# Trialling the efficacy of a technological visuo-cognitive training program as a compensatory tool for visual rehabilitation after stroke: A pilot study

## TL;DR

This pilot study shows that technological visuo-cognitive training can improve visual search and reduce fatigue in stroke survivors with visual field loss, though it does not restore all visual functions.

## Contribution

The study introduces a novel technological approach for visual rehabilitation after stroke and demonstrates its usability and preliminary efficacy.

## Key findings

- Participants showed significant improvements in visual search and functional vision tasks.
- Reported visual difficulties and fatigue decreased with large effect sizes.
- Qualitative feedback highlighted increased confidence and real-world application of scanning strategies.

## Abstract

Visual impairments are common post-stroke and can lead to diminished functioning and difficulty accomplishing everyday tasks, such as reading and navigating unfamiliar environments independently. This pilot study investigates the usability, acceptability and preliminary efficacy of technological visuo-cognitive training (TVT) using the Senaptec Sensory Station for stroke survivors with visual field loss. Ten stroke survivors (8 males, 2 females; 43–79 years old; Mage = 65, SDage = 11.03) with a non-progressive visual field defect underwent TVT comprising baseline assessment, five 30-minute training sessions over 2–3 weeks, and post-intervention assessment. Measures of visual cognition, patient-reported outcomes, usability, and acceptability were assessed pre- and post-intervention, supplemented by qualitative interviews. Participants demonstrated meaningful gains in several aspects of visual search and functional vision. Reaction times on target capture tasks improved significantly, mirrored by more efficient performance on the Bell’s Test. These behavioural changes aligned with reductions in reported visual difficulties and fatigue, both showing large effect sizes. Across sessions, participants also showed improvement in hand–eye coordination and visuomotor integration. Engagement with the system was high: perceived competence increased and usability ratings were excellent. Qualitative accounts contextualised these findings, describing enjoyment of the technology, occasional challenges related to adaptive difficulty or physical limitations, and perceived benefits such as greater awareness of visual scanning strategies in daily life. Notably, several sensory measures (e.g., visual clarity, contrast sensitivity, depth perception) remained unchanged, indicating that improvements were domain-specific rather than global. Overall, TVT demonstrated acceptability with selective improvements in visual search function and vision-related quality of life. Larger randomised controlled trials are needed to determine efficacy and comparative effectiveness against standard rehabilitation approaches.

Many stroke survivors experience visual field loss, which can make daily activities like reading and maintaining independence more challenging. We explored whether technological visuo-cognitive training (TVT) could be a feasible rehabilitation tool for people with post-stroke visual impairment. Using the Senaptec Sensory Station, 10 stroke survivors took part in a structured training program over two weeks. We assessed their visual cognition, usability of the system, and overall acceptability of the training before and after the intervention. Visual search performance improved, and participants reported significantly fewer visual difficulties and reduced fatigue. Importantly, they transferred improved scanning strategies to real-world activities, becoming more aware of their blind side when painting, crossing roads, and watching television. All participants became more confident with the technology and would recommend the intervention to others. However, some objective vision measures (clarity, contrast sensitivity) did not improve significantly. Barriers emerged including the need for adjustable difficulty levels and challenges with physical demands like standing and reaching. Our findings suggest that TVT has potential as a rehabilitation approach for stroke survivors with visual impairments, but further research is needed to determine its effectiveness compared to standard rehabilitation approaches and identify the best timing for delivering such training after stroke.