Structured Abstract
Stroke Structured Abstract - S #20
Training in cognitive and perceptual processing may enhance perceptual ablities in stroke clients with left hemiplegia
CITATION: Young, G. C., Collins, D., & Hren, M. (1983). Effect of pairing scanning design training with block training in the remediation of perceptual problems in left hemiplegics. Journal of Clinical Neuropsychology, 5, 201-212.
LEVEL OF EVIDENCE: IIC2b
RESEARCH QUESTION
What is the effect of pairing scanning training with block design training in the remediation of perceptual problems in persons with left hemiplegia?
DESIGN
Independent group design (randomization not reported).
SAMPLING PROCEDURE/INCLUSION CRITERIA
NR
SAMPLE
|
N = 27 |
Male = NR |
Female = NR |
Mean age = 64 |
|
LCVA = 0 |
RCVA = 27 |
Attrition = NR |
|
x |
Acute |
|
Chronic |
NR = Not Reported
Patients were included if they had a right cerebral vascular accident (CVA), were aged 45 to 80, and had significant left neglect and/or visual scanning deficits.
OUTCOME MEASURES
(R = Reliability established; V = Validity established)
Wechsler Adult Intelligence Scale (WAIS) - R, V
Letter Cancellation Task - R, V
Wide Range Achievement Test (WRAT) Reading Subtest - R
Copying an Address (reliability not established)
Counting Faces (in a picture) &ndash R
INTERVENTION DESCRIPTION
Control Group #1 (C1): Was trained for the whole hour on activities of daily living (ADL) and perceptual tasks.
Control Group #2 (C2): Was trained for 20 minutes on routine OT (as C1), 20 minutes on word cancellation tasks, and 20 minutes on the scanning apparatus.
Experimental Group (E): Received 20 minutes of training on word cancellation tasks, 20 minutes on the scanning apparatus, and 20 minutes on block design training.
WHO DELIVERED INTERVENTION
Two OTs
SETTING
Clinics
FREQUENCY & DURATION
1 hour of training each weekday for 20 successive days, excluding weekends.
RESULTS
The authors used an Effectiveness Index score rather than simple difference scores to account for differences in abilities among subjects.
Between Groups/Conditions/Times:
There were no significant differences between C1 and C2.
Wide Range Achievement Test - Reading Subtest: E > C1 (t = -2.70, p < .01, r = .56); E > C2 (t = -2.70, p < .01, r = .56).
Copying an Address: E > C1 (t = -2.41, p < .025, r = .52), E > C2 (t = -0.897, NS, r = .22).
Letter Cancellation: E > C1 (t= -3.24, p < .005, r = .63), E > C2 (t = -2.06, p < .05, r = .46).
Counting Faces: NS, r = .14.
Within Groups/Conditions/Times:
C2 and E improved on measures of visual scanning, reading, and writing to a significantly greater extent than C1 (p < .05).
E improved to a significantly greater extent than C2 (p < .05).
The average effect sizes for C1, C2, and E were .70, .73, and .85, respectively (confounded with maturation effect).
THREATS TO VALIDITY
Possible selection bias due to no random assignment.
Expectaion: Treaters were not blind to the hypothesis.
AUTHORS' CONCLUSIONS
Block design training enhances the effect of visual scanning training techniques in the remediation of perceptual problems in persons with left hemiplegia.
REVIEWERS' CONCLUSIONS
The study suggests the effectiveness of cancellation training, visual scanning training, and block design training on improving the perceptual performance of persons with right CVA.
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 Hui-ing Ma, ScD, OTR, and Catherine A. Trombly, ScD, OTR/L, FAOTA.
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.
