Department of Physical Medicine and Rehabilitation, Sunnyview Rehabilitation Hospital, Schenectady, NY, USA.
Department of Occupational Therapy, Sunnyview Rehabilitation Hospital, Schenectady, NY, USA.
NeuroRehabilitation. 2023;53(3):403-411. doi: 10.3233/NRE-230064.
BACKROUND: Spatial neglect (SN) after traumatic brain injury (TBI) is common, hindering rehabilitation progress and functional outcomes. Most research has focused on SN treatment after stroke with few published instances of post-TBI SN treated using prism adaptation treatment (PAT) in inpatient rehabilitation. OBJECTIVE: This case series characterizes the dose, after-effect, and treatment response of PAT in patients with SN after severe TBI. METHODS: Six patients exhibiting severe (n = 2), moderate (n = 2), or mild (n = 2) SN after severe TBI received 5 to 10 PAT sessions during their inpatient rehabilitation stay. Functional improvement in SN was measured by the Catherine Bergego Scale (CBS). RESULTS: Patients presented with a mean initial CBS score of 16.8 (range: 8.8-24.3). Prism after-effect was present after PAT. Following 5-10 sessions, the mean CBS score improved by 11.6 points to 5.2 (range: 7.8-21.8); the change in initial versus final CBS scores was significant (P = 0.031). CONCLUSION: This study is the first to demonstrate prism after-effect and functional SN improvement in individual patients with TBI. Patients showed a clinically meaningful improvement in mild, moderate, and severe SN following 5 to 10 PAT sessions. Additional studies are needed to assess tolerability, benefit, and optimal PAT dose for SN after TBI.
背景:创伤性脑损伤(TBI)后出现空间忽略(SN)很常见,这会阻碍康复进展和功能结果。大多数研究都集中在中风后的 SN 治疗上,很少有关于 TBI 后使用棱镜适应治疗(PAT)在住院康复中治疗 SN 的发表实例。
目的:本病例系列描述了严重 TBI 后 SN 患者接受 PAT 的剂量、后效和治疗反应。
方法:6 名患者在住院康复期间接受了 5 到 10 次 PAT 治疗,他们表现出严重(n=2)、中度(n=2)或轻度(n=2)SN。SN 的功能改善通过 Catherine Bergego 量表(CBS)进行测量。
结果:患者初始 CBS 评分平均为 16.8(范围:8.8-24.3)。PAT 后出现棱镜后效。经过 5-10 次治疗后,CBS 评分平均提高了 11.6 分,达到 5.2(范围:7.8-21.8);初始与最终 CBS 评分的变化具有统计学意义(P=0.031)。
结论:本研究首次证明了 TBI 个体患者的棱镜后效和功能 SN 改善。患者在接受 5 到 10 次 PAT 治疗后,轻度、中度和重度 SN 均出现了临床意义上的改善。需要进一步的研究来评估 TBI 后 SN 的耐受性、益处和最佳 PAT 剂量。
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