Development and 5-year Evaluation of Diagnosis-Specific Protocols for Visual Neuro-Rehabilitation in a Multicenter Inpatient Rehabilitation Network

To provide a retrospective evaluation of a new eye and vision rehabilitation care pathway in a U.S. multi-site inpatient rehabilitation network involving the occupational therapy (OT) staff and a consulting doctor of optometry (OD) specializing in vision rehabilitation. Retrospective study. Two Inpa...

Full description

Saved in:

Bibliographic Details
Published in:	Archives of rehabilitation research and clinical translation Vol. 5; no. 1; p. 100246
Main Authors:	Houston, Kevin E., Keilty, Matthew, Collins, Caroline, Trehan, Ritika, Mouldovan, Talia, Stuckart, Kim, Engelhardt, Nancy, Nadeau, Melanie, Rovito, Craig A., Merabet, Lotfi B.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-03-2023 Elsevier
Subjects:	Cranial nerve diseases Hemianopsia Hemispatial neglect Methodology and Research Protocols Neurorehabilitation Palsy Rehabilitation Saccadic eye movement Palsy Hemianopsia Neurorehabilitation Rehabilitation Cranial nerve diseases Hemispatial neglect Saccadic eye movement
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	To provide a retrospective evaluation of a new eye and vision rehabilitation care pathway in a U.S. multi-site inpatient rehabilitation network involving the occupational therapy (OT) staff and a consulting doctor of optometry (OD) specializing in vision rehabilitation. Retrospective study. Two Inpatient Rehabilitation Facilities (IRFs) and 1 Long Term Acute Care Hospital (LTACH). There were 2083 records reviewed (44% women, avg. age 59 years). The most common diagnoses were hemispatial neglect (19.2%), homonymous field defects (18.5%), and oculomotor cranial nerve palsies (16.7%) (N=2083). Clinical care was reviewed where diagnosis-specific protocols were developed and training was provided to OTs in order to reinforce OD-prescribed interventions during daily treatment sessions, including (1) third, fourth, and sixth ocular cranial nerve palsies (OCNPs) with prisms fitted for full time, postural adaptation training, and oculomotor re-education using pursuits, saccades, head-rotations, and binocular vision exercises including alternate cover and vergence; (2) homonymous hemianopia with training awareness of field loss, eccentric viewing, and fitting of Peli lens for optical field expansion; and (3) prism adaptation therapy (PAT) for left hemispatial neglect. Frequency of diagnoses. Diagnoses with developed protocols were most common. Secondarily, feasibility and efficacy by anonymous OT survey. 2083 vision consults were performed over 5 years. The most common diagnoses were hemispatial neglect (n=399, 19.2%), homonymous field defects (n=386, 18.5%), and OCNPs (n=347, 16.7%). None of the OTs reported the protocols were infeasible and 63% (IQR 38%-69%) reported their patients benefited from the interventions. The survey suggested prism for OCNPs helped in 42%, and Peli lens and PAT both helped in 38%. Data support the feasibility of this inpatient eye and vision rehabilitation care pathway which may be used as a foundation for creating or refining similar programs elsewhere. Uniform administration of IRF-based visual neuro-rehabilitation care could provide a substrate for future clinical trials to evaluate efficacy.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2590-1095 2590-1095
DOI:	10.1016/j.arrct.2022.100246