Feedback Training Improves the Lives of Stroke Survivors

A new study concludes that home-based visuomotor feedback training (VFT) can help treat chronic hemispatial neglect, a severe cognitive condition frequently observed after a stroke.

Researchers at the University of East Anglia and the University of Glasgow conducted a study to compare immediate and long-term effects of VFT, a rehabilitation technique that involves a simple, inexpensive, and individual training method that involves grasping-to-lift of rods at their center in order to treat hemispatial neglect, a severe cognitive condition that is associated with unawareness of one side of space, disability, and poor long-term outcome.

The study involved 20 stroke survivors with visual neglect who trained in their homes in Glasgow (Scotland). The patients were randomly allocated to VFT or a control group. VFT was delivered for two sessions by an experimenter and then self-administered for 10 sessions over two weeks. The results were evaluated after these sessions, and again four months after therapy ended. Outcome measures included the behavioral inattention test (BIT), line bisection, balloons test, landmark task, room description task, subjective straight-ahead pointing task, and the stroke impact scale.

The results showed that VFT produces marked and long-lasting improvements in visual neglect, even after just one hour of therapy. In particular, patients who received VFT were able to find many more items in their 'neglected' side of space than before treatment, and these improvements remained after the therapy had finished. The researchers also found that VFT improved aspects of the patients' daily lives, such as eating, dressing and social activities, and produced long-lasting improvements even with fewer sessions and on more severely impaired patients. The study was published on January 24, 2017, in Neuropsychological Rehabilitation.

“Visual neglect is a severe disorder and rehabilitation remains a challenge, as currently no approach has been recommended for clinical use. However, this study shows that VFT is an extremely promising therapy for large-scale implementation,” concluded lead author psychologist Stephanie Rossit, PhD, of the UEA. “In contrast to most available techniques, VFT can be easily taught and administered, it is non-invasive, cost-effective, and can be conducted by the patients themselves in their own homes.”

A stroke can affect the way the brain processes the information it receives from the eyes, which can cause a number of visual processing problems. Patients with visual neglect may not be aware of the left or right side depending on the side of their stroke. For example, if the stroke affects the right side of the brain then patients will have problems processing the left side. This means they might accidentally ignore people, or even their own body, and may bump into things because they do not realize they are there.