Stroboscopic visual training: The potential for clinical application in neurological populations

Abstract

Visual problems are common in people who have neurological injury or disease, with deficits linked to postural control and gait impairment. Vision therapy could be a useful intervention for visual impairment in various neurological conditions such as stroke, head injury, or Parkinson’s disease. Stroboscopic visual training (SVT) has been shown to improve aspects of visuomotor and cognitive performance in healthy populations, but approaches vary with respect to testing protocols, populations, and outcomes. The purpose of this structured review was to examine the use of strobe glasses as a training intervention to inform the development of robust protocols for use in clinical practice. Within this review, any studies using strobe glasses as a training intervention with visual or motor performance–related outcomes was considered. PubMed, Scopus, and ProQuest databases were searched in January 2023. Two independent reviewers (JD and RM) screened articles that used strobe glasses as a training tool. A total of 33 full text articles were screened, and 15 met inclusion/exclusion criteria. Reported outcomes of SVT included improvements in short–term memory, attention, and visual response times, with emerging evidence for training effects translating to balance and physical performance. However, the lack of standardisation across studies for SVT protocols, variation in intervention settings, duration and outcomes, and the limited evidence within clinical populations demonstrates that further work is required to determine optimal strobe dosage and delivery. This review highlights the potential benefits, and existing research gaps regarding the use of SVT in clinical practice, with recommendations for clinicians considering adopting this technology as part of future studies in this emerging field. Author summary Visual problems are common in people who have neurological disease and can affect balance and walking. Vision therapy could be a useful intervention for visual problems in various neurological conditions such as stroke, head injury, or Parkinson’s disease. Stroboscopic visual training (SVT) is a type of visual training that involves the use of specialist glasses equipped with liquid crystal technology lenses. These lenses regulate visual information by producing an intermittent clear and opaque flicker effect without light or flash being used. Training with these glasses has been shown to improve aspects of visuomotor and cognitive (thinking) performance in healthy populations, but approaches to training vary. Here, we examine the use of strobe glasses as a training intervention with the aim to help develop protocols for use in clinical practice. We found evidence that SVT can improve visual skills, with the potential to enhance aspects of physical performance such as balance. However, we also found a lack of standardisation across studies for SVT protocols, and there was limited evidence for use of SVT within clinical populations. Our review not only highlights the potential benefits of using SVT in clinical practice but also emphasises where there are gaps in the current research. Based on our finding, we have made recommendations to help guide future research in this emerging field.