Clinical and demographic predictors of unilateral spatial neglect recovery after prism therapy among stroke survivors in the sub-acute phase of recovery

ABSTRACT

BACKGROUND AND AIMS: Unilateral Spatial Neglect (USN) affects the rehabilitation process and leads to poor outcomes after stroke. Factors that influence USN recovery following prism adaptation therapy have not been investigated. This study investigated predictors of USN recovery after prism therapy at the sub-acute phase of recovery. METHODS: This study was a randomized controlled trial. USN was assessed with the Behavioural Inattention Test and Catherine Bergego scale. Seventy-four patients with USN were divided into control and intervention group (prism). The prism group used 20 dioptre prism lenses for repeated aiming for 12 sessions while the control group used neutral lenses for aiming training. Regression analysis was conducted to establish clinical and sociodemographic factors that influence USN recovery. RESULTS: Gender, age, years of education, race, employment status, handedness, type of stroke, time since stroke and site of stroke (p > 0.005) showed no significant influence on USN recovery following PA treatment. Higher Cognitive function (OR  = 1.52, CI = 1.08–2.14, p =  0.016) and group allocationng (being in the prism group) (OR = 63.10, CI =  9.70–410.59, P < 0.001) were found to significantly influence USN recovery following PA treatment session. CONCLUSIONS: A significant modulating effect on general cognitive ability was found in this study. This suggests that prism adaptation therapy’s effect on neural activity and spatial neglect depends on the cognitive function of stroke survivors.

Trial registration: Pan African Clinical Trial Registry identifier: PACTR201903732473573.

KEYWORDS:

• Unilateral spatial neglect
• Stroke
• Prism therapy
• Randomised control trial
• Physiotherapy

Acknowledgements

Special thanks to Dr Ajidahun Adedayo and Dr Juliet Nwachukwu-Umeonwuka for assisting with the statistical analysis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data emanating from this research is available upon Request.

Additional information

Funding

The work was supported for postgraduate degree funding received from the University of Witwatersrand, Faculty of Health Sciences, Medical Endowment Fund..