Article

Patients with right or more rarely left parietotemporal lesions after
stroke may have profound visuospatial disorders that impair activities of daily
living (ADL) and long-term outcome. Clinical studies indicate improvements with
systematic training of perception. Studies of perceptual learning in healthy
persons suggest rapid improvements in perceptual learning of spatial line
orientation with partial transfer to nontrained line orientations.
The authors investigated a novel feedback-based perceptual training procedure for the
rehabilitation of patients after stroke. METHODS: In an uncontrolled trial, 13
participants showing profound deficits in line orientation and related
visuospatial tasks within 12 to 28 weeks of onset performed repetitive
feedback-based, computerized training of visual line orientation over 4 weeks of
treatment. Visual line-orientation discrimination and visuospatial and
visuoconstructive tasks were assessed before and after training. RESULTS: The
authors found (a) rapid improvements in trained but also in nontrained spatial
orientation tests in all 13 participants, partially up to a normal level; (b)
stability of the obtained improvements at 2-month follow-up; (c) interocular
transfer of training effects to the nontrained eye in 2 participants suggesting a
central, postchiasmatic locus for this perceptual improvement; and (d) graded
transfer of improvements to related spatial tasks, such as horizontal writing,
analog clock reading, and visuoconstructive capacities but no transfer to
unrelated measures of visual performance. CONCLUSIONS: These results suggest the
potential for treatment-induced improvements in visuospatial deficits by
feedback-based, perceptual orientation training as a component of rehabilitation
after stroke.

Langue : ANGLAIS