title: A randomized controlled trial comparing 2 interventions for visual field loss with standard occupational therapy during inpatient stroke rehabilitation.
abstract: OBJECTIVE
  Compensatory and restorative treatments have been developed to improve visual field defects after stroke. However, no controlled trials have compared these interventions with standard occupational therapy (OT).
  
  
  METHODS
  A total of 45 stroke participants with visual field defect admitted for inpatient rehabilitation were randomized to restorative computerized training (RT) using computer-based stimulation of border areas of their visual field defects or to a computer-based compensatory therapy (CT) teaching a visual search strategy. OT, in which different compensation strategies were used to train for activities of daily living, served as standard treatment for the active control group. Each treatment group received 15 single sessions of 30 minutes distributed over 3 weeks. The primary outcome measures were visual field expansion for RT, visual search performance for CT, and reading performance for both treatments. Visual conjunction search, alertness, and the Barthel Index were secondary outcomes.
  
  
  RESULTS
  Compared with OT, CT resulted in a better visual search performance, and RT did not result in a larger expansion of the visual field. Intragroup pre-post comparisons demonstrated that CT improved all defined outcome parameters and RT several, whereas OT only improved one.
  
  
  CONCLUSIONS
  CT improved functional deficits after visual field loss compared with standard OT and may be the intervention of choice during inpatient rehabilitation. A larger trial that includes lesion location in the analysis is recommended.
authors.affiliation: Rehabilitationszentrum Oldenburg, Oldenburg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Mödden
authors.forename: Marion
authors.initials: M
authors.lastname: Behrens
authors.forename: Iris
authors.initials: I
authors.lastname: Damke
authors.forename: Norbert
authors.initials: N
authors.lastname: Eilers
authors.forename: Andreas
authors.initials: A
authors.lastname: Kastrup
authors.forename: Helmut
authors.initials: H
authors.lastname: Hildebrandt
mesh_terms: D000203:Activities of Daily Living; D000222:Adaptation, Physiological; D000328:Adult; D000368:Aged; D001288:Attention; D003194:Computer-Assisted Instruction / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D010468:Perceptual Disorders / Q000209:etiology* / Q000534:rehabilitation*; D010775:Photic Stimulation; D026741:Physical Therapy Modalities; D011932:Reading; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014794:Visual Fields / Q000502:physiology*