过程有重要影响的因素。第二部分纳入了 30 项详细描述针对视野缺损干预措施的研究,综述者认为这些措施可能会影响适应过程。没有研究专门调查和总结影响脑卒中后患者适应视野缺损的因素。
有大量证据表明,可以使用多种策略和方法来支持患者适应脑卒中后的视野缺损。然而,本次系统综述强调了一个事实,即在适应视野缺损领域仍有许多未解决的问题。需要进一步研究改善适应策略和方法,以帮助临床医生在患者康复过程中为其提供支持。