Novel Positioning Device for Stroke Patients with Hemispatial Neglect and Documentation with Clinical iPad

Abstract Description

Authors (including presenting author) :

Ching CY(1)

Affiliation :

(1)Department of Occupational Therapy, Caritas Medical Centre

Introduction :

Hemispatial neglect (HSN) is a complex and disabling phenomenon which affects up to 80% of patients with right hemisphere stroke in acute phase. It is a poor prognostic indicator for stroke survivors’ functional independence. HSN causes various complications, it is not surprising for those stroke patients to experience muscle tightness and pain. However, this problem is usually being ignored, and there is not much literature studying this disturbing issue.

Objectives :

The aim of this project is to ensure early complication prevention by maintain heads of patients with HSN in midline, enhance the positioning procedures to target stroke patients, and communication among multidisciplinary team members, so as to reduce the musculoskeletal complications caused by HSN.

Methodology :

New head positioning support for stroke patients with HSN was designed and tailor-made. Regular assessment and continuous evaluation of head positioning devices in acute phase were formulated. Communication among disciplines was enhanced by incorporating the utilization of clinical iPad, “Patient Album” in CMS and cue cards at bedside. Therefore, compliance and effectiveness of positioning device were improved.

Result & Outcome :

5 stroke patients with HSN were assessed in acute stroke unit and custom-fit head positioning devices were prescribed for them from April to August 2018. All of their heads could maintain in midline position with the devices. 60% of them had improvement in perceptual performance and head control towards affected side, with reduced neck muscle tightness and pain. As a result, they were able to wean off the devices before discharge. Communication between staff and compliance of the devices improved with the newly applied clinical iPad and cue cards. Furthermore, HSN patients’ outcome can be optimized with the combination of other occupational therapy interventions such as sensori-perceptual and functional training.