The Effects of Fresnel Prism Glasses on Visual Perception, Balance, Gait and Functional Independence in Post-Stroke Patients
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 50
- 主要终点
- Motor-Free Visual Perception Test
研究概览
简要总结
This randomized controlled trial aims to evaluate the effects of Fresnel prism glasses on visual perception, balance, gait, and functional independence in post-stroke patients. Stroke survivors, particularly those with right hemisphere involvement, often experience visuospatial deficits such as unilateral spatial neglect, leading to impaired balance, abnormal gait, and reduced functional independence. Fresnel prism glasses offer a low-cost, non-invasive intervention that may improve visuospatial alignment and postural control by modifying visual input. Adult post-stroke patients will be randomly allocated into an intervention group receiving Fresnel prism glasses alongside conventional physical therapy, and a control group receiving conventional therapy alone. Outcome measures will include the Motor-Free Visual Perception Test, Berg Balance Scale, Functional Independence Measure, and JAKC Observational Gait Analysis. Assessments will be conducted at baseline, post-intervention, and follow-up. The study is expected to provide evidence on whether Fresnel prism glasses can serve as an effective adjunct to conventional rehabilitation for improving mobility, balance, and functional outcomes in stroke survivors.
详细描述
Stroke is one of the leading causes of long-term disability worldwide and is frequently associated with impairments in balance, gait, motor function, and visuospatial perception. Among these deficits, unilateral spatial neglect (USN) is particularly common following right hemisphere stroke and significantly limits functional recovery. Individuals with USN often demonstrate impaired awareness of the contralesional space, distorted midline perception, postural asymmetry, and abnormal gait patterns, which collectively increase the risk of falls and dependence in activities of daily living. Despite advances in conventional stroke rehabilitation, including physical and occupational therapy, many patients continue to experience persistent functional limitations, highlighting the need for innovative and adjunctive rehabilitation strategies.
Recent developments in neurorehabilitation emphasize sensory-based interventions that promote neuroplasticity by modifying sensory input. Fresnel prism glasses represent a low-cost, non-invasive visual intervention designed to shift the visual field and facilitate visuospatial realignment. By altering visual input, Fresnel prisms may enhance sensory integration and improve postural control, balance, and gait performance in stroke survivors. Preliminary studies have demonstrated improvements in balance measures, gait symmetry, and visual perception following prism use; however, findings remain inconsistent, and evidence regarding functional outcomes and long-term effects is limited.
This randomized controlled trial aims to evaluate the effectiveness of Fresnel prism glasses as an adjunct to conventional physiotherapy in post-stroke patients. Eligible participants with a confirmed diagnosis of stroke will be randomly allocated into two groups: an experimental group receiving Fresnel prism glasses in addition to standard rehabilitation, and a control group receiving conventional physiotherapy alone. The intervention will be delivered over a defined treatment period, with assessments conducted at baseline and post-intervention.
Primary outcome measures will assess balance and postural control using standardized tools such as the Berg Balance Scale and Functional Reach Test. Secondary outcomes will include gait analysis, visual perception, and functional independence measured through validated clinical scales. The study also seeks to examine whether visual realignment through Fresnel prisms can facilitate weight transfer toward the affected side and reduce asymmetry during standing and walking.
The findings of this study are expected to contribute to the growing body of evidence on sensory-based rehabilitation interventions for stroke. By addressing current gaps related to functional outcomes and feasibility, this research may help establish Fresnel prism glasses as an effective, accessible adjunct therapy in stroke rehabilitation, particularly in resource-limited settings. Ultimately, the study aims to support improved mobility, independence, and quality of life among stroke survivors.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 55 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Right hemisphere with left side neglect (14). Adults (40-65 years old) who have experienced an ischemic stroke for the first time (1-3 months post-stroke) are eligible (15) A score of 2-4 in the Functional Ambulation Category (FAC) (16) and MMSE ≥24 (to guarantee training-related cognitive ability)(17). Patient who can walk more than 10m Independently
排除标准
- •Severe comorbidities, such as neurological or orthopedic disorders and impair gait(18) Hearing and vision problems that are not assisted. Patients with profound sensory impairment or significant cognitive dysfunction(19) Individuals who have recently suffered from cardiac failure, myocardial infarction, or other severe illnesses(20)
结局指标
主要结局
Motor-Free Visual Perception Test
时间窗: Baseline, before intervention, 8 weeks post intervention
The Motor-Free Visual Perception Test (MVPT) is a standardized assessment tool consisting of 36 items that evaluate multiple domains of visual perception, including figure-ground discrimination, visual discrimination, visual memory, visual closure, and spatial relationships. It is designed to assess visual field deficits and overall visual perceptual function in patients who have experienced brain injuries or strokes. In this study, we measured participants' response behaviors to identify the extent of unilateral neglect by recording their responses to both the left and right sides of the body, regardless of accuracy. Correct responses are scored as raw points, while the total time taken to complete the assessment is recorded as the visual perceptual processing time. The maximum score achievable is 36 points. The MVPT demonstrates high reliability, with a test-retest intraclass correlation coefficient (ICC) of 0.92 (95% CI: 0.84-0.96). In this trial, the MVPT will be utilized.
JAKC's Observational Gait Analysis
时间窗: Baseline, before intervention, 8 week post intervention
The JAKC Observational Gait Analysis (Joint Angle Kinematic Coordination) is a wellstructured clinical tool designed to evaluate gait patterns, especially in individuals dealing with neurological or musculoskeletal issues like stroke. It zeroes in on the coordination and quality of movement in key joints-namely the hip, knee, ankle, and trunk-throughout various stages of the gait cycle. By closely observing joint angles, timing, and how limbs work together, therapists can spot unusual movement patterns and compensatory behaviors. The JAKC scale aids in clinical decision-making by pinpointing specific gait deviations, which helps in crafting targeted interventions and tracking progress over time. It's a practical, non-invasive approach that's widely embraced in rehabilitation environments
Berg Balance Scale
时间窗: baseline, before interventio, 8 weeks post intervention
The Functional Independence Measure (FIM) is a key tool used to assess the level of disability in patients undergoing rehabilitation. It evaluates 18 different activities of daily living on a scale from 1 to 7, where 1 means the person is fully dependent and 7 means they can do everything independently without any assistance. The highest possible score is 126, which signifies complete functional independence, while the lowest score of 18 indicates total dependence. The activities are divided into two main categories: 13 motor skills (like personal care, sphincter control, mobility, and locomotion) and five cognitive skills (which include communication and social cognition)
Functional Independence Measure
时间窗: baseline, before intervention, 8 weeks post intervention
Independence Measure (FIM) is a key tool used to assess the level of disability in patients undergoing rehabilitation. It evaluates 18 different activities of daily living on a scale from 1 to 7, where 1 means the person is fully dependent and 7 means they can do everything independently without any assistance(23). The highest possible score is 126, which signifies complete functional independence, while the lowest score of 18 indicates total dependence. The activities are divided into two main categories: 13 motor skills (like personal care, sphincter control, mobility, and locomotion) and five cognitive skills (which include communication and social cognition)
次要结局
未报告次要终点