Effects of Optokinetic Stimulation Without a Reading Task in Patients With Hemianopic Alexia
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Change in reading speed on paper
研究概览
简要总结
The goal of this clinical trial is to investigate whether optokinetic stimulation delivered without a reading task can improve reading performance in adults with post-stroke hemianopic alexia. The main question it aims to answer is: does optokinetic stimulation without a reading task improve reading speed more than optokinetic stimulation with a reading task? Optokinetic stimlation with a reading task is considered the standard rehabilitation. These two conditions will be administered according to a randomized crossover design to determine wether the presence or absence of a reading task influences reading outcomes.
Participants will
- receive 4 weeks of optokinetic stimulation without a reading task and 4 weeks of optokinétic stimulation with a reading task, with the order of these two interventions determined by randomization,
- undergo assesments of reading performance, oculomotor behavior, visual field and rehabilitation tolerability before and after each intervention period,
- undergo a follow-up assesment 1 month after completion of the interventions.
详细描述
Stroke can cause a visual field defect known as homonymous hemianopia (HH). When this visual field loss involves the macula, the central area of vision, it may result in reading difficulties known as hemianopic alexia (HA).
The literature reports improved reading performance in these patients after repeated induction of horizontal optokinetic nystagmus (i.e., an oculomotor reflex consisting of horizontal saccades). To induce this nystagmus, previous studies have used a reading task involving text scrolling from right to left.
However, this type of exercise, which relies on reading, is cognitively demanding and may lead to frustration due to reading difficulties, fatigue, and reduced motivation and potentially the impact of rehabilitation. Therefore, the use of a non-reading task could help overcome these limitations.
The present study aims to compare the efficacy of optokinetic stimulation with reading to optokinetic stimulation without reading in patients with HA.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Time since lesion > 1 month
- •Diagnosis of homonymous hemianopia post-stroke without macular sparing
- •Reading complaint and/or reading impairment
- •Proficiency in reading French
- •Agreed to give informed consent
- •Afiliated with national health insurance
排除标准
- •History of neurological or psychiatric disorders
- •Visual impairment of peripheral origin (i.e., related to damage to the structures of the eye or the optic nerve)
- •Uncorrected visual acuity deficit
- •Reading disorder prior to the stroke (dyslexia)
- •Instability of reading impairment
- •Instability of homonymous hemianopia
- •Major cognitive that would limit the ability of the patient to participate in the study (unilateral spatial neglect, simultanagnosia, comprehension disorder, oral expression disorder)
研究组 & 干预措施
Group A
Patients receive 15 sessions of optokinetic rehabilitation with a reading task, followed by 15 sessions of optokinetic rehabilitation without an associated reading task.
The optokinetic rehabilitation sessions with reading are considered the standard of care, while optokinetic rehabilitation without an associated reading task is the experimental condition. Each patient undergoes both conditions sequentially and serves as their own control.
干预措施: Optokinetic stimulation without reading task (Other)
Group A
Patients receive 15 sessions of optokinetic rehabilitation with a reading task, followed by 15 sessions of optokinetic rehabilitation without an associated reading task.
The optokinetic rehabilitation sessions with reading are considered the standard of care, while optokinetic rehabilitation without an associated reading task is the experimental condition. Each patient undergoes both conditions sequentially and serves as their own control.
干预措施: Optokinetic stimulation with reading task (Other)
Group B
Patients receive 15 sessions of optokinetic rehabilitation without an associated reading task, followed by 15 sessions of optokinetic rehabilitation with a reading task.
The optokinetic rehabilitation sessions with reading are considered the standard of care, while optokinetic rehabilitation without an associated reading task is the experimental condition. Each patient undergoes both conditions sequentially and serves as their own control.
干预措施: Optokinetic stimulation without reading task (Other)
Group B
Patients receive 15 sessions of optokinetic rehabilitation without an associated reading task, followed by 15 sessions of optokinetic rehabilitation with a reading task.
The optokinetic rehabilitation sessions with reading are considered the standard of care, while optokinetic rehabilitation without an associated reading task is the experimental condition. Each patient undergoes both conditions sequentially and serves as their own control.
干预措施: Optokinetic stimulation with reading task (Other)
结局指标
主要结局
Change in reading speed on paper
时间窗: Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
Change in the number of correctly read words per minute, assessed using the International Reading Speed Texts (IReST). For each participant, the change in reading speed will be calculated separately for the optokinetic rehabilitation condition with a reading task and for the optokinetic rehabilitation condition without a reading task. The within-participant changes obtained after each 4-week period will be pooled across the two randomized sequences and compared between conditions. A higher reading speed indicates better reading performance.
次要结局
- Change in reading accuracy on paper(Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8)
- Change in reading speed on screen(Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8)
- Change in reading accuracy on screen(Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8)
- Change in subjective reading abilities(Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8)
- Change in ocular fixations during reading(Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8)
- Change in ocular saccades during reading(Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8)
- Change in optokinetic nystagmus(Baseline and at the end of both rehabilitation: Week 0 and Week 8)
- Change in visual detection during standard perimetry(Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8)
- Change in visual detection during screen-based perimetry(Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8)
- Tolerability of rehabilitation(Before and after each rehabilitation session)
- Motivation for rehabilitation(End of each 4-week rehabilitation period: Week 4 and Week 8)