Assessment of visual problems after acquired brain injury: a survey of current practice in Danish hospitals

Authors

  • Trine Schow Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Copenhagen, Denmark; Neurorehabilitation-Cph, Copenhagen, Denmark
  • Eike Ines Wehling Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway; Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway https://orcid.org/0000-0002-3186-3023
  • Helle K. Falkenberg Department of optometry, radiography and lighting design, University of South-Eastern Norway, Notodden, Norway https://orcid.org/0000-0001-7532-442X
  • Anne Norup Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Copenhagen, Denmark; Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark https://orcid.org/0000-0002-5598-6116
  • Karin Spangsberg Kristensen Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Copenhagen, Denmark

DOI:

https://doi.org/10.2340/jrm.v56.28793

Keywords:

Brain injuries, stroke, surveys and questionnaires, symptom assessment, vision disorders

Abstract

Objectives: To explore current hospital practice in relation to the assessment of vision problems in patients with acquired brain injury.

Design: A survey study.

Subjects: A total of 143 respondents from hospital settings, with background in occupational therapy and physical therapy, participated in the survey.

Methods: The survey questionnaire, developed collaboratively by Danish and Norwegian research groups, encompassed 22 items categorically covering “Background information”, “Clinical experience and current practice”, “Vision assessment tools and protocols”, and “Assessment barriers”. It was sent out online, to 29 different hospital departments and 18 separate units for occupational therapists and physiotherapists treating patients with acquired brain injury.

Results: Most respondents worked in acute or subacute hospital settings. Few departments had an interdisciplinary vision team, and very few therapists had formal education in visual problems after acquired brain injury. Visual assessment practices varied, and there was limited use of standardized tests. Barriers to identifying visual problems included patient-related challenges, knowledge gaps, and resource limitations.

Conclusion: The study emphasized the need for enhanced interdisciplinary collaboration, formal education, and standardized assessments to address visual problems after acquired brain injury. Overcoming these challenges may improve identification and management, ultimately contributing to better patient care and outcomes in the future.

Downloads

Download data is not yet available.

Author Biography

Helle K. Falkenberg, Department of optometry, radiography and lighting design, University of South-Eastern Norway, Notodden, Norway

Helle is part of the studygroup, contributed to the development of the survey and writing the paper

References

Rizzolatti G, Sinigaglia C, Anderson F (trans.). Mirrors in the brain: how our minds share actions and emotions. Oxford: Oxford University Press; 2007.

https://doi.org/10.1093/oso/9780199217984.001.0001 DOI: https://doi.org/10.1093/oso/9780199217984.001.0001

Falkenberg HK, Mathisen TS, Ormstad H, Eilertsen G. “Invisible” visual impairments: a qualitative study of stroke survivors’ experience of vision symptoms, health services and impact of visual impairments. BMC Health Serv Res 2020; 20: 1–12.

https://doi.org/10.1186/s12913-020-05176-8 DOI: https://doi.org/10.1186/s12913-020-05176-8

Mathisen TS, Macedo AFT, Falkenberg HK. Stroke and vision. Scand J Optom Vis Sci 2023; 16: 1–3. DOI: https://doi.org/10.15626/sjovs.v16i1.3989

https://doi.org/10.15626/sjovs.v16i2.4134 DOI: https://doi.org/10.15626/sjovs.v16i2.4134

Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2021; 20: 1–26.

https://doi.org/10.1016/S1474-4422(21)00252-0 DOI: https://doi.org/10.1016/S1474-4422(21)00252-0

Bourne RRA, Flaxman SR, Braithwaite T, Cicinelli MV, Das A, Jonas JB, et al. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. Lancet Glob Health 2017; 5: e888–e897.

https://doi.org/10.1016/S2214-109X(17)30293-0 DOI: https://doi.org/10.1016/S2214-109X(17)30293-0

Armstrong RA. Visual problems associated with traumatic brain injury. Clin Exp Optom J Aust Optom Assoc 2018; 101: 716–726.

https://doi.org/10.1111/cxo.12670 DOI: https://doi.org/10.1111/cxo.12670

Merezhinskaya N, Mallia RK, Park D, Bryden DW, Mathur K, Barker FM. Visual deficits and dysfunctions associated with traumatic brain injury: a systematic review and meta-analysis. Optom Vis Sci J Am Acad Optom 2019; 96: 542–555.

https://doi.org/10.1097/OPX.0000000000001407 DOI: https://doi.org/10.1097/OPX.0000000000001407

Felleman DJ, Van Essen DC. Distributed hierarchical processing in the primate cerebral cortex. [cited 2023 Nov 6]. Available from: https://academic.oup.com/cercor/article/1/1/1/408896. DOI: https://doi.org/10.1093/cercor/1.1.1

Rowe FJ, Hepworth LR, Howard C, Hanna KL, Cheyne CP, Currie J. High incidence and prevalence of visual problems after acute stroke: an epidemiology study with implica-tions for service delivery. PLoS One 2019; 14: e0213035.

https://doi.org/10.1371/journal.pone.0213035 DOI: https://doi.org/10.1371/journal.pone.0213035

Greenwald BD, Kapoor N, Singh AD. Visual impairments in the first year after traumatic brain injury. Brain Inj TBI 2012; 26: 1338–1359.

https://doi.org/10.3109/02699052.2012.706356 DOI: https://doi.org/10.3109/02699052.2012.706356

Schow T, Harris P, Teasdale TW, Rasmussen MA. Evaluation of a four month rehabilitation program for stroke patients with balance problems and binocular visual dysfunction. NeuroRehabilitation 2016; 38: 331–341.

https://doi.org/10.3233/NRE-161324 DOI: https://doi.org/10.3233/NRE-161324

Schow T, Teasdale TW, Quas KJ, Rasmussen MA. Problems with balance and binocular visual dysfunction are associated with post-stroke fatigue. Top Stroke Rehabil 2017; 24: 41–49.

https://doi.org/10.1080/10749357.2016.1188475 DOI: https://doi.org/10.1080/10749357.2016.1188475

Mathisen TS, Eilertsen G, Ormstad H, Falkenberg HK. “If we don’t assess the patient’s vis-ion, we risk starting at the wrong end”: a qualitative evaluation of a stroke service know-ledge translation project. BMC Health Serv Res 2022; 22: 351.

https://doi.org/10.1186/s12913-022-07732-w DOI: https://doi.org/10.1186/s12913-022-07732-w

Hepworth L, Rowe F. Visual impairment following stroke – the impact on quality of life: a systematic review. Ophthalmol Res An Int J 2016; 5: 1–15.

https://doi.org/10.9734/OR/2016/23272 DOI: https://doi.org/10.9734/OR/2016/23272

Norup A, Guldberg AM, Friis CR, Deurell EM, Forchhammer HB. An interdisciplinary visual team in an acute and sub-acute stroke unit: providing assessment and early rehabilitat-ion. NeuroRehabilitation 2016; 39: 451–461.

https://doi.org/10.3233/NRE-161376 DOI: https://doi.org/10.3233/NRE-161376

Berthold-Lindstedt M, Johansson J, Ygge J, Borg K. How to assess visual function in acquired brain injury: asking is not enough. Brain Behav 2021; 11: e01958.

https://doi.org/10.1002/brb3.1958 DOI: https://doi.org/10.1002/brb3.1958

Berthold-Lindstedt M, Ygge J, Borg K. Visual dysfunction is underestimated in patients with acquired brain injury. J Rehabil Med 2017; 49: 327–332.

https://doi.org/10.2340/16501977-2218 DOI: https://doi.org/10.2340/16501977-2218

Ripley DL, Politzer T, Berryman A, Rasavage K, Weintraub A. The Vision Clinic: an interdi-sciplinary method for assessment and treatment of visual problems after traumatic brain injury. NeuroRehabilitation 2010; 27: 231–235.

https://doi.org/10.3233/NRE-2010-0602 DOI: https://doi.org/10.3233/NRE-2010-0602

Hanna KL, Hepworth LR, Rowe F. Screening methods for post-stroke visual impairment: a systematic review. Disabil Rehabil 2017; 39: 2531–2543.

https://doi.org/10.1080/09638288.2016.1231846 DOI: https://doi.org/10.1080/09638288.2016.1231846

Pollock A, Hazelton C, Brady M. Visual problems after stroke: a survey of current practice by occupational therapists working in UK stroke inpatient settings. Top Stroke Rehabil 2011:18: 643–651.

https://doi.org/10.1310/tsr18s01-643 DOI: https://doi.org/10.1310/tsr18s01-643

Colwell MJ, Demeyere N, Vancleef K. Visual perceptual deficit screening in stroke survi-vors: evaluation of current practice in the United Kingdom and Republic of Ireland. Disabil Rehabil 2022; 44: 6620–6632.

https://doi.org/10.1080/09638288.2021.1970246 DOI: https://doi.org/10.1080/09638288.2021.1970246

Evald L, Wilms I, Nordfang M. Assessment of spatial neglect in clinical practice: a nation-wide survey. Neuropsychol Rehabil 2021; 31: 1374–1389.

https://doi.org/10.1080/09602011.2020.1778490 DOI: https://doi.org/10.1080/09602011.2020.1778490

Sundhedsstyrelsen. Anbefalinger for tvaersektorielle forløb for voksne med erhvervet hjerneskade [cited 2023 Jul 7]. Available from: www.sst.dk

Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap): a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed informatics 2009; 42: 377–381.

https://doi.org/10.1016/j.jbi.2008.08.010 DOI: https://doi.org/10.1016/j.jbi.2008.08.010

IBM Corp. IBM SPSS Statistics for Windows. Armonk, NY: IBM Corp.

Kheradmand A, Zee DS. The bedside examination of the vestibulo-ocular reflex (VOR): an update. Rev Neurol 2012; 168: 710–719.

https://doi.org/10.1016/j.neurol.2012.07.011

Fuller G. Neurological examination made easy. 6th ed. Amsterdam: Elsevier Health Sci-ences; 2019, p. 256.

Rowe FJ, Hepworth LR, Howard C, Hanna KL, Helliwell B. Developing a stroke-vision care pathway: a consensus study. Disabil Rehabil 2022; 44: 487–495.

https://doi.org/10.1080/09638288.2020.1768302 DOI: https://doi.org/10.1080/09638288.2020.1768302

Rowe FJ. International practice in care provision for post-stroke visual impairment. Stra-bismus 2017; 25: 112–119.

https://doi.org/10.1080/09273972.2017.1349812 DOI: https://doi.org/10.1080/09273972.2017.1349812

Kheradmand A, Zee DS. The bedside examination of the vestibulo-ocular reflex (VOR): an update. Rev Neurol (Paris) 2012; 168: 710–719.

https://doi.org/10.1016/j.neurol.2012.07.011 DOI: https://doi.org/10.1016/j.neurol.2012.07.011

NICE. Stroke rehabilitation in adults. NICE Clin Guidel 2013 (12 June): 1–43.

National Clinical Guideline for Stroke for the United Kingdom and Ireland. Chapter 4: Re-habilitation and recovery. 2023 [cited 2023 Oct 27]. Available from: www.strokeguideline.org

Vision Research Institute. Stroke-vision care pathway. 2020.

NICE. Stroke rehabilitation in adults. NICE Clin Guidel 2023 (18 October): 1–43.

Rowe FJ, Hepworth LR, Kirkham JJ. Development of core outcome sets for vision scre-ening and assessment in stroke: a Delphi and consensus study. BMJ Open 2019; 9: 1–10.

https://doi.org/10.1136/bmjopen-2019-029578 DOI: https://doi.org/10.1136/bmjopen-2019-029578

Rowe FJ, Hepworth LR, Kirkham JJ. Development of core outcome sets and core outcome measures for central visual impairment, visual field loss and ocular motility disorders due to stroke: a Delphi and consensus study. BMJ open 2022; 12: e056792.

https://doi.org/10.1136/bmjopen-2021-056792 DOI: https://doi.org/10.1136/bmjopen-2021-056792

Mathisen TS, Eilertsen G, Ormstad H, Falkenberg HK. Barriers and facilitators to the im-plementation of a structured visual assessment after stroke in municipal health care ser-vices. BMC Health Serv Res 2021; 21: 1–13.

https://doi.org/10.1186/s12913-021-06467-4 DOI: https://doi.org/10.1186/s12913-021-06467-4

Rowe F, Walker M, Rockliffe J, Pollock A, Noonan C, Howard C, et al. Delivery of high quali-ty stroke and vision care: experiences of UK services. Disabil Rehabil 2016; 38: 813–817.

https://doi.org/10.3109/09638288.2015.1061604 DOI: https://doi.org/10.3109/09638288.2015.1061604

Published

2024-05-14

How to Cite

Schow, T., Wehling, E. I., Falkenberg, H. K., Norup, A., & Kristensen, K. S. (2024). Assessment of visual problems after acquired brain injury: a survey of current practice in Danish hospitals. Journal of Rehabilitation Medicine, 56, jrm28793. https://doi.org/10.2340/jrm.v56.28793

Issue

Section

Original Report

Categories