Prism Adaptation Treatment Improves Inpatient Rehabilitation Outcome in Individuals With Spatial Neglect: A Retrospective Matched Control Study

OBJECTIVE: To determine whether prism adaptation treatment (PAT) integrated into the standard of care improves rehabilitation outcome in patients with spatial neglect (SN). DESIGN: Retrospective matched control study based on information extracted from June 2017-September 2019. SETTING: Inpatient rehabilitation. PARTICIPANTS: Patients from 14 rehabilitation hospitals scoring >0 on the Catherine Bergego Scale (N=312). The median age was 69.5 years, including 152 (49%) female patients and 275 (88%) patients with stroke. INTERVENTIONS: Patients were matched 1:1 by age (±5 years), FIM score at admission (±2 points), and SN severity using the Catherine Bergego Scale (±2 points) and classified into 2 groups: treated (8-12 daily sessions of PAT) vs untreated (no PAT). MAIN OUTCOME MEASURES: FIM and its minimal clinically important difference (MCID) were the primary outcome variables. Secondary outcome was home discharge. RESULTS: Analysis included the 312 matched patients (156 per group). FIM scores at discharge were analyzed using repeated-measures analyses of variance. The treated group showed reliably higher scores than the untreated group in Total FIM, F=5.57, P=.020, partial η(2)=0.035, and Cognitive FIM, F=19.20, P<.001, partial η(2)=0.110, but not Motor FIM, F=0.35, P=.553, partial η(2)=0.002. We used conditional logistic regression to examine the odds ratio of reaching MCID in each FIM score and of returning home after discharge. No reliable difference was found between groups in reaching MCID or home discharge. CONCLUSIONS: Patients with SN receiving PAT had better functional and cognitive outcomes, suggesting that integrating PAT into the standard of care is beneficial. However, receiving PAT may not determine home discharge.