Clinical Research Directory

Dosing and Deployment Trial: A Home-based Optokinetic Treatment

Several interventions exist for remediation of spatial neglect, but they have mixed evidence. Optokinetic stimulation is a bottom-up intervention; in other words, it is a stimulus-driven process, with Level A (strongest) evidence, and is recommended in clinical practice guidelines such as the American Heart Association's stroke guidelines. The studies currently published all use varing doses (number of sessions a week), did not assess the impact on mobility and risk of falls, and have not been implemented in the home setting. It is imperative to understand how to successfully implement this intervention at home, and learn how it will impact mobility in order to better support a large population of individuals living with chronic spatial neglect and who face barriers to accessing care because they require caregiver support to leave the home. This will be done using both qualitative and quantitative methods.

Dynamic Auditory Cueing for Spatial Neglect in Stroke

Spatial neglect is a common condition after stroke and can make it difficult for people to pay attention to one side of space. This problem can negatively affect daily activities and functional independence. This study aims to evaluate whether dynamic auditory cueing for spatial neglect (DAC-SN) can improve spatial neglect in people with stroke. Participants are randomly assigned to one of two groups. One group receives conventional rehabilitation, while the other group receives conventional rehabilitation combined with dynamic auditory cueing. Dynamic auditory cueing uses moving sounds to guide attention toward the affected side. The intervention is applied for about ten minutes per day, five days a week, for four weeks. Spatial neglect and functional outcomes are assessed using standardized clinical tests and scales at baseline and at predefined time points during and after the intervention. The results of this study may provide evidence for the use of auditory-based approaches in the rehabilitation of spatial neglect after stroke.

A Biomarker for Personalized Care in Post-Stroke Spatial Neglect

More than 30,000 Veterans are hospitalized for stroke each year, and in the critical first months of recovery, at least half are disabled by abnormal 3-D spatial function (spatial neglect). Their self-care, mobility, and ability to return home are severely limited.

Spatial-Motor Stroke-Rehab Study

The purpose of this study is to understand how prism adaptation training with and without electrical stimulation changes visuospatial behavior, motor system neurophysiology, and walking dysfunction.

Engaging Mobile Prism Adaptation Treatment at Home

Spatial neglect is a common disorder after stroke which leads to problems with noticing or responding to information from the left side of the body or space. This condition has been linked to reduced independence in a wide range of daily life activities including eating, dressing, and mobility. Despite its high prevalence in stroke patients, there is currently no standard of care for spatial neglect. Prism adaptation (PA) is a promising treatment, however, there are limitations to using PA in standard clinical care as it requires daily exposure for at least two weeks, yet access to equipment and supervision is limited. To solve this problem, the investigators have developed a new game-like PA treatment (Peg-the-Mole, PTM) that can be used at home without the need for daily in person therapist set-up and supervision. In this study the investigators aim to evaluate the feasibility and effectiveness of the gamified and portable PA procedure in an inpatient and home setting, with the hypothesis that the PA procedure will improve patient's neglect symptoms.

Spatial Cognition Assessment in Virtual Reality

Unilateral spatial neglect (USN) is a highly-prevalent neuropsychological syndrome following a cerebral stroke characterized by massive impairments in daily life. The evaluation and the rehabilitation of USN encounter many limits whereas immersive virtual reality (VR) could be an efficient tool to go through these limits by imitating an environment of perception and action very close to the real one. The investigators will test a multisensory battery of evaluation based on VR for the diagnostic of USN.