Visual daily functioning of chronic stroke patients assessed by goal attainment scaling after visual restorative training: an explorative study

OBJECTIVE: To determine visual training effects on measures of daily life activities in cerebral blindness patients. METHOD: The study design was an explorative pre-post test design of patients in the chronic phase of stroke (not greater-than8 months) with visual field defects. Twelve hemianopic patients were trained by using visual restorative training, which is aimed at reducing the visual field defect. Goal attainment scaling (GAS) was applied to assess whether the functional impact of visual field defects on daily life activities was reduced after defects were reduced. RESULTS: Visual field defect reduction was observed in all 12 patients to varying degrees. GAS score improvements were observed in 9 patients. In 5 of these 9 patients, all goals were attained or over-attained; in 2 of these patients, some goals were attained and other goals were not attained; and in 2 patients, goals were not attained. As a group, patients significantly improved their GAS scores (t test, P <.005). The correlation between GAS and defect reduction was not significant (Pearson's r = 0.37, P not greater-than .01). It is likely that this was due to the fact that the set goals were not tuned to the part of the visual field where defect reduction could be expected. This, in turn, may have led to slightly underestimated results. CONCLUSIONS: Visual restorative function training does not only lead to visual field enlargement, as assessed with dynamic Goldmann perimetry, but it may also lead to a subjective improvement of daily visual functioning as evaluated by means of GAS