Short-term effect of prism adaptation treatment on severity of unilateral spatial neglect following right hemispheric...

This work aimed to investigate the effects of prism adaptation on unilateral spatial neglect following right hemispheric stroke.

Systematic review and meta-analysis of randomized controlled trials (RCTs).

Patients with unilateral spatial neglect following right hemispheric stroke.

RCTs comparing prism adaptation with placebo therapy were systematically searched across 4 databases (PubMed, Web of Science, CINAHL, and Cochrane Library). Screening, data extraction, and quality assessment were performed by 2 independent reviewers.

A total of 7 RCTs, involving 227 participants, satisfied the eligibility criteria. The results showed significant short-term effects of prism adaptation on neglect outcomes (SMD: 0.49 [95% CI: 0.07 to 0.92], p = 0.02) but not on the Catherine Bergego Scale (CBS) (SMD: -0.38 [95% CI: -1.27 to 0.51], p = 0.40). Subgroup analyses revealed that larger prism angles (exceeding 10°) had greater prism adaptation effects on both neglect outcomes and CBS (SMD: 0.71 [95% CI: 0.30 to 1.12], p = 0.0007 and SMD: -0.77 [95% CI: -1.51 to -0.02], p = 0.04, respectively).

This study demonstrated that larger prism angle with greater than 10° was identified as a crucial factor in eliciting prism adaptation effects. These findings support the use of prism adaptation with angles exceeding 10° as a therapeutic approach for unilateral spatial neglect.