Structured Abstract
Brain Injury Structured Abstract - BI #11
Perceptual training may be no more effective than conventional therapy in improving perceptual functioning or ADL
CITATION: Lincoln, N. B., Whiting, S. E., Cockburn, J., & Bhavnani, G. (1985). An evaluation of perceptual retraining. International Journal of Rehabilitation Medicine, 7(3), 99-101.
LEVEL OF EVIDENCE: IIB1a
This is a non-RCT 2 group treatment comparison design study, sample size below 20 per condition (n = 17, n = 16, total n = 33) with high internal validity and high external validity, provided a IIB level of evidence.
RESEARCH OBJECTIVE/QUESTION
To compare the effects of perceptual retraining and conventional occupational therapy groups on visual perception or on activities of daily living in persons with acquired brain injury.
DESIGN
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RCT |
|
Single Case |
|
Case Control |
| |
Cohort |
X |
Before-After |
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Cross-Sectional |
This study design is used to evaluate a group of individuals who are undergoing the same treatment. Information regarding a group of people is collected both before and after treatment. This is a common design that is generally paralleled with a single case/individual study. A before-after design usually involves more than one person whereas a single case study may involve only one individual. Patients underwent baseline studies, then intervention, then reassessment on RPAB and activity of daily living
SAMPLING PROCEDURE
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Random |
X |
Consecutive |
| |
Controlled |
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Convenience |
Individuals involved in the study were selected consecutively as they entered a certain program or clinic where the study was being conducted.
SAMPLE
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N = 33 |
M age = 50.06 |
Male = 17 |
Ethnicity = NR |
Female = 16 |
NR = Not reported
- Participants were randomly assigned to either perceptual training treatment (n = 17) or to conventional therapy group (n = 16). Participants were recruited from a rehabilitation center. There were no significant differences between the two groups in age, sized of lesion or time post-onset. The participants' age ranged from 17-69 years (mean 50.06, SD 15-13 years).
- 14 right hemisphere lesions; 13 left hemisphere lesions.
PARTICIPANT CHARACTERISTICS
Mixed diagnoses Traumatic Brain Injury and Cerebal Vascular Accidents
MEDICAL DIAGNOSIS/CLINICAL DISORDER
Traumatic Brain Injury (6) and Cerebral Vascular Accidents (27)
OT TREATMENT DIAGNOSIS
Physical substrate: Visual deficit/impaired
OUTCOMES
1. Visual perception
2. ADL
|
Measures |
Reliability |
Validity |
|
1. Rivermead Perceptual Assessment Battery (RPAB) |
NR |
NR |
|
2. Rivermead Activity of Daily Living Scale (AOL Scale) |
NR |
NR |
NR = Not Reported
Outcome - OT terminology
I. Performance Component
A. Sensory processing: visual
C. Perceptual Processing:
6. Form Constancy
7. Position in Space
8. Visual Closure
9. Figure Ground
10. Depth Perception
11. Spatial Relations
12. Topographical Orientation
Outcome - ICIDH-2 terminology
Body Structure
INTERVENTION
Comparison
1. Perceptual Training treatment
2. Conventional therapy group
Description
Perceptual Training Group
- Stick length sorting
- Picture lotto
- Perceptual trait recognition game
- Color category
Conventional Therapy Group
- Physical training activities
- Games
- Craft work
- Gardening
- Solitaire
- Battleship
Who delivered
Occupational therapists
Setting
Rivermead Rehabilitation Centre, Oxford, Great Britain
FREQUENCY/DURATION
Baseline
Initial Assessment
Frequency
4 Hours per week, 1 hour sessions, 3 activities each session
Duration
For 4 weeks
Follow-up
Reassessment of RPAB and activity of daily living scales
RESULTS
- Statistical Tests Used for Analysis: t-test
- Statistical Significance: 17 t tests between conventional occupational therapy group and occupational therapy perceptual training group (refer to Table 2 in article)
- Summarize Key Results: There were no significant differences were found between the groups either before or after treatment
CONCLUSIONS
Biases
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Attention |
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Masking/blinding |
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Drop outs |
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X |
Contamination |
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Co-intervention |
|
- The study cannot provide conclusive evidence that practice on perceptual tasks is either effective or ineffective
- Limitations: small sample size, varying etiologies of injury, spontaneous recovery
Terminology used in this document is based on two systems of classification current at the time the evidence-based literature reviews were completed: Uniform Terminology for Occupational Therapy Practice - Third Edition (AOTA, 1994) and International Classification of Functioning, Disability and Health (ICIDH-2) (World Health Organization [WHO], 1999). More recently, the Uniform Terminology document was replaced by Occupational Therapy Practice Framework: Domain and Process (AOTA, 2002), and modifications to ICIDH-2 were finalized in the International Classification of Functioning, Disability and Health (WHO, 2001).
This work is based on the evidence-based literature review completed by Beatriz C. Abreu, PhD, OTR, FAOTA, and colleagues. For more information about the Evidence-Based Literature Review Project, contact the Practice Department at the American Occupational Therapy Association, 301-652-6611, x 2040.
Copyright 2003 American Occupational Therapy Association, Inc. All rights reserved. This material may be reproduced and distributed without prior written consent.
