Functional improvements following the use of the NVT Vision Rehabilitation program for patients with hemianopia following stroke

Issue title: Community Based Rehabilitation after Neurologic Injury

Guest editors: Stephanie A. Kowlakowsky-Hayner

Article type: Research Article

Authors: Hayes, Allison^{a; *} | Chen, Celia S.^b | Clarke, Gayle^a | Thompson, Annette^c

Affiliations: [a] NVT Systems, Torrensville, SA, Australia | [b] Department of Ophthalmology, Flinders Medical Centre and Flinders University, Bedford Park, SA, Australia | [c] Royal Society for the Blind, Adelaide, SA, Australia | Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA, USA

Correspondence: [*] Corresponding author: Allison Hayes, NVT Systems, PO Box 131, Torrensville, SA 5031, Australia. Tel.: +61 8 8354 2004; Fax: +61 8 8354 3004; E-mail: [email protected]

Abstract: The incidence of visual deficits following stroke ranges from 20%–68% and has significant impact on activities of daily living. The NVT system is a compensatory visual scanning training program that consists of combined static and mobility training and transfer to activities of daily living. The study aims to evaluate functional changes following the NVT program for people who have homonymous hemianopia (HH) following stroke. Method:Interventional case series of 13 consecutive participants with HH undergoing NVT vision rehabilitation. The primary outcome measure was the number of targets missed on a standardized Mobility Assessment Course (MAC). Other outcome measures included assessment of visual scanning, vision specific Quality of Life questionnaires and reading performance. Results:The average number of targets (sd) missed on the MAC course was 39.6 ± 20.9% before intervention, 27.5 ± 16.3% immediately post intervention and 20.8 ± 15.5% at 3 months post rehabilitation. The study showed a statistically significant trend in improvement in mobility related subscales of National Eye Institute Visual Function Questionnaire-NEI VFQ-25 (p = 0.003) and the Veteran Affairs Low Vision Visual Function Questionnaire-VA LVFQ-48 (p = 0.036) at 3 months post rehabilitation. Discussion:The NVT intervention resulted in functional improvements in mobility post rehabilitation. The NVT training showed improvement in vision specific quality of life. There is a need for standardised vision therapy intervention, in conjunction with existing rehabilitation services, for patients with stroke and traumatic brain injury.

Keywords: Neurological vision deficits, acquired brain injury, hemianopia, stroke, traumatic brain injury, mobility, activities of daily living, quality of life, compensatory visual scanning.

DOI: 10.3233/NRE-2012-0771

Journal: NeuroRehabilitation, vol. 31, no. 1, pp. 19-30, 2012