Prism adaptation: is this an effective means of rehabilitating neglect?

Abstract

Aim: Controversy exists as to whether prism adaptation improves the symptoms of neglect. The purpose of this review is to investigate the efficacy of prism adaptation techniques in the rehabilitation of neglect. Methods: A literature review was conducted using the search engines Pubmed, Medline, Embase, Ovid, Google scholar and http://pcwww.liv.ac.uk/~rowef/index_files/Page646.htm. Study and review abstracts from the literature search were analysed and marked for inclusion if they contained the following terms in reference to visual neglect: ‘visual inattention’, ‘visual neglect’, ‘stroke’, ‘cerebro-vascular accident’, ‘rehabilitation’ and ‘prism adaptation’. Only journals written in English with full text access were included in this review. Results: Neglect is now known as a multi-component disorder and recent studies have suggested using a combination therapy approach for the rehabilitation of neglect. There have been promising reports when prism adaptation has been used in combination with other methods of rehabilitation. However, there is not yet an adequate amount of evidence to definitively guide rehabilitation and thus additional research is advocated. Conclusion: Although negative results have been reported, the majority of studies advocate the use of prism adaptation. However, there is not yet enough evidence to incorporate prism adaptation into the clinical rehabilitation programme for neglect patients. Further studies need to concentrate on the clinical significance of improvements in neglect symptoms and the extent to which improvements extend to the everyday lives of patients.

Keywords

• Neglect
• Prism adaptation
• Rehabilitation
• Stroke
• Visual inattention