Feasibility and effectiveness of translating a new computerized prism adaptation procedure for spatial neglect to the home environment

Spatial neglect is a common disorder after stroke which leads to problems with noticing or responding to information from the left side of the body or space. This condition has been linked to reduced independence in a wide range of daily life activities including eating, dressing, and mobility. There is currently no standard of care for spatial neglect, but prism adaptation (PA) is a promising treatment. During PA treatment, patients wear goggles fitted with prisms that shift vision, and point repeatedly at targets presented on a computer screen for about 15 minutes. After PA, when the goggles are removed, stroke patients now pay more attention to the previously neglected left side of the world. However, there are limitations to using PA in standard clinical care as PA requires daily exposure for at least two weeks, yet access to equipment and supervision is limited. To solve this problem, we developed a new game-like PA treatment (Peg-the-Mole, PTM) that can be used at home without the need for daily in person therapist set-up and supervision. However, PTM has not yet been tested at home to treat chronic neglect. The present study will examine the feasibility and effectiveness of translating our new PA procedure to the home environment. Stroke patients with neglect will use PTM for 15 minutes a day for 2 weeks at home. For feasibility, I will examine how easy it is to learn, use, and complete the protocol and gather feedback on how engaging it is. For effectiveness, I will measure changes in neglect symptoms and self-reports of benefits to daily life. The results will help us determine if this innovative treatment can be used successfully at home and who is most likely to benefit. These findings should aid in achieving more effective and accessible continuing care and enhance the well-being of Canadians by improving rehabilitation outcomes after stroke.