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

Objective: To compare the effectiveness of the transfer of training and fun ctional approaches in improving perceptual and functional abilities after s troke. Design: Patients identified as having perceptual problems were randomly all ocated to either the transfer of training approach or the functional approa ch 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 si x 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 o n patient characteristics or impairments. The results also showed no signif icant 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). Wil coxon matched pairs signed ranks tests showed a significant improvement in both groups after treatment on perceptual and functional abilities (percept ual z = 6.02, p < 0.001, functional z = 6.72, p < 0.001). Conclusions: These results indicated that the improvement in perceptual abi lities was equivalent using either of the two approaches. This could be due to spontaneous recovery or the effects of the Stroke Unit.