Skip to main content

Research Repository

Advanced Search

A study of prisms and therapy in attention loss after stroke (SPATIAL): A feasibility randomised controlled trial

Longley, Verity; Woodward-Nutt, Kate; Turton, Ailie; Stocking, Katie; Checketts, Matthew; Bamford, Anne; Douglass, Emma; Taylor, Julie; Woodley, Julie; Moule, Pam; Vail, Andrew; Bowen, Audrey

A study of prisms and therapy in attention loss after stroke (SPATIAL): A feasibility randomised controlled trial Thumbnail


Verity Longley

Kate Woodward-Nutt

Ailie Turton
Senior Lecturer in Occupational Therapy

Katie Stocking

Matthew Checketts

Anne Bamford

Julie Taylor
Associate Lecturer - HAS - HSW - UHSW0001

Pam Moule

Andrew Vail

Audrey Bowen


Objective: Investigate feasibility and acceptability of prism adaptation training for people with inattention (spatial neglect), early after stroke, during usual care. Design: Phase II feasibility randomised controlled trial with 3:1 stratified allocation to standard occupational therapy with or without intervention, and nested process evaluation. Setting: Ten hospital sites providing in-patient stroke services. Participants: Screened positive for inattention more than one-week post-stroke; informal carers. Occupational therapists participated in qualitative interviews. Intervention: Adjunctive prism adaptation training at the start of standard occupational therapy sessions for three weeks. Main measures: Feasibility measures included recruitment and retention rates, intervention fidelity and attrition. Outcomes collected at baseline, 3 weeks and 12 weeks tested measures including Nottingham Extended Activities of Daily Living Scale. Acceptability was explored through qualitative interviews and structured questions. Results: Eighty (31%) patients were eligible, 57 (71%) consented, 54 randomised (40:13, +1 exclusion) and 39 (74%) completed 12-week outcomes. Treatment fidelity was good: participants received median eight intervention sessions (IQR: 5, 12) lasting 4.7 min (IQR: 4.1, 5.0). All six serious adverse events were unrelated. There was no signal that patients allocated to intervention did better than controls. Twenty five of 35 recruited carers provided outcomes with excellent data completeness. Therapists, patients and carers found prism adaptation training acceptable. Conclusions: It is feasible and acceptable to conduct a high-quality definitive trial of prism adaptation training within occupational therapy early after stroke in usual care setting, but difficult to justify given no sign of benefit over standard occupational therapy. Clinical trial registration: Ref ISRCTN88395268.


Longley, V., Woodward-Nutt, K., Turton, A., Stocking, K., Checketts, M., Bamford, A., …Bowen, A. (2023). A study of prisms and therapy in attention loss after stroke (SPATIAL): A feasibility randomised controlled trial. Clinical Rehabilitation, 37(3), 381-393.

Journal Article Type Article
Acceptance Date Oct 4, 2022
Online Publication Date Oct 26, 2022
Publication Date Mar 1, 2023
Deposit Date Jul 20, 2022
Publicly Available Date Oct 27, 2022
Journal Clinical Rehabilitation
Print ISSN 0269-2155
Electronic ISSN 1477-0873
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 37
Issue 3
Pages 381-393
Keywords stroke; inattention; spatial neglect; rehabilitation; prism; occupational therapy; fidelity; trial; feasibility
Public URL
Publisher URL


You might also like

Downloadable Citations