A Study of Prisms And Therapy In Attention Loss after stroke (SPATIAL): a feasibility randomised controlled trial

Longley, V. et al. (2023) A Study of Prisms And Therapy In Attention Loss after stroke (SPATIAL): a feasibility randomised controlled trial. Clinical Rehabilitation, 37(3), pp. 381-393. (doi: 10.1177/02692155221134060) (PMID:36285484) (PMCID:PMC9912302)

Abstract

Objective Investigate feasibility and acceptability of prism adaptation training for people with inattention (spatial neglect), early after stroke, during usual care. Design: Phase II feasibility randomised controlled trial with 3:1 stratified allocation to standard occupational therapy with or without intervention, and nested process evaluation. Setting: Ten hospital sites providing in-patient stroke services. Participants: Screened positive for inattention more than one-week post-stroke; informal carers. Occupational therapists participated in qualitative interviews. Intervention: Adjunctive prism adaptation training at the start of standard occupational therapy sessions for three weeks. Main measures: Feasibility measures included recruitment and retention rates, intervention fidelity and attrition. Outcomes collected at baseline, 3 weeks and 12 weeks tested measures including Nottingham Extended Activities of Daily Living Scale. Acceptability was explored through qualitative interviews and structured questions. Results: Eighty (31%) patients were eligible, 57 (71%) consented, 54 randomised (40:13, +1 exclusion) and 39 (74%) completed 12-week outcomes. Treatment fidelity was good: participants received median eight intervention sessions (IQR: 5, 12) lasting 4.7 min (IQR: 4.1, 5.0). All six serious adverse events were unrelated. There was no signal that patients allocated to intervention did better than controls. Twenty five of 35 recruited carers provided outcomes with excellent data completeness. Therapists, patients and carers found prism adaptation training acceptable. Conclusions: It is feasible and acceptable to conduct a high-quality definitive trial of prism adaptation training within occupational therapy early after stroke in usual care setting, but difficult to justify given no sign of benefit over standard occupational therapy.

• Item Type: Articles
• Additional Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This independent research is funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0816-20016). This research also received funding from The University of Manchester Research Impact Scholarship (MC) and Stroke Association, UK (AB; grant number TSA LECT 2015/01 – SCOPE: Strategies to COPE with cognitive difficulties after stroke).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Checketts, Dr Matthew
• Authors: Longley, V., Woodward-Nutt, K., Turton, A., Stocking, K., Checketts, M., Bamford, A., Douglass, E., Taylor, J., Woodley, J., Moule, P., Vail, A., and Bowen, A.
• College/School: College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
• Journal Name: Clinical Rehabilitation
• Publisher: SAGE Publications
• ISSN: 0269-2155
• ISSN (Online): 1477-0873
• Published Online: 26 October 2022
• Copyright Holders: Copyright © The Author(s) 2022
• First Published: First published in Clinical Rehabilitation 37(3):381-393
• Publisher Policy: Reproduced under a Creative Commons licence