***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The objective of this study was to determine the effect of a visual rehabilitation intervention on visual field defects in a US cohort .  Vision Restoration Therapy ( VRT ) consists of a specific pattern of stimulation that is directed at the border of the blind field . METHODS This retrospective study evaluated individuals with homonymous visual field defect from retrochiasmatic lesions treated with 6 modules of VRT .  Suprathreshold visual field testing of the central 43x32 was obtained at baseline and after each module . The main outcome measures were the change in stimuli detection and the shift in the position of the border of the blind field . The impact of age , time from injury and type of visual field defect were analyzed . RESULTS Among 161 patients , the mean absolute improvement in stimuli detection was 12.8 % . The average border shift was 4.87 . Improvements of > or =3 % was noted in 76 % of patients . Absolute change in stimulus detection of > or =3 % at mid-therapy was associated with a greater final improvement . Age , time from lesion and type of visual field defect did not influence the degree of field expansion . CONCLUSIONS VRT improves stimulus detection and results in a shift of the position of the border of the blind field as measured on suprathreshold visual field testing . These results support prior reports and support VRT as a useful rehabilitative intervention for a proportion of patients with visual field defects from retrochiasmatic lesions Background . Vision Restoration Therapy ( VRT ) aims to improve visual field function by systematic ally training regions of residual vision associated with the activity of suboptimal firing neurons within the occipital cortex . Transcranial direct current stimulation ( tDCS ) has been shown to modulate cortical excitability . Objective . Assess the possible efficacy of tDCS combined with VRT . Methods . The authors conducted a r and omized , double-blind , demonstration-of-concept pilot study where participants were assigned to either VRT and tDCS or VRT and sham . The anode was placed over the occipital pole to target both affected and unaffected lobes . One hour training sessions were carried out 3 times per week for 3 months in a laboratory . Outcome measures included objective and subjective changes in visual field , recording of visual fixation performance , and vision-related activities of daily living ( ADLs ) and quality of life ( QOL ) . Results . Although 12 participants were enrolled , only 8 could be analyzed . The VRT and tDCS group demonstrated significantly greater expansion in visual field and improvement on ADLs compared with the VRT and sham group . Contrary to expectations , subjective perception of visual field change was greater in the VRT and sham group . QOL did not change for either group . The observed changes in visual field were unrelated to compensatory eye movements , as shown with fixation monitoring . Conclusions . The combination of occipital cortical tDCS with visual field rehabilitation appears to enhance visual functional outcomes compared with visual rehabilitation alone . TDCS may enhance inherent mechanisms of plasticity associated with training Background Visual information comprises one of the most salient sources of information used to control walking and the dependence on vision to maintain dynamic stability increases following a stroke . We hypothesize , therefore , that rehabilitation efforts incorporating visual cues may be effective in triggering recovery and adaptability of gait following stroke . This feasibility trial aims to estimate probable recruitment rate , effect size , treatment adherence and response to gait training with visual cues in contrast to conventional overground walking practice following stroke . Methods / design A 3-arm , parallel group , multi-centre , single blind , r and omised control feasibility trial will compare overground visual cue training ( O-VCT ) , treadmill visual cue training ( T-VCT ) , and usual care ( UC ) .  Participants ( n = 60 ) will be r and omly assigned to one of three treatments by a central r and omisation centre using computer generated tables to allocate treatment groups . The research assessor will remain blind to allocation . Treatment , delivered by physiotherapists , will be twice weekly for 8 weeks at participating outpatient hospital sites for the O-VCT or UC and in a University setting for T-VCT participants .Individuals with gait impairment due to stroke , with restricted community ambulation ( gait speed < 0.8 m/s ) , residual lower limb paresis and who are able to take part in repetitive walking practice involving visual cues ( i.e. , no severe visual impairments , able to walk with minimal assistance and no comorbid medical contraindications for walking practice ) will be included . The primary outcomes concerning participant enrolment , recruitment , retention , and health and social care re source use data will be recorded over a recruitment period of 18 months . Secondary outcome measures will be undertaken before r and omisation ( baseline ) , after the eight-week intervention ( outcome ) , and at three months ( follow-up ) . Outcome measures will include gait speed and step length symmetry ; time and steps taken to complete a 180 ° turn ; assessment of gait adaptability ( success rate in target stepping ) ; timed up and go ; Fugl-Meyer lower limb motor assessment ; Berg balance scale ; falls efficacy scale ; SF-12 ; and functional ambulation category . Discussion Participation and compliance measured by treatment logs , accrual rate , attrition , and response variation will determine sample sizes for an early phase r and omised controlled trial and indicate whether a definitive late phase efficacy trial is justified . Trial registration Clinical trials.gov , NCT01600391 Background and Purpose — Right hemisphere stroke patients frequently experience spatial neglect , a severe lack of awareness for contralesional hemispace . Although neglect counts among the strongest predictors for poor functional outcome after stroke , there is no established therapy , particularly not for the acute stage . Methods — In a r and omized controlled trial , we compared the combined treatment of hemifield eye patching and repetitive optokinetic stimulation in acute stroke patients with neglect to the spontaneous course . Outcome measures were a neuropsychological test battery for neglect as well as scales of functional independence and clinical impairment . Outcomes were assessed at baseline ( day 1 ) , post treatment ( day 8) , and at 1-month follow-up ( day 30 ) . Results — Final analysis included 21 acute right hemisphere stroke patients with neglect ( 23 enrolled , 2 lost to follow-up ) allocated either to the treatment ( 1 week hemifield eye patching and daily sessions of optokinetic stimulation , n=11 ) or the control group ( no neglect-specific treatment , n=10 ) . At baseline , both groups did not differ in neuropsychological test performance , clinical impairment , or functional disability . At the post treatment session , both groups had improved in all these measures , and results were stable or further improved at follow-up . However , there was no significant difference in this change between the treatment and the control group . Conclusions — An early intervention of combined hemifield eye patching and optokinetic stimulation in acute stroke patients with spatial neglect has no additive effect to the spontaneous remitting course of the disorder . Clinical Trial Registration — URL : http://www . clinical trials.gov . Unique identifier : NCT01617343 Background : Neurologically impaired persons seem to benefit from driving-training programs , but there is no convincing evidence to support this notion . The authors therefore investigated the effect of simulator-based training on driving after stroke . Methods : Eighty-three first-ever subacute stroke patients entered a 5-week 15-hour training program in which they were r and omly allocated to either an experimental ( simulator-based training ) or control ( driving-related cognitive tasks ) group . Performance in off-road evaluations and an on-road test were used to assess the driving ability of subjects pre- and post-training . Outcome of an official predriving assessment administered 6 to 9 months poststroke was also considered . Results : Both groups significantly improved in a visual and many neuropsychological evaluations and in the on-road test after training . There were no significant differences between both groups in improvements from pre- to post-training except in the “ road sign recognition test ” in which the experimental subjects improved more . Significant improvements in the three-class decision ( “ fit to drive , ” “ temporarily unfit to drive , ” and “ unfit to drive ” ) were found in favor of the experimental group post-training . Academic qualification and overall disability together determined subjects that benefited most from the simulator-based driving training . Significantly more experimental subjects ( 73 % ) than control subjects ( 42 % ) passed the follow-up official predriving assessment and were legally allowed to resume driving . Conclusions : Simulator-based driving training improved driving ability , especially for well educated and less disabled stroke patients . However , the findings of the study may have been modified as a result of the large number of dropouts and the possibility of some neurologic recovery unrelated to training Objective : To demonstrate that Visual Midline Shift Syndrome ( VMSS ) following a cerebrovascular accident ( CVA ) can be corrected with yoked prisms . Research design : This r and omized study describes how the use of yoked prisms affects visual midline and documents the influence of yoked prisms on improving postural orientation . Methods and procedures : Evaluation of VMSS and its correlation with postural lean during ambulation were studied in 30 post-CVA subjects and 30 controls . Experimental interventions : Yoked prisms were used to treat VMSS by correcting posture and balance . Outcomes and results : Over 50 % of post-CVA subjects showed positive visual midline shift ( p < 0.001 ; 95 % confidence interval [ CI ] , 0.660.93 for right CVAs and p = 0.001 ; 95 % CI , 0.61–0.93 for left CVAs ) . A statistically significant proportion of those with a positive shift showed a decrease in shift utilizing yoked prisms  ( p < 0.001 ; 95 % CI , 0.73–0.97 for right CVAs and p = 0.001 ; 95 % CI , 0.07–0.39 for left CVAs ) . Additionally , over 50 % of CVA subjects developed lean or drift away from hemiparesis and many subjects showed increased weight-bearing on the hemiparetic side with yoked prisms . Conclusions : Yoked prisms are an effective means of treating VMSS in this population and may be useful in other neurological syndromes with visuo-spatial involvement Objective : To assess the effectiveness of a computerized visual perception rehabilitation programme using motion tracking technology for visual perception impairment . Design : R and omized controlled , single-blinded , pilot clinical trial study . Setting : Inpatient rehabilitation hospital . Subjects : Sixteen left hemiplegic patients with visual perceptional impairment . Intervention : Subjects were r and omly assigned to receive either ( 1 ) participation in a computerized visual perception rehabilitation programme with an interactive patient — computer interface applying motion tracking technology based on the CAMSHIFT algorithm or ( 2 ) use of the PSS CogRehab program for three sessions per week , 30 minutes per session for four weeks . There were eight patients in each group . Main measures : Mini-Mental Status Examination , Motor-free Visual Perception Test and Modified Barthel Index were assessed at the beginning and end of the training . A survey was conducted to evaluate the degree of patients ' interest using an interest scale . Results : After training , the mean ( SD ) Motor-free Visual Perception Test score increased significantly in both experimental group ( from 65.8 ( 19.5 ) to 77.8 ( 28.7 ) ) and control group ( from 68.3 ( 11.4 ) to 74.1 ( 14.8 ) ) ( P<0.01 ) . Modified Barthel Index score increased significantly in both groups , with the experimental group recording a higher increase . Mean ( SD ) interest scale score was greater in the experimental group ( 2.2 ( 0.8 ) ) than in the control group ( 1.3 ( 0.7 ) ) ( P<0.01 ) . Conclusions : A computerized visual perception rehabilitation programme with interactive computer interface using motion tracking technology could be considered as a treatment option for stroke patients with visual perception impairment PURPOSE ( 1 ) To compare the outcomes of orientation and mobility and driving training with Fresnel prisms and the Gottlieb Visual Field Awareness System for patients with homonymous hemianopsia , and ( 2 ) To determine whether the patients continue to use the optical enhancement devices at a 2-year follow-up point . METHODS Patients with homonymous hemianopsia were provided with a rehabilitation program where they were fitted with prism lenses and trained to use them for navigation and driving . Telephone interviews were used to obtain information about device usage 2 years following the completion of the training program . RESULTS Patients ' performance was compared with a test-retest criterion in the visual skills areas of recognition , mobility , peripheral detection , scanning , tracking , and visual memory .  Patients with hemianopic loss showed improvements in all of the visual skills categories , ranging from the highest improvements of 26 % of tasks improved in the mobility category to 13 % in the recognition category . The majority of the hemianopic patients reported using the devices at the 2-year follow-up interview . CONCLUSIONS The patients with homonymous hemianopsia showed improvements in visual functioning using prism lenses , although these improvements were smaller than those found in previous studies with central or bilateral peripheral vision loss groups who were trained to use other optical enhancement devices for navigation and driving using a similar curriculum . However , given the evidence of increased risk of accidents for patients with peripheral vision loss , the safety of peripheral enhancement devices for driving must be thoroughly evaluated before their impact on public safety is known Background and Purpose — Studies continue to reveal persistent gaps in stroke awareness despite existing stroke messages , especially when the length of time from message exposure increases . Therefore , there is a need to discover messages that promote long-term retention of stroke knowledge . We modified a st and ard stroke education poster using one health communications model , Extended Parallel Process , to assess its comparative effect on public stroke awareness and information retention . Methods — This was a single blinded , r and omized , pretest , posttest study using 2 age cohorts : younger ( 18 to 30 years ) and older ( 50 + years ) .  Stroke 
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However , there was low or very-low quality evidence of no effect on measures of visual field , extended activities of daily living , reading , and scanning ability .
There was low- quality evidence of no significant increase in adverse events in people doing scanning training , as compared to no treatment .
Due to the quality and quantity of evidence , we remain uncertain about the benefits of assessment interventions .
There is a lack of evidence relating to the effect of interventions on our primary outcome of functional ability in activities of daily living .
There is limited low- quality evidence that compensatory scanning training may be more beneficial than placebo or control at improving quality of life , but not other outcomes .
There is insufficient evidence to reach any generalised conclusions about the effect of restitutive interventions or substitutive interventions ( prisms ) as compared to placebo , control , or no treatment .
There is low- quality evidence that prisms may cause minor adverse events