title: The feasibility of computer-based prism adaptation to ameliorate neglect in sub-acute stroke patients admitted to a rehabilitation center.
abstract: BACKGROUND
  There is wide interest in transferring paper-and-pencil tests to a computer-based setting, resulting in more precise recording of performance. Here, we investigated the feasibility of computer-based testing and computer-based prism adaptation (PA) to ameliorate neglect in sub-acute stroke patients admitted to a rehabilitation center.
  
  
  METHODS
  Thirty-three neglect patients were included. PA was performed with a pair of goggles with wide-field point-to-point prismatic lenses inducing an ipsilesional optical shift of 10°. A variety of digitalized neuropsychological tests were performed using an interactive tablet immediately before and after PA.
  
  
  RESULTS
  All 33 patients [mean age 60.36 (SD 13.30)], [mean days post-stroke 63.73 (SD 37.74)] were able to work with the tablet and to understand, perform, and complete the digitalized tests within the proposed time-frame, indicating that there is feasibility of computer-based assessment in this stage post-stroke. Analyses of the efficacy of PA indicated no significant change on any of the outcome measures, except time.
  
  
  CONCLUSIONS
  In conclusion, there is feasibility of computer-based testing in such an early stage, which makes the computer-based setting a promising technique for evaluating more ecologically valid tasks. Secondly, the computer-based PA can be considered as a reliable procedure. We can conclude from our analysis, addressing the efficacy of PA, that the effectiveness of single session PA may not be sufficient to produce short-term effects on our static tasks. Further studies, however, need to be done to evaluate the computer-based efficacy with more ecologically valid assessments in an intensive double-blind, sham-controlled multiple PA treatment design.
authors.affiliation: Rudolf Magnus Institute of Neuroscience, Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat , Utrecht , Netherlands ; Department of Experimental Psychology, Utrecht University , Utrecht , Netherlands.
authors.forename: Miranda
authors.initials: M
authors.lastname: Smit
authors.forename: Stefan
authors.initials: S
authors.lastname: Van der Stigchel
authors.forename: Johanna M A
authors.initials: JM
authors.lastname: Visser-Meily
authors.forename: Mirjam
authors.initials: M
authors.lastname: Kouwenhoven
authors.forename: Anja L H
authors.initials: AL
authors.lastname: Eijsackers
authors.forename: Tanja C W
authors.initials: TC
authors.lastname: Nijboer
keywords: computer-based assessment; computer-based prism adaptation; efficacy; feasibility; neglect; stroke
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