Article

Compensatory and restorative treatments have been
developed to improve visual field defects after stroke. However, no controlled
trials have compared these interventions with standard occupational therapy (OT).
METHODS: A total of 45 stroke participants with visual field defect admitted for
inpatient rehabilitation were randomized to restorative computerized training
(RT) using computer-based stimulation of border areas of their visual field
defects or to a computer-based compensatory therapy (CT) teaching a visual search
strategy. OT, in which different compensation strategies were used to train for
activities of daily living, served as standard treatment for the active control
group. Each treatment group received 15 single sessions of 30 minutes distributed
over 3 weeks. The primary outcome measures were visual field expansion for RT,
visual search performance for CT, and reading performance for both treatments.
Visual conjunction search, alertness, and the Barthel Index were secondary
outcomes. RESULTS: Compared with OT, CT resulted in a better visual search
performance, and RT did not result in a larger expansion of the visual field.
Intragroup pre-post comparisons demonstrated that CT improved all defined outcome
parameters and RT several, whereas OT only improved one. CONCLUSIONS: CT improved
functional deficits after visual field loss compared with standard OT and may be
the intervention of choice during inpatient rehabilitation. A larger trial that
includes lesion location in the analysis is recommended.

Langue : ANGLAIS