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Rehabilitation of Visual and Perceptual Dysfunction after Severe Traumatic Brain Injury

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Technical Report,01 Mar 2012,28 Feb 2013

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Schepens Eye Research Institute Boston United States

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The overall aim is to conduct preliminary evaluations of new rehabilitation strategies and new functional assessment methods for homonymous hemianopia HH and spatial neglect SN, disabling visual and cognitive perception conditions that commonly occur as a result of severe traumatic brain injury TBI and stroke. Both HH and SN prevent detection of objects on the affected side, resulting in unsafe walking and driving. Using realistic tasks in virtual environments representative of everyday mobility challenges we are evaluating a novel optical device expansion prism EP glasses - combined with a new computerized perceptual-motor training regimen in helping people with HH and SN detect and avoid obstacles on the affected side. In the first year we developed the training software and prepared the functional assessments. In the second year we have made excellent progress in recruiting and running participants in the main pilot study, with a totalof 25 participants screened and 14 enrolled. There are about 15 visits for each participant, including about 6 visits for intensive computerized perceptual-motor training. Preliminary results are encouraging. After training there were significant improvements in the ability to accurately touch targets presented in areas of prism-expanded vision in the blind hemifield. Before training, the error in touching was 17, which reduced significantly p 0.001 to only 1.0 after training equivalent to seeing side accuracy. Blindside detection performance improved significantly when using the prism glasses both in a collision judgment task in a virtual walking simulator and a pedestrian detection task in a driving simulator. Recruitment and data collection are ongoing.

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