Congruent movement training (CMT) for patients with spatial neglect: Perspectives of end-users on clinical implementation

Spatial neglect (SN) is a disabling consequence of stroke requiring intensive rehabilitation. A prior study demonstrated that contralesional eye- and reaching movements can facilitate SN recovery (Congruent Movement Training, CMT). To increase CMT's accessibility, a tablet-based CMT game was designed. In addition, as therapy time is restricted, clinical implementation would be facilitated if CMT can be delivered in sessions not supervised by a clinician. In this study, end-user feedback was gathered on the tablet-based CMT and treatment delivery strategies. Fifteen clinicians and 10 SN patients played and evaluated the CMT game. The clinicians almost unanimously indicated a need to revise the in-game feedback on how patients played the game. Clinicians also deemed it feasible that some patients would use CMT training in unsupervised sessions. Eight right-hemispheric patients were able to use the CMT training and were positive about their experience. Two left-hemispheric patients were not able to use the training due to language comprehension difficulties. Six patients believed they could use CMT training independently. The results revealed two implementation barriers: the design of the feedback on game performance, and the accessibility for left-hemispheric patients. The results also clarified that unsupervised training is considered feasible by clinicians and patients.