Visuospatial Rehabilitation after Right Hemisphere Stroke

右半球中风后的视觉空间康复

• 批准号: 7736737
• 负责人: Peii Chen
• 金额: $ 7.67万
• 依托单位: KESSLER FOUNDATION, INC.
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-10 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7736737
• 关键词: Activities of Daily Living; Acute; American Heart Association; Attention; Automobile Driving; Behavior Therapy; Behavioral; Caring; Clinical; Clinical Research; Competence; Complex; Computers; Educational process of instructing; Elements; Impairment; Instruction; Internet; Knowledge; Laboratories; Link; Literature; Maps; Marshal; Memory; Methods; Morbidity - disease rate; Neuropsychological Tests; Neurosciences; Perception; Performance; Pilot Projects; Procedures; Process; Production; Recommendation; Rehabilitation Outcome; Rehabilitation therapy; Reporting; Research; Research Personnel; Social Behavior; Sports; Sterile coverings; Stroke; Survivors; Symptoms; System; Task Performances; Techniques; Therapeutic; To specify; Training; Translating; Translational Research; United States; Vision; Visual; Visuospatial; Walkers; base; clinical application; cognitive neuroscience; cost; disability; effective therapy; functional disability; improved; public health relevance; response; treatment trial

DESCRIPTION (provided by applicant): Of 5.7 million stroke survivors in the United States, up to 90% may have visuospatial deficits, linked to poor rehabilitation outcomes, an increase of clinical morbidity, and impairments in competent driving, shopping, sports, computer/internet use, and other activities. Right hemisphere (RH) stroke may critically reduce the capability to perceive, internally represent, and process spatially-distributed, global information, as well as the ability to activate automatic visuospatial response systems. These consequences of RH stroke and visuospatial impairment are established in the neuroscience literature, but current visuospatial behavioral treatments do not integrate these concepts. Translating our knowledge of the cognitive neuroscience of visuospatial disability into behavioral techniques may increase the impact of treatment on the high cost of stroke in acute rehabilitation care and functional disability. The proposed research aims to specifically tailor a promising treatment for visuospatial deficits in RH stroke survivors to clinical application in training RH stroke survivors with visuospatial deficits. We hypothesize that optimized standard visuospatial rehabilitation after RH stroke may require 1) specific training in global visual organization, and 2) practicing verbal self-instructions. Lastly, 3) training must transfer to functional task performance to improve disability. This application aims to integrate the three elements of successful therapy into a strategy for visuospatial rehabilitation, to be applied clinically and used in treatment trials. In the proposed research, we will examine whether teaching organizational strategies to increase global processing improves recall of a standard neuropsychological test of visuospatial impairment, the Rey-Osterrieth complex figure in stroke survivors with RH stroke, whether verbal instruction further augments this effect, and whether training effects generalize to everyday visuospatial tasks. This study may provide a treatment method for clinical use and study, but may also clarify the mechanisms of visuospatial deficits following RH stroke, contributing to translational science of vision and attention. PUBLIC HEALTH RELEVANCE: Visuospatial deficits are linked to impeding rehabilitation outcomes, increasing clinical morbidity, and inducing problems with dressing, driving, shopping, sports, computer/internet use, and other activities of daily living. The significance of the proposed research is to establish effective treatments for visuospatial deficits in right hemisphere stroke survivors so that functional disability and cost of rehabilitation care will be reduced.

描述（由申请人提供）：在美国 570 万中风幸存者中，高达 90% 的人可能存在视觉空间缺陷，这与康复结果不佳、临床发病率增加以及驾驶、购物、运动、计算机/能力受损有关。互联网使用和其他活动。右半球（RH）中风可能会严重降低感知、内部表示和处理空间分布的全局信息的能力，以及激活自动视觉空间反应系统的能力。右侧脑卒中和视觉空间损伤的这些后果已在神经科学文献中确立，但当前的视觉空间行为治疗并未整合这些概念。将我们对视觉空间残疾的认知神经科学知识转化为行为技术可能会增加治疗对中风急性康复护理和功能残疾的高成本的影响。拟议的研究旨在专门针对 RH 中风幸存者视觉空间缺陷制定一种有前景的治疗方法，以临床应用来培训患有视觉空间缺陷的 RH 中风幸存者。我们假设右脑卒中后优化的标准视觉空间康复可能需要 1）全局视觉组织的特定训练，以及 2）练习口头自我指导。最后，3）训练必须转化为功能性任务表现，以改善残疾情况。该应用旨在将成功治疗的三个要素整合到视觉空间康复策略中，应用于临床和治疗试验。在拟议的研究中，我们将研究教授组织策略以增加全局处理是否可以改善对视觉空间损伤的标准神经心理学测试的回忆，右旋中风的中风幸存者的雷-奥斯特里思复杂图，口头指导是否进一步增强了这种效果，以及是否训练效果可推广到日常视觉空间任务。这项研究可能为临床使用和研究提供一种治疗方法，但也可能阐明RH卒中后视觉空间缺陷的机制，为视觉和注意力的转化科学做出贡献。公共卫生相关性：视觉空间缺陷与阻碍康复结果、增加临床发病率以及引发穿衣、驾驶、购物、运动、计算机/互联网使用和其他日常生活活动的问题有关。本研究的意义在于建立针对右半球中风幸存者视觉空间缺陷的有效治疗方法，从而降低功能障碍和康复护理成本。