A comparison of two approaches in the treatment of perceptual problems after stroke

Objective: To compare the effectiveness of the transfer of training and functional approaches in improving perceptual and functional abilities after stroke. Design: Patients identified as having perceptual problems were randomly allocated to either the transfer of training approach or the functional approach for perceptual treatment. On completion of six weeks of treatment, each patient was reassessed for perceptual and functional abilities. Subjects and setting: Eighty inpatients on the Nottingham Stroke Unit. Interventions: Perceptual treatment was given for 2.5 hours per week for six weeks. Main outcome measures: Rivermead Perceptual Assessment Battery, Barthel ADL Index and Edmans ADL index. Results: There was no significant difference between the treatment groups on patient characteristics or impairments. The results also showed no significant difference between the treatment groups before and after treatment on perceptual ability total scores, individual perceptual subtest scores, or functional ability total scores (Mann-Whitney U 642.5-798.0, p > 0.05). Wilcoxon matched pairs signed ranks tests showed a significant improvement in both groups after treatment on perceptual and functional abilities (perceptual z = 6.02, p < 0.001, functional z = 6.72, p < 0.001). Conclusions: These results indicated that the improvement in perceptual abilities was equivalent using either of the two approaches. This could be due to spontaneous recovery or the effects of the Stroke Unit.