Page 97 - Petelin, Ana, ur. 2024. Zdravje delovno aktivnih in starejših odraslih / Health of Working-Age and Older Adults. Zbornik povzetkov z recenzijo ▪︎ Book of Abstracts. Koper: Založba Univerze na Primorskem/University of Primorska Press

Prism Adaptation for unilateral spatial neglect (USN) following stroke
– A Systematic Review

Bernarda Helbel, Matej Voglar
University of Primorska Faculty of Health Sciences, Izola, Slovenia

Introduction: Unilateral spatial neglect (USN), a common neurocognitive syndrome fol-
lowing stroke, results in biased behaviour towards the ipsilesional side. Despite its
previous association with right hemisphere damage, it occurs after left hemisphere in-
jury as well. USN involves attention deficits and extends beyond spatial bias, affecting
to affect various cognitive functions. The syndromes’ heterogeneity poses challeng-
es in pinpointing a singular dysfunction or lesion. Patients may exhibit diverse neglect
symptoms, supporting a heterogeneous account of visuospatial neglect. The breadth
of diversity encompasses more than just the origins, as interventions designed to alle-
viate the symptoms of USN are equally varied. One of the more researched interven-
tions for USN is Prism Adaptation (PA).
Methods: The main objective was to determine the effects of PA intervention for pa-
tients with unilateral spatial neglect (USN) after ischemic or haemorrhagic stroke, tak-
ing into account both the location of the brain lesion and the exhibited behavioural
symptoms, with a specific focus on discerning between allo- and ego-centric neglect.
The search was conducted on PubMed, Scopus, and PEDro, in which we sought for
randomised controlled studies using PA intervention in the rehabilitation of unilateral
spatial neglect in stroke patients. Inclusion criteria encompassed original English-lan-
guage articles from 2013 to 2024, focusing on studies related to ischemic or haem-
orrhagic stroke with unilateral neglect. Exclusion criteria targeted studies with phar-
macological treatments, crossover designs, pilot and feasibility studies, and specific
populations (traumatic brain injury, acquired brain injury, tumours). preventiva in rehabilitacija ... | prevention and rehabilitation ...
Results: Five studies were included in this systematic literature review with individ-
uals aged 46-68. Most used outcome measures to assess the severity of USN and
its sensory and motor symptoms, pre- and post- intervention, were the Catherine
Bergego Scale, Line Bisection Test and variations of the Broken Hearts Test, as well
as the Behavioural Inattention Test, among others. Most studies (4) report significant
short terms effects of PA on different aspects of USN. Out of the two studies that
assessed the long-term effects, one reports significant long-term effects of PA after
three months with no intervention,
Discussion and conclusions: In conclusion, PA has potential to be identified as an effec-
tive measure for ameliorating some of the various aspects of USN. Moving forward,
continued research is vital to refine interventions and to specify and unify the outcome
measures, thus possibly improving the functional outcomes for individuals affected by
neglect.
Keywords: unilateral spatial neglect, stroke, prism adaptation, neurorehabilitation,
CVA, hemispatial neglect

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