London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 769 801 Rehabilitation and reorganisation after stroke Simulating Hemianopia with Partially Obscured Contact Lenses P.L. Clatworthy1, K. Morris2, E. Sewter3, I.D. Gilchrist4 University of Bristol, Bristol, UNITED KINGDOM1, University of Bristol, Bristol, UNITED KINGDOM2, University of Bristol, Bristol, UNITED KINGDOM3, University of Bristol, Bristol, UNITED KINGDOM4 Background Homonymous hemianopia is a common effect of stroke, impairing daily living and quality of life. It can distort size perception, shift perceived visual straight ahead, impair visual search, and may cause impaired balance and falls. The contribution of visual loss alone to impairments is confounded by other effects of brain damage. Realistic simulation of hemianopia in healthy participants, without constraints imposed by gaze-contingent displays, would help us understand the effects of hemiano-pia. Methods 4 healthy, right-handed participants (1 male; age 22-24) took part in this study, which was approved by our department’s Ethics Committee. All were regular contact lens wearers. Participants wore “hemianopic” contact lenses (Figure 1) for 6 sessions on separate days. Rotationally stabilised lens-es (Cantor and Nissel), each pair made to an individual’s prescription, were professionally hand painted to obscure the right half of each pupil. In the first and last sessions, participants rated lenses’ 1) comfort, 2) stability, & 3) visual effects. Pe-rimetry was performed at all sessions with a Humphrey Matrix perimeter, while lenses were worn. Results Perimetry results were very variable (Figure 2 shows left eye examples). In some cases hemianopia was approximately complete, but in others no field loss was apparent, even in the same participant using the same lenses. Questionnaires showed all participants found the lenses comfortable by the last session. None felt that they remained stable on the eyes. Participants could see their vision was partially obscured. Two thought the lenses reduced awareness and two felt they had to actively compensate for their effects. Conclusions Simulation of hemianopia using contact lenses is feasible in regular contact lens wearers. In this study, encouraging subjective effects were found: active compensation; imbalance; reduced aware-ness. However, lenses sat unstably on the eyes. We are currently procuring lenses with improved sta-bility. 802 Rehabilitation and reorganisation after stroke The Effect of Respiratory Muscle Training according to Patient’s Initial Pulmonary Function in Acute Stroke Patients M.K. Sim1, M.H. Chun2, J.H. Yi3, S.J. Lee4 Asan medical center, Seoul, SOUTH KOREA1, Asan medical center, Seoul, SOUTH KOREA2, Asan medical center, Seoul, SOUTH KOREA3, Asan medical center, Seoul, SOUTH KOREA4 Objective Decline in respiratory function has been reported in stroke patients. Previous study showed that re-spiratory muscle training improved pulmonary function in stroke patients. The aim of this study was to determine which subgroup showed more improvement of pulmonary function and functional sta-tus after respiratory muscle training according to their initial FEV1. Methods Patients with first episode of unilateral stroke were recruited. All subjects participated in conven-tional stroke rehabilitation program and pulmonary rehabilitation program. Pulmonary rehabilitation program consisted of inspiratory muscle training using volumetric incentive spirometer and expira-tory muscle training using positive expiratory pressure breathing device. All patients trained daily for 5 sessions of 5 times of inspiration and expiration muscle training, 6 times a week for 3 weeks. Subjects performed pulmonary function test and were assessed for modified Barthel index (MBI) and Brief Fatigue Inventory (BFI) at baseline and at the end of the training. The results were as-sessed in 5 groups according to initial relative FEV1. Results 24 stroke patients were enrolled. There were no significant differences in age, gender, type of stroke, lesion site, body mass index, duration of disease, and history of smoking according to initial FEV1. Patients with moderate pulmonary function (2nd, 3rd, 4th quintile) showed significant improvement in FEV1, BFI after the training. There was a statistically significant increase in MBI score in sub-jects in the 2nd, 3rd, 4th, and 5th quintile of FEV1. Conclusion Patients showed difference in results according to initial pulmonary function after pulmonary reha-bilitation program. Patients with moderate pulmonary function showed more improvement than pa-tients with severe and mild pulmonary function. This study suggests that respiratory muscle training using volumetric incentive spirometry and positive expiratory pressure breathing device was effec-tive for improvement of pulmonary function and recovery of functional status.
Karger_ESC London_2013
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