Rehabilitation of Visual and Perceptual Dysfunction after Severe Traumatic Brain Injury
Final rept. 1 Mar 2011-28 Feb 2014
SCHEPENS EYE RESEARCH INST BOSTON MA
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The overall aim was to conduct preliminary evaluations of a new rehabilitation strategy 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 evaluated 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 and third years we made excellent progress in recruiting and running participants, with a total of 40 participants screened and 24 enrolled. There were at least 15 visits per participant total about 50 hours, 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 18 , which reduced significantly p 0.007 to only 2.0 after training equivalent to seeing side accuracy. Blind side detection performance improved significantly with the prism glasses from median 35 without glasses at baseline to 50 with glasses before training p 0.003. There was a further improvement to 80 after training p 0.028, which was maintained at 3 months 88.
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