Department of Neurology, University Hospitals Schleswig-Holstein, Campus Lübeck, Germany; Neurological Center Segeberger Kliniken, Bad Segeberg, Germany.
Department of Neurology, University Hospitals Schleswig-Holstein, Campus Lübeck, Germany; Department of Psychology II, University of Lübeck, Germany.
Ann Phys Rehabil Med. 2023 Jun;66(5):101713. doi: 10.1016/j.rehab.2022.101713. Epub 2023 Jan 14.
Hemispatial neglect is a disabling cognitive disorder following stroke and effective therapies are required.
To evaluate the effects of combined optokinetic stimulation (OKS) and cueing-assisted reading therapy (READ) on the remission of hemispatial neglect following stroke.
Randomized, controlled, two-period, crossover trial conducted at a German neurorehabilitation center. Twenty participants with left neglect following right hemispheric stroke (mean age 66 years (SD 11), mean time since stroke 50 days (SD 33)) finished the trial (12 received OKSREAD first, 8 CONTROL first). The intervention consisted of 15 daily sessions of OKS (20 min) and text reading assisted by a therapist providing cues (20 min). The control treatment was a same-number, same-length neuropsychological treatment not targeting visuospatial attention. Primary outcomes were the change in performance of a customized neuropsychological test battery for neglect (0% worst - 100% best) and a test of neglect-related functional disability (Catherine Bergego Scale, 0 no impairment - 30 severest impairment), assessed before and after each treatment period. Secondary outcomes were performance in the 6 single tests composing the battery (e.g., omissions in text reading, center of cancellation in the Bells test, spatial bias of fixations when freely viewing photographs) and a clinical test of anosognosia.
Overall performance in the neglect test battery improved slightly more after OKSREAD than after CONTROL (d=6%; p=0.002). The remission of neglect-related functional disability did not differ between treatments (d=-2; p=0.291). Ipsilesional fixation bias during free viewing was the only secondary outcome that was improved by OKSREAD as compared to CONTROL (d= -2.8°; p=0.005).
At the applied intensity, the combined OKSREAD intervention slightly attenuated the ipsilesional attention bias in persons with neglect, but it did not improve neglect-related functional disability, anosognosia, or other neglect symptoms to a clinically meaningful degree.
URL: http://www.
gov. Unique identifier: NCT04273620.
半侧空间忽略是一种中风后导致的致残性认知障碍，需要有效的治疗方法。
评估组合式视动刺激（OKS）和提示辅助阅读疗法（READ）对中风后半侧空间忽略缓解的效果。
在德国神经康复中心进行的一项随机、对照、两周期、交叉试验。20 名右侧半球中风后出现左侧忽略的参与者（平均年龄 66 岁（SD 11），中风后时间 50 天（SD 33））完成了试验（12 名先接受 OKSREAD，8 名先接受 CONTROL）。干预措施包括 15 次每日的 OKS（20 分钟）和由治疗师提供提示的文本阅读辅助（20 分钟）。对照组治疗是相同数量、相同长度的非针对视觉空间注意力的神经心理学治疗。主要结局是忽略的定制神经心理学测试组合的表现变化（0%最差-100%最好）和忽略相关功能障碍的测试（Catherine Bergego 量表，0 无损伤-30 最严重损伤），在每个治疗期前后进行评估。次要结局是组成测试组合的 6 项单项测试中的表现（例如，文本阅读遗漏、Bells 测试中的中心取消、自由观看照片时的注视点空间偏差）和一种失认症的临床测试。
在忽略测试组合中的整体表现，在接受 OKSREAD 后比接受 CONTROL 后略有改善（d=6%；p=0.002）。忽略相关功能障碍的缓解在两种治疗方法之间没有差异（d=-2；p=0.291）。与 CONTROL 相比，仅在接受 OKSREAD 后，自由观看时的患侧注视偏差得到改善（d=-2.8°；p=0.005）。
在应用的强度下，组合式 OKSREAD 干预稍微减轻了忽略患者的患侧注意力偏差，但并没有在临床上显著改善忽略相关的功能障碍、失认症或其他忽略症状。
网址：http://www.。
NCT04273620。
