The Effects of Compensatory Scanning Training on Mobility in Patients with Homonymous Visual Field Defects: Further Support, Predictive Variables and Follow-Up

Introduction People with homonymous visual field defects (HVFD) often report difficulty detecting obstacles in the periphery on their blind side in time when moving around. Recently, a randomized controlled trial showed that the InSight-Hemianopia Compensatory Scanning Training (IH-CST) specifically improved detection of peripheral stimuli and avoiding obstacles when moving around, especially in dual task situations. Method The within-group training effects of the previously reported IH-CST are examined in an extended patient group. Performance of patients with HVFD on a pre-assessment, post-assessment and follow-up assessment and performance of a healthy control group are compared. Furthermore, it is examined whether training effects can be predicted by demographic characteristics, variables related to the visual disorder, and neuropsychological test results. Results Performance on both subjective and objective measures of mobility-related scanning was improved after training, while no evidence was found for improvement in visual functions (including visual fields), reading, visual search and dot counting. Self-reported improvement did not correlate with improvement in objective mobility performance. According to the participants, the positive effects were still present six to ten months after training. No demographic characteristics, variables related to the visual disorder, and neuropsychological test results were found to predict the size of training effect, although some inconclusive evidence was found for more improvement in patients with left-sided HVFD than in patients with right-sided HFVD. Conclusion Further support was found for a positive effect of IH-CST on detection of visual stimuli during mobility-related activities specifically. Based on the reports given by patients, these effects appear to be long-term effects. However, no conclusions can be drawn on the objective long-term training effects.

[1]  N. Lincoln,et al.  Cognitive rehabilitation for spatial neglect following stroke. , 2007, The Cochrane database of systematic reviews.

[2]  J. Schafer,et al.  Missing data: our view of the state of the art. , 2002, Psychological methods.

[3]  R. Massof,et al.  Perceived visual ability for independent mobility in persons with retinitis pigmentosa. , 1999, Investigative ophthalmology & visual science.

[4]  Jelle Jolles,et al.  Rey's verbal learning test: Normative data for 1855 healthy participants aged 24–81 years and the influence of age, sex, education, and mode of presentation , 2005, Journal of the International Neuropsychological Society.

[5]  M. Leen.  Neuropsychologische diagnostiek, de klinische praktijk , 2009 .

[6]  C. Hoyng,et al.  [The Dutch version of the Radner Reading Chart for assessing vision function]. , 2007, Nederlands tijdschrift voor geneeskunde.

[7]  M. R. Boer,et al.  Intra‐ and interrater agreement and reliability of the Functional Field Score , 2005, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[8]  J. Ormel,et al.  A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects , 1997, Psychological Medicine.

[9]  Frans W. Cornelissen,et al.  GRONINGEN EDGE CONTRAST CHART (GECKO) AND GLARE MEASUREMENTS , 1994 .

[10]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[11]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[12]  J. Zihl,et al.  Die Anamnese zerebral bedingter Sehstörungen , 1990 .

[13]  F. Ferris,et al.  New visual acuity charts for clinical research. , 1982, American journal of ophthalmology.

[14]  Difficulties in Daily Life Reported by Patients With Homonymous Visual Field Defects , 2015, Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society.

[15]  A. Pollock,et al.  Cognitive rehabilitation for spatial neglect following stroke. , 2013, The Cochrane database of systematic reviews.

[16]  Craig K. Enders,et al.  An introduction to modern missing data analyses. , 2010, Journal of school psychology.

[17]  Ulrike Willinger,et al.  Eine neue Lesetafel* zur gleichzeitigen Bestimmung von Lesevisus und Lesegeschwindigkeit , 1998 .

[18]  R. Reitan.  Validity of the Trail Making Test as an Indicator of Organic Brain Damage , 1958 .

[19]  John O. Willis,et al.  Wechsler Adult Intelligence Scale–Third Edition , 2008 .

[20]  Joost Heutink,et al.  The Effects of Compensatory Scanning Training on Mobility in Patients with Homonymous Visual Field Defects: A Randomized Controlled Trial , 2015, PloS one.

[21]  C. Kennard,et al.  Can visual function be restored in patients with homonymous hemianopia? , 1997, The British journal of ophthalmology.

[22]  W. Brouwer,et al.  Attention and Driving in Traumatic Brain Injury: A Question of Coping with Time‐Pressure , 2002, The Journal of head trauma rehabilitation.

[23]  L. M. Wellock.  Guides to the Evaluation of Permanent Impairment , 1972 .

[24]  R. Hays,et al.  Development of the 25-item National Eye Institute Visual Function Questionnaire. , 2001, Archives of ophthalmology.

[25]  M. Tant,et al.  Visual performance in homonymous hemianopia: assessment, training and driving , 2002 .

[26]  N. Newman,et al.  Natural history of homonymous hemianopia , 2006, Neurology.

[27]  W. Brouwer,et al.  Spontaneous recovery and treatment effects in patients with homonymous visual field defects: a meta-analysis of existing literature in terms of the ICF framework. , 2014, Survey of ophthalmology.

[28]  L. Cocchiarella,et al.  Guides to the evaluation of permanent impairment , 2000 .