Feasibility of Using Prism Adaptation to Treat Spatial Neglect and Motor Function in Stroke

This research project is a study designed to address both motor and cognitive changes after
stroke, two common stroke disabilities. For example: two third of patients reported loss of
upper limb function as a major problem after stroke and spatial neglect occurs in more than
350,000 US right hemisphere stroke survivors annually. These two impairments if not treated,
lead to immediate impairment in basic life activities, long term functional disability,
increased risk for falls and increased healthcare costs. The literature displays many strong
research studies that trialed the use of multiple treatment approaches to remediate spatial
neglect, including prism adaptation treatment (PAT), resulting in positive results. Similar
findings result for treatment studies that attempt to remediate the upper extremity (UE).
However, in all group of patients that were tested in these studies (both for spatial
neglect and UE dysfunction) only had one stroke and past medical histories that were
unremarkable. Rehabilitation professionals help clients that have had all types of strokes
achieve improved quality of life by helping to increase independence by remediating
impairment. In addition, these professionals need to know more about the effects of PAT in
stroke survivors with multiple lesions because these are patients commonly being treated in
the clinical setting. Also, it has not been investigated whether using PAT, a very promising
and easy to administer treatment, to remediate spatial neglect will also increase
spontaneous UE movement of the limb affected by the stroke because of an influence on
motor-intentional aiming errors. Thus, in this pilot research proposal, the researcher
intends to first investigate the feasibility of this two week treatment on stroke survivors
that have had multiple lesions and second verify if PAT will improve spatial neglect and
jointly increase spontaneous movement of the UE.

Inclusion Criteria:

- Between the ages of 18 and 90.

- New stroke on the right side of the brain.

- Has an UE impairment of the arm affected by the stroke (WMFT score of less than 75).

- Has the presence of spatial neglect (greater than 1 on the KF-NAP).

- Is able to give informed consent.

- Past medical history includes having had a stroke or more than one. This can be
ischemic or hemorrhagic, and on either side of the brain.

Exclusion Criteria:

- Is under the age of 18.

- Has severe communication deficit.

- Has a left brain stroke as the primary diagnosis and/or the primary diagnosis is
anything other than stroke.

- Is blind in one or both eyes.

- Is not staying at the inpatient rehabilitation hospital

- Has a cognitive impairment that inhibits their ability to recall information.

- Has severely impaired upper extremity function in bilateral arms (cannot participate
in the prism task).