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Attention Training Might Help Stroke Victims

Program to improve focus got mixed results, researchers say

THURSDAY, July 23 (HealthDay News) -- The inability to focus is a common problem for stroke survivors, and a new study finds they might benefit from attention-training.

New Zealand psychologists evaluated 78 stroke patients who underwent attention process training (APT) and found significant improvement on one test of attention compared to those who had standard stroke therapy, according to a report in the July 23 issue of Stroke.

But the improvement in attention was not accompanied by significant improvements in performance, and no differences were seen in three other tests of attention.

The study is "really important and exciting," said McKay Moore Sohlberg, an associate professor in the department of communication disorders and sciences at the University of Oregon. She and a colleague, Catherine A. Mateer, developed APT in the 1980s when both were at the University of Washington. Mateer, a neuropsychologist, now is at the University of Victoria in British Columbia, Canada. They designed APT for accident victims with brain injuries.

"It's an exciting paper in terms of being a rigorous, controlled trial," Sohlberg said. "There has not been a lot of information available on APT after stroke. The positive results suggest that it might be something that is helpful."

APT is a series of exercises designed to improve cognitive function. "For example, you listen for a particular stimulus, a letter or word, and perform an appropriate response," Sohlberg said. "Different exercises are matched to different problems."

The New Zealand study is "a first step to establish whether people who have strokes can profit from APT," Sohlberg said.

"What we don't know from this paper is how well the results generalize to functional tasks," she said. "Does doing better on cognitive tests translate to a better ability to hold conversations or read? That is the next step, looking at the functional effects of it."

Loss of the ability to focus attention is a major problem for people after a stroke, said Dr. Larry B. Goldstein, director of the Duke University Stroke Center in Durham, N.C. "You can be sitting in a room and something is going on in the hallway and you have no idea of what's going on out there," he said. "Or your left arm is not working well, and you might not even realize that it's your arm."

But the New Zealand study does not establish the value of APT in stroke therapy, Goldstein noted. It is a small and very preliminary study, he said. "It looks like only half the participants completed the therapy. They found some benefit, but no significant changes in quality of life or global level of deficit," Goldstein said.

Nevertheless, the results indicate that use of APT in stroke therapy "is worthy of further research," he said.

More information

Learn about stroke therapy from the National Stroke Association.

SOURCES: McKay Moore Sohlberg, Ph.D, associate professor, department of communication disorders and sciences, University of Oregon, Portland; Larry A. Goldstein, M.D, director, Duke University Stroke Center, Durham, N.C.; July 23, 2009, Stroke

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