Stimulating Visual Exploration of the Neglected Space in the Early Stage of Stroke by Hemifield Eye-patching: a Randomized Controlled Trial in Patients with Right Brain Damage

Background: It has been well established that the presence of neglect is a predictor of poor functional outcome after stroke. Most rehabilitation studies on neglect have been performed with at least two months post-stroke. However, a recent series of stroke management indications highlight the importance of early rehabilitation treatment and evidence regarding neglect rehabilitation in the early phase after stroke is needed.

Aim: To evaluate the effectiveness of right half-field patches in treating neglect in patients during the early phase of stroke.

Design: Randomized controlled trial.

Setting: Acute care setting in an urban general hospital.

Population: Eighteen patients with left unilateral neglect recruited among 56 patients consecutively admitted with right hemispheric stroke.

Methods: The patients were evaluated at pre-treatment, post-treatment, and at a 7-day follow-up. The experimental group received right half-field patch treatment (n=10) for approximately 8 hours a day for 15 consecutive days. The control group received visual scanning training (n=8) for 40 minutes every weekday in a 15 day period.

Results: Both groups significantly improved their performance in all outcome measures. No difference in the amount of improvement between the two groups was found.

Conclusion: Right half-field eye patching could be a promising technique for treating visual spatial neglect during the early stages of stroke.

Clinical Rehabilitation Impact: The eye-patching technique may represent an easily applicable and inexpensive method for neglect rehabilitation in the early stage after stroke.