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Adaptation to post-stroke homonymous hemianopia - a prospective longitudinal cohort study to identify predictive factors of the adaptation process

Howard, C, Czanner, G, Helliwell, B and Rowe, FJ (2021) Adaptation to post-stroke homonymous hemianopia - a prospective longitudinal cohort study to identify predictive factors of the adaptation process. Disability and Rehabilitation, 44 (18). pp. 5152-5161. ISSN 0963-8288

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Purpose: To determine any factors that predict how an individual will adapt to post-stroke hemianopic visual field loss, with close monitoring of the adaptation process from an early stage.
Materials and methods: The Hemianopia Adaptation Study (HAST) is a prospective observational longitudinal cohort clinical study. Adult stroke survivors (n = 144) with new onset homonymous hemianopia were monitored using standardised mobility assessment course (MAC) as the primary outcome measure of adaptation.
Results: Several baseline variables were found to be good predictors of adaptation. Three variables were associated with adaptation status at 12-weeks post-stroke: inferior % visual field, % total MAC omissions, and MAC completion time (seconds). Baseline measurements of these variables can predict the adaptation at 12 weeks with moderate to high accuracy (area under ROC curve, 0.82, 95% CI 0.74–0.90). A cut-off score of ≤25% target omissions is suggested to predict which individuals are likely to adapt by 12-weeks post-stroke following gold standard care.
Conclusions: Adaptation to hemianopia is a personal journey with several factors being important for prediction of its presence, including MAC outcomes and extent of inferior visual field loss. A clinical recommendation is made for inclusion of the MAC as part of a functional assessment for hemianopia. Implications for rehabilitation The mobility assessment course (MAC) should be considered as an assessment of mobility/scanning in the rehabilitation of patients with homonymous hemianopia. A cut-off score of ≤25% omissions on MAC could be employed to determine those likely to adapt to hemianopia long-term. Targeted support and therapy for patients with significant visual loss in the inferior visual field area should be considered.

Item Type: Article
Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 29th May 2021, available at: http://www.tandfonline.com/10.1080/09638288.2021.1927207
Uncontrolled Keywords: adaptation; Hemianopia; Life Sciences & Biomedicine; mobility assessment course; MOVEMENT; NEGLECT; prediction; Rehabilitation; Science & Technology; stroke; visual impairment; VISUAL-FIELD DEFICITS; Science & Technology; Life Sciences & Biomedicine; Rehabilitation; Hemianopia; stroke; adaptation; visual impairment; mobility assessment course; prediction; VISUAL-FIELD DEFICITS; MOVEMENT; NEGLECT; Humans; Vision Disorders; Hemianopsia; Cohort Studies; Longitudinal Studies; Prospective Studies; Visual Fields; Adult; Stroke; Hemianopia; adaptation; mobility assessment course; prediction; stroke; visual impairment; Adult; Cohort Studies; Hemianopsia; Humans; Longitudinal Studies; Prospective Studies; Stroke; Vision Disorders; Visual Fields; 11 Medical and Health Sciences; Rehabilitation
Subjects: Q Science > QA Mathematics > QA75 Electronic computers. Computer science
R Medicine > R Medicine (General)
Divisions: Computer Science & Mathematics
Publisher: Taylor & Francis
SWORD Depositor: A Symplectic
Date Deposited: 06 Feb 2023 11:42
Last Modified: 06 Feb 2023 11:45
DOI or ID number: 10.1080/09638288.2021.1927207
URI: https://researchonline.ljmu.ac.uk/id/eprint/18811
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