Article

OBJECTIVES: To verify the efficacy of prism adaptation as a practical means of
rehabilitation for subjects with unilateral spatial neglect by conducting
goal-directed tasks in the presence of similar visual flankers in the right
hemispace using an activity of daily living, namely, wheelchair operation.
DESIGN: Prospective cohort study. SETTING: Rehabilitation center located in
Japan. PARTICIPANTS: Patients with unilateral spatial neglect (N=10).
INTERVENTION: Prism adaptation. MAIN OUTCOME MEASURES: A midpoint-directed task
in which the subject faces the center of 2 symbols placed in front and moves the
wheelchair toward it, and a goal-directed task in which the subject must
differentiate a single target from multiple symbols and move the wheelchair
toward it. RESULTS: In the midpoint-directed task, there was a significant shift
in the reach position bias from +27.7 cm prior to prism adaptation to +3.1cm
after prism adaptation (P<.01). In the goal-directed task, the time taken to
reach the outer left target decreased from 21.2 seconds prior to prism adaptation
to 11.8 seconds after prism adaptation, and the difference between placement of
the targets was eliminated. CONCLUSIONS: Prism adaptation exhibited the potential
to generalize the effects on activities of daily living such as driving a
wheelchair and to ameliorate unilateral spatial neglect even in the presence of
right-hemispace flankers. Prism adaptation is an effective therapeutic modality
in rehabilitation because it prevents the appearance of neglect symptoms despite
situational or contextual changes.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS