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adolescent assessment,\r\n
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<p style="text-align:center"> </p>\n
\n
<p style="text-align:center"><span style="font-size:x-large"><strong><span style="color:#993300; font-family:book antiqua,palatino">TREAT SPATIAL NEGLECT FROM STROKE</span></strong></span></p>\n
\n
<p style="text-align:center"><span style="font-size:x-large"><strong><span style="color:#993300; font-family:book antiqua,palatino"><span style="font-size:large">IMPROVE FUNCTIONAL RECOVERY AFTER STROKE</span></span></strong></span></p>\n
\n
<p style="text-align:left"> </p>\n
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<p><strong><u><u>SPATIAL NEGLECT</u></u></strong></p>\n
\n
<ul>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Affects 30-50% of stroke patients</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Majority do not realize it</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Debilitating- Interferes with mobility, self-care, navigation, reading, employment, safety</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Requires treatment for improvement</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Improving spatial attention and spatial awareness leads to improvement in other domains</span></li>\n
</ul>\n
\n
<p>Your browser does not support the video tag.</p>\n
\n
<p> </p>\n
\n
<div>\n
<hr /></div>\n
\n
<p style="text-align:center"><span style="color:#3366ff; font-family:tahoma,arial,helvetica,sans-serif; font-size:x-large">Missing Critical Information Can Have Devastating Consequences</span></p>\n
\n
<div style="align-items:center; display:flex; justify-content:center">\n
<div style="flex:50%; padding:5px"><img alt="" src="http://www.stoeltingco.com/Psychological/media/womens_bathroom_sign_neglect.jpg" style="width:50%" /></div>\n
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<div style="flex:50%; padding:5px"><img alt="" src="http://www.stoeltingco.com/Psychological/media/car_crosswalk_neglect.jpg" style="width:75%" /></div>\n
</div>\n
\n
<hr />\n
<p><strong><u><u>PRISM ADAPTATION TREATMENT</u></u></strong></p>\n
\n
<ul>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Treats neural networks- Sustained improvement</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Evidence-based- Recommended by medical associations</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Easy for patients to participate</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Improvements seen within 10 sessions of 20 minutes</span></li>\n
</ul>\n
\n
<div><iframe align="middle" frameborder="0" height="200" name="KF-PAT Demonstration" scrolling="no" src="/Psychological/media/Kessler_Foundation_Prism_Adaptation_Treatment_Demonstration.mp4" title="KF-PAT Demonstration" width="300"></iframe></div>\n
\n
<p> </p>\n
\n
<hr />\n
<p><strong><u><u>KESSLER FOUNDATION PRISM ADAPTATION TREATMENT (KF-PAT)</u></u></strong></p>\n
\n
<ul>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Patented portable system</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Complete system with manual to administer entire course of treatment </span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Ongoing clinical and technical support </span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Extensive research support </span></li>\n
</ul>\n
\n
<div>\n
<p style="text-align:left"><span style="color:#3366ff"><span style="font-family:book antiqua,palatino; font-size:medium"><span style="color:#000000"><strong>Authors: </strong></span></span><span style="font-family:book antiqua,palatino; font-size:medium">Peii</span><em><span style="font-family:book antiqua,palatino; font-size:medium"> Chen, PhD & Kimberly Hreha, EdD, OTR/L</span></em></span></p>\n
\n
<p style="text-align:left"><br />\n
<span style="color:#3366ff"><strong><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium">Kessler Foundation Prism Adaptation Treatment (KF-PAT)</span></strong><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium"> is a complete system to administer prism adaptation treatment for the treatment of spatial neglect. Prism adaptation uses prism goggles (goggles with lenses tilted either to the right or left) to effect a visuomotor phenomenon (prism adaptation), which improves spatial neglect. Researchers at Kessler Foundation who developed this device and treatment protocol have conducted extensive research involving federally funded clinical trials that have resulted in numerous peer-reviewed journal articles (see Details Tab for references). Prism adaptation treatment has been recommended as a frontline treatment for spatial neglect by the American Heart/Stroke Association, the Canadian Stroke Association, and in many meta-analyses and systematic reviews.</span></span></p>\n
</div>\n
\n
<div><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium"><strong>Spatial neglect</strong> is a syndrome caused by damaged neural networks critical for attention and related functions in the brain.<sup> </sup>Because attention, especially spatial attention, is essential for a wide variety of functions, spatial neglect affects many perceptual, cognitive, and motor functions. Deficits caused by spatial neglect disrupt basic self-care activities (e.g., dressing, grooming), impair postural balance, interfere with reading ability, and impede navigation.</span></div>\n
\n
<div> </div>\n
\n
<div><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium"><strong>Yet, the majority of the time spatial neglect goes untreated, due to lack of assessment and lack of recognition by the patient</strong> due to neurological deficits related to the neglect.</span></div>\n
\n
<div> </div>\n
\n
<div style="text-align:center"><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium"><span style="color:#003300; font-family:'arial black','avant garde'">KF-PAT Prism Adaptation Sequence</span></span></div>\n
\n
<div style="align-items:center; display:flex; justify-content:center"><img alt="kf-pat adaptation sequence" src="http://www.stoeltingco.com/Psychological/media/kf-pat_adaptation_sequence.JPG" />></div>\n
\n
<div> </div>\n
\n
<div><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium">The KF-PAT treatment is typically administered over 10 sessions of approximately 20 minutes each. Patients wear goggles that shift their vision slightly horizontally while reaching for targets presented by the therapist. Visual feedback regarding the missed target is “sent” to the motor system, which corrects the subsequent attempts to reach towards the target. This process is then repeated with the goggles removed. Because the patient's motor system had adapted to the image shifted from the actual target by the goggles, the patient is again off-target when reaching for the target, but then adapts to this distortion and is able to again accurately reach to the target. </span></div>\n
\n
<div> </div>\n
\n
<div><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium">This entire process of adaptation helps bring attention and awareness to the neglected side of space and improves symptoms of spatial neglect. The benefits of this treatment compared to others is that:</span></div>\n
\n
<div>\n
<ol>\n
\t<li><span style="font-family:book antiqua,palatino">Improvements occur automatically. Patients do not have to learn skills, read, remember information, or perform other actions that may be difficult for those with symptoms of stroke.</span></li>\n
\t<li><span style="font-family:book antiqua,palatino">Most patients can participate. The movements necessary are minimal and because the KF-PAT has a patented portable design, the treatment can even be brought to patients for whom travel would be difficult. </span></li>\n
\t<li><span style="font-family:book antiqua,palatino">Effects are sustained. Treatment occurs at a fundamental neurological level. Thus, changes that occur do not require deliberate effort or are the result of skills that may be forgotten or neglected.</span></li>\n
</ol>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium">The KF-PAT administration protocol has two built-in assessments of pointing performance both administered before and after prism adaptation to help you detect and measure prism after-effects in two different ways. The two assessments are Proprioceptive Pointing and Visual-Proprioceptive Pointing. </span></p>\n
\n
<h4><em><span style="font-family:book antiqua,palatino; font-size:medium">Proprioceptive Pointing</span></em></h4>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium">During the Proprioceptive Pointing task, patients will point straight ahead while blindfolded. You will assess patient’s deviation from the patient’s midline. This task assesses the patient’s innate sense of proprioception without visual cues. That is, they rely on their proprioception to make the movement.</span></p>\n
\n
<h4><em><span style="font-family:book antiqua,palatino; font-size:medium">Visual-Proprioceptive Pointing</span></em></h4>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium">During these tasks, patients will point at a visual target (hence “visual” in the name of this task), i.e., a pen held up by the therapist, while they are blocked from seeing their own arm, hand, or fingers when making the reaching and pointing movement (hence “proprioceptive” in the name of the task). You will assess the deviation of patient’s pointing, which indicates the (mis)alignment between the patient’s visual and motor systems.</span></p>\n
\n
<h4><em><span style="font-family:book antiqua,palatino; font-size:medium">After-Effect</span></em></h4>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium">As stated, both pointing tasks are administered before and after prism adaptation, thus creating four assessment conditions. Data is collected by the therapist during those tasks and the change in performance from before to after treatment is calculated and recorded in included <strong>reproducible record and summary forms</strong>.</span></p>\n
\n
<p><u><strong>Therapist Qualifications</strong></u></p>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium">You should have advanced training and/or educational degree with advanced coursework in neuro-rehabilitation of individuals with stroke or brain injury, or work under the license of someone with these credentials. Qualifications that typically fulfill these qualification requirements are: occupational therapists (OTs), physical therapists aka physiotherapists (PTs), speech and language pathologists (SLPs), clinical psychologists, neuropsychologists, neurologists, and physiatrists. </span></p>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium">The KF-PAT manaul is designed to guide everyone through the steps of training and learning to administer the KF-PAT so that they can administer an entire course of KF-PAT treatment. Ongoing clinical and technical support is provided. Additional training may acquired. Please contact us for details and options.</span></p>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium"><strong>The KF-PAT Kit</strong> (31100) contains all the equipment listed above as separate components. All equipment is necessary to administer the treatment.</span></p>\n
\n
<div> </div>\n
\n
<div>\n
<hr /></div>\n
</div>\n
\n
<h2>KF-PAT Components</h2>\n
\n
<p> </p>\n
\n
<ul>\n
\t<li>Right-based prism lenses <img alt="" id="img1" src="http://www.stoeltingco.com/Psychological/media/31100L_KF-PAT_left_goggles.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Left-based prism lenses <img alt="" id="img2" src="http://www.stoeltingco.com//Psychological/media/31100R_KF-PAT_right_goggles.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Position Board <img alt="" id="img6" src="http://www.stoeltingco.com/Psychological/media/31100P_KF-PAT_Position_Board.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Ruler Board <img alt="" id="img8" src="http://www.stoeltingco.com/Psychological/media/31100U_KF-PAT_Ruler_Board.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Visual‐proprioceptive task (VPT) Box <img alt="" id="img10" src="http://www.stoeltingco.com/Psychological/media/31100_KF-PAT_VPT_Box.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Visual field occluder <img alt="" id="img12" src="http://www.stoeltingco.com/Psychological/media/31100C_KF-PAT_visual_field_occluder.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Visual field occluder stand <img alt="" id="img14" src="http://www.stoeltingco.com/Psychological/media/31100S_KF-PAT_visual_occluder_stand.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>KF-PAT Manual <img alt="" id="img16" src="http://www.stoeltingco.com/Psychological/media/31100M_KF-PAT_manual.JPG" style="margin-left:80px; width:20%" /></li>\n
\t<li>Opaque apron <img alt="" id="img18" src="http://www.stoeltingco.com/Psychological/media/31100A_KF-PAT_Opaque_apron.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Kit binding strap <img alt="" id="img20" src="http://www.stoeltingco.com/Psychological/media/31100K_KF-PAT_kit_binding_strap.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Carrying bag <img alt="" id="img22" src="http://www.stoeltingco.com/Psychological/media/31100B_KF-PAT_bag.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Eye mask, pk/30 <img alt="" id="img24" src="http://www.stoeltingco.com/Psychological/media/31100E_KF-PAT_disposable_eye_mask.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Pen <img alt="" id="img26" src="http://www.stoeltingco.com/Psychological/media/31100F_KF-PAT_felt-tip_pen.png" style="margin-left:80px; width:20%" /></li>\n
\t<li>Laminated printed stimuli sheets <img alt="" id="img28" src="http://www.stoeltingco.com/Psychological/media/31100T_KF-PAT_stimulus_sheets.png" style="margin-left:80px; width:20%" /></li>\n
\t<li>Neck wraps, pk/50 <img alt="" id="img30" src="http://www.stoeltingco.com/Psychological/media/31100N_KF-PAT-neck_wraps.jpg" style="margin-left:80px; width:20%" /></li>\n
</ul>\n
"""
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<h2 style="text-align:center"><strong><span style="font-family:book antiqua,palatino; font-size:medium">References</span></strong></h2>\n
\n
<h3>Suggested APA 7th ed. Reference for KF-PAT</h3>\n
\n
<p><span style="font-family:'book antiqua',palatino; font-size:large">Chen, P. & Hreha, K. (2020). <em>Kessler Foundation Prism Adaptation Treatment 2020 manual</em>, Stoelting.</span></p>\n
\n
<h3>Complete References from Manual</h3>\n
\n
<ul>\n
\t<li><a data-tabindex-counter="4" data-tabindex-value="none" href="http://www.stoeltingco.com/Psychological/media/KF-PAT_Manual_references.pdf" tabindex="-1" target="_blank">KF-PAT Manual References</a></li>\n
</ul>\n
\n
<h3>Relevant Publication</h3>\n
\n
<p><a data-tabindex-counter="2" data-tabindex-value="none" href="/Products%20Import/Psychological-Testing/Hreha%20et%20al%202022.pdf" pimcore_id="4269" pimcore_type="asset" tabindex="-1">Hreha et al 2022.pdf</a> The Implementation Process of Two Evidence-Based Protocols: A Spatial Neglect Network Initiative, Frontiers in Health Services</p>\n
\n
<p><a data-tabindex-counter="2" data-tabindex-value="none" href="/Products%20Import/Psychological-Testing/Chen%20et%20al%202022%20PAT%20Dosage%20Matters.pdf" pimcore_id="4268" pimcore_type="asset" tabindex="-1">Chen et al 2022 PAT Dosage Matters.pdf</a> Impacts of Prism Adaptation Treatment on Spatial Neglect and Rehabilitation Outcome: Dosage Matters, American Society of Neurorehabilitation</p>\n
\n
<h3>Selected References of Prism Adaptation Efficacy</h3>\n
\n
<ul>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium">Angeli, V., Benassi, M. G., & Ladavas, E. (2004). Recovery of oculo-motor bias in neglect patients after prism adaptation. <em>Neuropsychologia, 42</em>(9), 1223-1234. doi:10.1016/j.neuropsychologia.2004.01.007 </span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium">Chen, P., Goedert, K. M., Shah, P., Foundas, A. L., & Barrett, A. M. (2014). Integrity of medial temporal structures may predict better improvement of spatial neglect with prism adaptation treatment. <em>Brain Imaging and Behavior, 8</em>(3), 346-358. doi:10.1007/s11682-012-9200-5</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium">Chen, P., Landar, V., Noce, N., & Hreha, K. (2020). Prism adaptation treatment for spatial neglect post brain tumor removal: A case report. <em>Hong Kong Journal of Occupational Therapy</em>. doi:10.1177/1569186120921472</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Farne, A., Rossetti, Y., Toniolo, S., & Ladavas, E. (2002). Ameliorating neglect with prism adaptation: Visuo-manual and visuo-verbal measures. <em>Neuropsychologia, 40</em>(7), 718-729. doi:10.1016/s0028-3932(01)00186-5 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Fortis, P., Chen, P., Goedert, K. M., & Barrett, A. M. (2011). Effects of prism adaptation on motor-intentional spatial bias in neglect. <em>Neuroreport, 22</em>(14), 700-705. doi:10.1097/WNR.0b013e32834a3e20</span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Fortis, P., Maravita, A., Gallucci, M., Ronchi, R., Grassi, E., Senna, I., . . . Vallar, G. (2010). Rehabilitating patients with left spatial neglect by prism exposure during a visuomotor activity. <em>Neuropsychology, 24</em>(6), 681-697. doi:10.1037/a0019476 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Fortis, P., Ronchi, R., Velardo, V., Calzolari, E., Banco, E., Algeri, L., . . . Vallar, G. (2020). A home-based prism adaptation training for neglect patients. <em>Cortex, 122</em>, 61-80. doi:10.1016/j.cortex.2018.09.001</span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Frassinetti, F., Angeli, V., Meneghello, F., Avanzi, S., & Ladavas, E. (2002). Long-lasting amelioration of visuospatial neglect by prism adaptation. <em>Brain, 125</em>(Pt 3), 608-623. doi:10.1093/brain/awf056 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Goedert, K. M., Chen, P., Boston, R. C., Foundas, A. L., & Barrett, A. M. (2014). Presence of motor-intentional aiming deficit predicts functional improvement of spatial neglect with prism adaptation. <em>Neurorehabilitation and Neural Repair, 28</em>(5), 483-492. </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Goedert, K. M., Chen, P., Foundas, A. L., & Barrett, A. M. (2020). Frontal lesions predict response to prism adaptation treatment in spatial neglect: A randomised controlled study. <em>Neuropsychological Rehabilitation, 30</em>(1), 32-53. doi:10.1080/09602011.2018.1448287</span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Gossmann, A., Kastrup, A., Kerkhoff, G., Lopez-Herrero, C., & Hildebrandt, H. (2013). Prism adaptation improves ego-centered but not allocentric neglect in early rehabilitation patients. <em>Neurorehabilitation and Neural Repair, 27</em>(6), 534-541. doi:10.1177/1545968313478489 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Jacquin-Courtois, S., Rode, G., Pisella, L., Boisson, D., & Rossetti, Y. (2008). Wheel-chair driving improvement following visuo-manual prism adaptation. <em>Cortex, 44</em>(1), 90-96. doi:10.1016/j.cortex.2006.06.003 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Luaute, J., Michel, C., Rode, G., Pisella, L., Jacquin-Courtois, S., Costes, N., . . . Rossetti, Y. (2006). Functional anatomy of the therapeutic effects of prism adaptation on left neglect. <em>Neurology, 66</em>(12), 1859-1867. doi:10.1212/01.wnl.0000219614.33171.01 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Mizuno, K., Tsuji, T., Takebayashi, T., Fujiwara, T., Hase, K., & Liu, M. (2011). Prism adaptation therapy enhances rehabilitation of stroke patients with unilateral spatial neglect: a randomized, controlled trial. <em>Neurorehabilitation and Neural Repair, 25</em>(8), 711-720. doi:10.1177/1545968311407516</span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Nijboer, T. C., Olthoff, L., Van der Stigchel, S., & Visser-Meily, J. M. (2014). Prism adaptation improves postural imbalance in neglect patients. <em>Neuroreport, 25</em>(5), 307-311. doi:10.1097/WNR.0000000000000088 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Rabuffetti, M., Folegatti, A., Spinazzola, L., Ricci, R., Ferrarin, M., Berti, A., & Neppi-Modona, M. (2013). Long-lasting amelioration of walking trajectory in neglect after prismatic adaptation. <em>Frontiers in Human Neuroscience, 7</em>, 382. doi:10.3389/fnhum.2013.00382 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Rode, G., Rossetti, Y., & Boisson, D. (2001). Prism adaptation improves representational neglect. <em>Neuropsychologia, 39</em>(11), 1250-1254. doi:10.1016/s0028-3932(01)00064-1</span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium">Rossetti, Y., Rode, G., Pisella, L., Farne, A., Li, L., Boisson, D., & Perenin, M. T. (1998). Prism adaptation to a rightward optical deviation rehabilitates left hemispatial neglect. <em>Nature, 395</em>(6698), 166-169. doi:10.1038/25988 </span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium">Tilikete, C., Rode, G., Rossetti, Y., Pichon, J., Li, L., & Boisson, D. (2001). Prism adaptation to rightward optical deviation improves postural imbalance in left-hemiparetic patients. <em>Current Biology, 11</em>(7), 524-528. doi:10.1016/s0960-9822(01)00151-8</span></li>\n
</ul>\n
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<p style="text-align:center"> </p>\n
\n
<p style="text-align:center"><span style="font-size:x-large"><strong><span style="color:#993300; font-family:book antiqua,palatino">TREAT SPATIAL NEGLECT FROM STROKE</span></strong></span></p>\n
\n
<p style="text-align:center"><span style="font-size:x-large"><strong><span style="color:#993300; font-family:book antiqua,palatino"><span style="font-size:large">IMPROVE FUNCTIONAL RECOVERY AFTER STROKE</span></span></strong></span></p>\n
\n
<p style="text-align:left"> </p>\n
\n
<p><strong><u><u>SPATIAL NEGLECT</u></u></strong></p>\n
\n
<ul>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Affects 30-50% of stroke patients</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Majority do not realize it</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Debilitating- Interferes with mobility, self-care, navigation, reading, employment, safety</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Requires treatment for improvement</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Improving spatial attention and spatial awareness leads to improvement in other domains</span></li>\n
</ul>\n
\n
<p>Your browser does not support the video tag.</p>\n
\n
<p> </p>\n
\n
<div>\n
<hr /></div>\n
\n
<p style="text-align:center"><span style="color:#3366ff; font-family:tahoma,arial,helvetica,sans-serif; font-size:x-large">Missing Critical Information Can Have Devastating Consequences</span></p>\n
\n
<div style="align-items:center; display:flex; justify-content:center">\n
<div style="flex:50%; padding:5px"><img alt="" src="http://www.stoeltingco.com/Psychological/media/womens_bathroom_sign_neglect.jpg" style="width:50%" /></div>\n
\n
<div style="flex:50%; padding:5px"><img alt="" src="http://www.stoeltingco.com/Psychological/media/car_crosswalk_neglect.jpg" style="width:75%" /></div>\n
</div>\n
\n
<hr />\n
<p><strong><u><u>PRISM ADAPTATION TREATMENT</u></u></strong></p>\n
\n
<ul>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Treats neural networks- Sustained improvement</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Evidence-based- Recommended by medical associations</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Easy for patients to participate</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Improvements seen within 10 sessions of 20 minutes</span></li>\n
</ul>\n
\n
<div><iframe align="middle" frameborder="0" height="200" name="KF-PAT Demonstration" scrolling="no" src="/Psychological/media/Kessler_Foundation_Prism_Adaptation_Treatment_Demonstration.mp4" title="KF-PAT Demonstration" width="300"></iframe></div>\n
\n
<p> </p>\n
\n
<hr />\n
<p><strong><u><u>KESSLER FOUNDATION PRISM ADAPTATION TREATMENT (KF-PAT)</u></u></strong></p>\n
\n
<ul>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Patented portable system</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Complete system with manual to administer entire course of treatment </span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Ongoing clinical and technical support </span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:large">Extensive research support </span></li>\n
</ul>\n
\n
<div>\n
<p style="text-align:left"><span style="color:#3366ff"><span style="font-family:book antiqua,palatino; font-size:medium"><span style="color:#000000"><strong>Authors: </strong></span></span><span style="font-family:book antiqua,palatino; font-size:medium">Peii</span><em><span style="font-family:book antiqua,palatino; font-size:medium"> Chen, PhD & Kimberly Hreha, EdD, OTR/L</span></em></span></p>\n
\n
<p style="text-align:left"><br />\n
<span style="color:#3366ff"><strong><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium">Kessler Foundation Prism Adaptation Treatment (KF-PAT)</span></strong><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium"> is a complete system to administer prism adaptation treatment for the treatment of spatial neglect. Prism adaptation uses prism goggles (goggles with lenses tilted either to the right or left) to effect a visuomotor phenomenon (prism adaptation), which improves spatial neglect. Researchers at Kessler Foundation who developed this device and treatment protocol have conducted extensive research involving federally funded clinical trials that have resulted in numerous peer-reviewed journal articles (see Details Tab for references). Prism adaptation treatment has been recommended as a frontline treatment for spatial neglect by the American Heart/Stroke Association, the Canadian Stroke Association, and in many meta-analyses and systematic reviews.</span></span></p>\n
</div>\n
\n
<div><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium"><strong>Spatial neglect</strong> is a syndrome caused by damaged neural networks critical for attention and related functions in the brain.<sup> </sup>Because attention, especially spatial attention, is essential for a wide variety of functions, spatial neglect affects many perceptual, cognitive, and motor functions. Deficits caused by spatial neglect disrupt basic self-care activities (e.g., dressing, grooming), impair postural balance, interfere with reading ability, and impede navigation.</span></div>\n
\n
<div> </div>\n
\n
<div><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium"><strong>Yet, the majority of the time spatial neglect goes untreated, due to lack of assessment and lack of recognition by the patient</strong> due to neurological deficits related to the neglect.</span></div>\n
\n
<div> </div>\n
\n
<div style="text-align:center"><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium"><span style="color:#003300; font-family:'arial black','avant garde'">KF-PAT Prism Adaptation Sequence</span></span></div>\n
\n
<div style="align-items:center; display:flex; justify-content:center"><img alt="kf-pat adaptation sequence" src="http://www.stoeltingco.com/Psychological/media/kf-pat_adaptation_sequence.JPG" />></div>\n
\n
<div> </div>\n
\n
<div><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium">The KF-PAT treatment is typically administered over 10 sessions of approximately 20 minutes each. Patients wear goggles that shift their vision slightly horizontally while reaching for targets presented by the therapist. Visual feedback regarding the missed target is “sent” to the motor system, which corrects the subsequent attempts to reach towards the target. This process is then repeated with the goggles removed. Because the patient's motor system had adapted to the image shifted from the actual target by the goggles, the patient is again off-target when reaching for the target, but then adapts to this distortion and is able to again accurately reach to the target. </span></div>\n
\n
<div> </div>\n
\n
<div><span style="color:#333333; font-family:book antiqua,palatino; font-size:medium">This entire process of adaptation helps bring attention and awareness to the neglected side of space and improves symptoms of spatial neglect. The benefits of this treatment compared to others is that:</span></div>\n
\n
<div>\n
<ol>\n
\t<li><span style="font-family:book antiqua,palatino">Improvements occur automatically. Patients do not have to learn skills, read, remember information, or perform other actions that may be difficult for those with symptoms of stroke.</span></li>\n
\t<li><span style="font-family:book antiqua,palatino">Most patients can participate. The movements necessary are minimal and because the KF-PAT has a patented portable design, the treatment can even be brought to patients for whom travel would be difficult. </span></li>\n
\t<li><span style="font-family:book antiqua,palatino">Effects are sustained. Treatment occurs at a fundamental neurological level. Thus, changes that occur do not require deliberate effort or are the result of skills that may be forgotten or neglected.</span></li>\n
</ol>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium">The KF-PAT administration protocol has two built-in assessments of pointing performance both administered before and after prism adaptation to help you detect and measure prism after-effects in two different ways. The two assessments are Proprioceptive Pointing and Visual-Proprioceptive Pointing. </span></p>\n
\n
<h4><em><span style="font-family:book antiqua,palatino; font-size:medium">Proprioceptive Pointing</span></em></h4>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium">During the Proprioceptive Pointing task, patients will point straight ahead while blindfolded. You will assess patient’s deviation from the patient’s midline. This task assesses the patient’s innate sense of proprioception without visual cues. That is, they rely on their proprioception to make the movement.</span></p>\n
\n
<h4><em><span style="font-family:book antiqua,palatino; font-size:medium">Visual-Proprioceptive Pointing</span></em></h4>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium">During these tasks, patients will point at a visual target (hence “visual” in the name of this task), i.e., a pen held up by the therapist, while they are blocked from seeing their own arm, hand, or fingers when making the reaching and pointing movement (hence “proprioceptive” in the name of the task). You will assess the deviation of patient’s pointing, which indicates the (mis)alignment between the patient’s visual and motor systems.</span></p>\n
\n
<h4><em><span style="font-family:book antiqua,palatino; font-size:medium">After-Effect</span></em></h4>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium">As stated, both pointing tasks are administered before and after prism adaptation, thus creating four assessment conditions. Data is collected by the therapist during those tasks and the change in performance from before to after treatment is calculated and recorded in included <strong>reproducible record and summary forms</strong>.</span></p>\n
\n
<p><u><strong>Therapist Qualifications</strong></u></p>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium">You should have advanced training and/or educational degree with advanced coursework in neuro-rehabilitation of individuals with stroke or brain injury, or work under the license of someone with these credentials. Qualifications that typically fulfill these qualification requirements are: occupational therapists (OTs), physical therapists aka physiotherapists (PTs), speech and language pathologists (SLPs), clinical psychologists, neuropsychologists, neurologists, and physiatrists. </span></p>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium">The KF-PAT manaul is designed to guide everyone through the steps of training and learning to administer the KF-PAT so that they can administer an entire course of KF-PAT treatment. Ongoing clinical and technical support is provided. Additional training may acquired. Please contact us for details and options.</span></p>\n
\n
<p><span style="font-family:book antiqua,palatino; font-size:medium"><strong>The KF-PAT Kit</strong> (31100) contains all the equipment listed above as separate components. All equipment is necessary to administer the treatment.</span></p>\n
\n
<div> </div>\n
\n
<div>\n
<hr /></div>\n
</div>\n
\n
<h2>KF-PAT Components</h2>\n
\n
<p> </p>\n
\n
<ul>\n
\t<li>Right-based prism lenses <img alt="" id="img1" src="http://www.stoeltingco.com/Psychological/media/31100L_KF-PAT_left_goggles.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Left-based prism lenses <img alt="" id="img2" src="http://www.stoeltingco.com//Psychological/media/31100R_KF-PAT_right_goggles.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Position Board <img alt="" id="img6" src="http://www.stoeltingco.com/Psychological/media/31100P_KF-PAT_Position_Board.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Ruler Board <img alt="" id="img8" src="http://www.stoeltingco.com/Psychological/media/31100U_KF-PAT_Ruler_Board.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Visual‐proprioceptive task (VPT) Box <img alt="" id="img10" src="http://www.stoeltingco.com/Psychological/media/31100_KF-PAT_VPT_Box.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Visual field occluder <img alt="" id="img12" src="http://www.stoeltingco.com/Psychological/media/31100C_KF-PAT_visual_field_occluder.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Visual field occluder stand <img alt="" id="img14" src="http://www.stoeltingco.com/Psychological/media/31100S_KF-PAT_visual_occluder_stand.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>KF-PAT Manual <img alt="" id="img16" src="http://www.stoeltingco.com/Psychological/media/31100M_KF-PAT_manual.JPG" style="margin-left:80px; width:20%" /></li>\n
\t<li>Opaque apron <img alt="" id="img18" src="http://www.stoeltingco.com/Psychological/media/31100A_KF-PAT_Opaque_apron.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Kit binding strap <img alt="" id="img20" src="http://www.stoeltingco.com/Psychological/media/31100K_KF-PAT_kit_binding_strap.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Carrying bag <img alt="" id="img22" src="http://www.stoeltingco.com/Psychological/media/31100B_KF-PAT_bag.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Eye mask, pk/30 <img alt="" id="img24" src="http://www.stoeltingco.com/Psychological/media/31100E_KF-PAT_disposable_eye_mask.jpg" style="margin-left:80px; width:20%" /></li>\n
\t<li>Pen <img alt="" id="img26" src="http://www.stoeltingco.com/Psychological/media/31100F_KF-PAT_felt-tip_pen.png" style="margin-left:80px; width:20%" /></li>\n
\t<li>Laminated printed stimuli sheets <img alt="" id="img28" src="http://www.stoeltingco.com/Psychological/media/31100T_KF-PAT_stimulus_sheets.png" style="margin-left:80px; width:20%" /></li>\n
\t<li>Neck wraps, pk/50 <img alt="" id="img30" src="http://www.stoeltingco.com/Psychological/media/31100N_KF-PAT-neck_wraps.jpg" style="margin-left:80px; width:20%" /></li>\n
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<h2 style="text-align:center"><strong><span style="font-family:book antiqua,palatino; font-size:medium">References</span></strong></h2>\n
\n
<h3>Suggested APA 7th ed. Reference for KF-PAT</h3>\n
\n
<p><span style="font-family:'book antiqua',palatino; font-size:large">Chen, P. & Hreha, K. (2020). <em>Kessler Foundation Prism Adaptation Treatment 2020 manual</em>, Stoelting.</span></p>\n
\n
<h3>Complete References from Manual</h3>\n
\n
<ul>\n
\t<li><a data-tabindex-counter="4" data-tabindex-value="none" href="http://www.stoeltingco.com/Psychological/media/KF-PAT_Manual_references.pdf" tabindex="-1" target="_blank">KF-PAT Manual References</a></li>\n
</ul>\n
\n
<h3>Relevant Publication</h3>\n
\n
<p><a data-tabindex-counter="2" data-tabindex-value="none" href="/Products%20Import/Psychological-Testing/Hreha%20et%20al%202022.pdf" pimcore_id="4269" pimcore_type="asset" tabindex="-1">Hreha et al 2022.pdf</a> The Implementation Process of Two Evidence-Based Protocols: A Spatial Neglect Network Initiative, Frontiers in Health Services</p>\n
\n
<p><a data-tabindex-counter="2" data-tabindex-value="none" href="/Products%20Import/Psychological-Testing/Chen%20et%20al%202022%20PAT%20Dosage%20Matters.pdf" pimcore_id="4268" pimcore_type="asset" tabindex="-1">Chen et al 2022 PAT Dosage Matters.pdf</a> Impacts of Prism Adaptation Treatment on Spatial Neglect and Rehabilitation Outcome: Dosage Matters, American Society of Neurorehabilitation</p>\n
\n
<h3>Selected References of Prism Adaptation Efficacy</h3>\n
\n
<ul>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium">Angeli, V., Benassi, M. G., & Ladavas, E. (2004). Recovery of oculo-motor bias in neglect patients after prism adaptation. <em>Neuropsychologia, 42</em>(9), 1223-1234. doi:10.1016/j.neuropsychologia.2004.01.007 </span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium">Chen, P., Goedert, K. M., Shah, P., Foundas, A. L., & Barrett, A. M. (2014). Integrity of medial temporal structures may predict better improvement of spatial neglect with prism adaptation treatment. <em>Brain Imaging and Behavior, 8</em>(3), 346-358. doi:10.1007/s11682-012-9200-5</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium">Chen, P., Landar, V., Noce, N., & Hreha, K. (2020). Prism adaptation treatment for spatial neglect post brain tumor removal: A case report. <em>Hong Kong Journal of Occupational Therapy</em>. doi:10.1177/1569186120921472</span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Farne, A., Rossetti, Y., Toniolo, S., & Ladavas, E. (2002). Ameliorating neglect with prism adaptation: Visuo-manual and visuo-verbal measures. <em>Neuropsychologia, 40</em>(7), 718-729. doi:10.1016/s0028-3932(01)00186-5 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Fortis, P., Chen, P., Goedert, K. M., & Barrett, A. M. (2011). Effects of prism adaptation on motor-intentional spatial bias in neglect. <em>Neuroreport, 22</em>(14), 700-705. doi:10.1097/WNR.0b013e32834a3e20</span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Fortis, P., Maravita, A., Gallucci, M., Ronchi, R., Grassi, E., Senna, I., . . . Vallar, G. (2010). Rehabilitating patients with left spatial neglect by prism exposure during a visuomotor activity. <em>Neuropsychology, 24</em>(6), 681-697. doi:10.1037/a0019476 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Fortis, P., Ronchi, R., Velardo, V., Calzolari, E., Banco, E., Algeri, L., . . . Vallar, G. (2020). A home-based prism adaptation training for neglect patients. <em>Cortex, 122</em>, 61-80. doi:10.1016/j.cortex.2018.09.001</span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Frassinetti, F., Angeli, V., Meneghello, F., Avanzi, S., & Ladavas, E. (2002). Long-lasting amelioration of visuospatial neglect by prism adaptation. <em>Brain, 125</em>(Pt 3), 608-623. doi:10.1093/brain/awf056 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Goedert, K. M., Chen, P., Boston, R. C., Foundas, A. L., & Barrett, A. M. (2014). Presence of motor-intentional aiming deficit predicts functional improvement of spatial neglect with prism adaptation. <em>Neurorehabilitation and Neural Repair, 28</em>(5), 483-492. </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Goedert, K. M., Chen, P., Foundas, A. L., & Barrett, A. M. (2020). Frontal lesions predict response to prism adaptation treatment in spatial neglect: A randomised controlled study. <em>Neuropsychological Rehabilitation, 30</em>(1), 32-53. doi:10.1080/09602011.2018.1448287</span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Gossmann, A., Kastrup, A., Kerkhoff, G., Lopez-Herrero, C., & Hildebrandt, H. (2013). Prism adaptation improves ego-centered but not allocentric neglect in early rehabilitation patients. <em>Neurorehabilitation and Neural Repair, 27</em>(6), 534-541. doi:10.1177/1545968313478489 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Jacquin-Courtois, S., Rode, G., Pisella, L., Boisson, D., & Rossetti, Y. (2008). Wheel-chair driving improvement following visuo-manual prism adaptation. <em>Cortex, 44</em>(1), 90-96. doi:10.1016/j.cortex.2006.06.003 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Luaute, J., Michel, C., Rode, G., Pisella, L., Jacquin-Courtois, S., Costes, N., . . . Rossetti, Y. (2006). Functional anatomy of the therapeutic effects of prism adaptation on left neglect. <em>Neurology, 66</em>(12), 1859-1867. doi:10.1212/01.wnl.0000219614.33171.01 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Mizuno, K., Tsuji, T., Takebayashi, T., Fujiwara, T., Hase, K., & Liu, M. (2011). Prism adaptation therapy enhances rehabilitation of stroke patients with unilateral spatial neglect: a randomized, controlled trial. <em>Neurorehabilitation and Neural Repair, 25</em>(8), 711-720. doi:10.1177/1545968311407516</span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Nijboer, T. C., Olthoff, L., Van der Stigchel, S., & Visser-Meily, J. M. (2014). Prism adaptation improves postural imbalance in neglect patients. <em>Neuroreport, 25</em>(5), 307-311. doi:10.1097/WNR.0000000000000088 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Rabuffetti, M., Folegatti, A., Spinazzola, L., Ricci, R., Ferrarin, M., Berti, A., & Neppi-Modona, M. (2013). Long-lasting amelioration of walking trajectory in neglect after prismatic adaptation. <em>Frontiers in Human Neuroscience, 7</em>, 382. doi:10.3389/fnhum.2013.00382 </span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium"><span style="font-family:book antiqua,palatino; font-size:medium">Rode, G., Rossetti, Y., & Boisson, D. (2001). Prism adaptation improves representational neglect. <em>Neuropsychologia, 39</em>(11), 1250-1254. doi:10.1016/s0028-3932(01)00064-1</span></span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium">Rossetti, Y., Rode, G., Pisella, L., Farne, A., Li, L., Boisson, D., & Perenin, M. T. (1998). Prism adaptation to a rightward optical deviation rehabilitates left hemispatial neglect. <em>Nature, 395</em>(6698), 166-169. doi:10.1038/25988 </span></li>\n
\t<li><span style="font-family:book antiqua,palatino; font-size:medium">Tilikete, C., Rode, G., Rossetti, Y., Pichon, J., Li, L., & Boisson, D. (2001). Prism adaptation to rightward optical deviation improves postural imbalance in left-hemiparetic patients. <em>Current Biology, 11</em>(7), 524-528. doi:10.1016/s0960-9822(01)00151-8</span></li>\n
</ul>\n
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