Dataset Information

The Effects of Compensatory Scanning Training on Mobility in Patients with Homonymous Visual Field Defects: A Randomized Controlled Trial.

ABSTRACT:

Introduction

Homonymous visual field defects (HVFD) are a common consequence of postchiasmatic acquired brain injury and often lead to mobility-related difficulties. Different types of compensatory scanning training have been developed, aimed at decreasing consequences of the HVFD by changing visual scanning.

Aim

The aim of the present study is to examine the effects of a compensatory scanning training program using horizontal scanning on mobility-related activities and participation in daily life.

Method

The main interest of this study is to assess the effectiveness of training on mobility-related activities and participation in daily life. Visual scanning tests, such as dot counting and visual search, and control measures for visual functions and reading have been included as well. First, it is examined how performance on scanning and mobility-related measures is affected in patients with HVFD by comparing scores with scores of a healthy control group (n = 25). Second, the effect of training is assessed using an RCT design, in which performance of 26 patients before and after training is compared to performance of 23 patients in a waiting list control group.

Results

Self-reported improvements after training were found, accompanied by improvements in detecting peripheral stimuli and avoiding obstacles during walking, especially in dual task situations in which a second task limits the attentional capacity available for compensatory scanning. Training only improved mobility-related activities in which detection of peripheral stimuli is important, while no improvement was found on tests that require other visual skills, such as reading, visual counting and visual search.

Conclusion

This is the first RCT to evaluate the effects of a compensatory scanning training that is based on a systematic horizontal scanning rhythm. This training improved mobility-related activities. The results suggest that different types of compensatory scanning strategies are appropriate for different types of activities.

Trial registration

ISRCTN Registry ISRCTN16833414.

SUBMITTER: de Haan GA

PROVIDER: S-EPMC4537273 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The Effects of Compensatory Scanning Training on Mobility in Patients with Homonymous Visual Field Defects: A Randomized Controlled Trial.

de Haan Gera A GA Melis-Dankers Bart J M BJ Brouwer Wiebo H WH Tucha Oliver O Heutink Joost J

PloS one 20150814 8

<h4>Introduction</h4>Homonymous visual field defects (HVFD) are a common consequence of postchiasmatic acquired brain injury and often lead to mobility-related difficulties. Different types of compensatory scanning training have been developed, aimed at decreasing consequences of the HVFD by changing visual scanning.<h4>Aim</h4>The aim of the present study is to examine the effects of a compensatory scanning training program using horizontal scanning on mobility-related activities and participat ...[more]

PMID: 26275160

Similar Datasets

Project description:ObjectiveIt is currently still unknown why some drivers with visual field loss can compensate well for their visual impairment while others adopt ineffective strategies. This paper contributes to the methodological investigation of the associated top-down mechanisms and aims at validating a theoretical model on the requirements for successful compensation among drivers with homonymous visual field loss.MethodsA driving simulator study was conducted with eight participants with homonymous visual field loss and eight participants with normal vision. Participants drove through an urban surrounding and experienced a baseline scenario and scenarios with visual precursors indicating increased likelihoods of crossing hazards. Novel measures for the assessment of the mental model of their visual abilities, the mental model of the driving scene and the perceived attention demand were developed and used to investigate the top-down mechanisms behind attention allocation and hazard avoidance.ResultsParticipants with an overestimation of their visual field size tended to prioritize their seeing side over their blind side both in subjective and objective measures. The mental model of the driving scene showed close relations to the subjective and actual attention allocation. While participants with homonymous visual field loss were less anticipatory in their usage of the visual precursors and showed poorer performances compared to participants with normal vision, the results indicate a stronger reliance on top-down mechanism for drivers with visual impairments. A subjective focus on the seeing side or on near peripheries more frequently led to bad performances in terms of collisions with crossing cyclists.ConclusionThe study yielded promising indicators for the potential of novel measures to elucidate top-down mechanisms in drivers with homonymous visual field loss. Furthermore, the results largely support the model of requirements for successful compensatory scanning. The findings highlight the importance of individualized interventions and driver assistance systems tailored to address these mechanisms.

Project description:BackgroundTo evaluate vision-related and health-related quality of life (VRQoL, HRQoL) in first stroke patients with homonymous visual field defects (VFD) with respect to the extent of the lesion. Since VFD occur in approximately 10% of stroke patients the main purpose of the study was to investigate the additional impact of VFD in stroke patients hypothesizing that VFD causes diminished VRQoL.MethodsIn 177 first stroke patients with persisting VFD 2.5 years after posterior-parietal lesions VRQoL was assessed by the National-Eye-Institute-Visual-Functioning-Questionnaire (NEI-VFQ) and HRQoL by the Medical-Outcome-Study Short-Form-36 Health-Survey (SF-36). Questionnaire results of VFD-patients were compared with age- and sex-matched healthy controls and with general non-selected stroke samples as published elsewhere. VFD-type and visual acuity were partially correlated with questionnaire results.ResultsCompared to healthy controls VFD-patients had lower NEI-VFQ scores except ocular pain (Z-range -11.34 to -3.35) and lower SF-36 scores except emotional role limitations (Z-range -7.21 to -3.34). VFD-patients were less impaired in SF-36 scores than general stroke patients one month post lesion (6/8 subscales) but had lower SF-36 scores compared to stroke patients six months post lesion (5/8 subscales). Visual acuity significantly correlated with NEI-VFQ scores (r-range 0.27 to 0.48) and VFD-type with SF-36 mental subscales (r-range -0.26 to -0.36).ConclusionsVFD-patients showed substantial reductions of VRQoL and HRQoL compared to healthy normals, but better HRQoL compared to stroke patients one month post lesion. VFD-patients (although their lesion age was four times higher) had significantly lower HRQoL than a general stroke population at six months post-stroke. This indicates that the stroke-related subjective level of HRQoL impairment is significantly exacerbated by VFD. While VRQoL was primarily influenced by visual acuity, mental components of HRQoL were influenced by VFD-type with larger VFD being associated with more distress.

Dataset Information

The Effects of Compensatory Scanning Training on Mobility in Patients with Homonymous Visual Field Defects: A Randomized Controlled Trial.

Introduction

Aim

Method

Results

Conclusion

Trial registration

Publications

The Effects of Compensatory Scanning Training on Mobility in Patients with Homonymous Visual Field Defects: A Randomized Controlled Trial.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets