After a stroke, up to one in three survivors will experience a condition called spatial neglect – but researchers say there isn’t enough research being done into the condition.
Spatial neglect is a type of vision loss, where a stroke survivor loses awareness of one side. It’s most common after strokes to the right hemisphere, where people will be unaware of objects or people on the right side, says Helen Morse, PhD student University of East Anglia, funded by the Stroke Association.
People with spatial neglect don’t have anything physically wrong with their eyes that causes these problems.
Morse calls it a ‘complex and bizarre condition’ that can also affect other ways people receive information, such as visually, as well as their hearing and sense of touch. This, she says, makes it a difficult condition to measure, detect and treat.
“It can make day to day life very difficult for people,” she said in a UK Stroke Assembly virtual event.
“Some people have it for more than a year after their stroke, this is worrying because people with spatial neglect tend to have worse recovery than those without.”
It can make it hard for people to engage in rehab. And this is exactly why there needs to be more research on the condition, Morse says.
“People don’t feel like they have enough support at home, and there’s not a lot of effective rehab and therapies out there.”
But, she adds, surveys have found that visual problems is one of top ten areas stroke survivors want to see more research in.
In response, Morse has developed Sight, a home-based, low-cost, patient-led therapy that stroke survivors can do independently. It involves people lifting and balancing a wooden rod repeatedly, and aims to improve and reduce symptoms.
Users will only see half of the rod, due to their spatial neglect, and will think the middle of the rod is much more to one side.
The therapy has shown improvement compared to control groups. After doing the therapy for two days in their homes, users reported less impact from the condition on everyday activities, and they showed improvements on tests used to show spatial neglect. Improvement was higher after 10 days and was still there four months later.
Over the last couple years, Morse has also been working to develop a computerised version of Sight, with the aim of monitoring how often people are using the therapy, whether they’re improving, and she’s hoping it’s more interesting for stroke survivors than conventional therapy that doesn’t use a computer.
Users are set up with the technology in their house, with the rods and the programme, which they can play on their TV screen, as well as a motion tracker that tracks how often they’re doing the therapy and whether they’re improving.
Morse worked with stroke survivors to develop the technology, as well as carers and clinicians, which enabled her to prioritise stroke survivors’ preferences and needs, she says.
“We will be working with stroke survivors to see how the technology helps, installing equipment in thier homes and training them how to use it,” she says.
They will complete the therapy for 10 days, doing 30 minutes twice a day, they’ll then be tested to see any change in their performance and improvement in spatial neglect, then they will be visited after one month to see if any of the improvements have lasted.
“This is the first step to see if Sight can help stroke survivors with spatial neglect from home without having to travel,” Morse says.
The ultimate aim of the therapy, she says, is to help people with spatial neglect after a stroke get the help they need and recover the best they can.
