Oculomotor Rehabilitation Program for a Patient with Brain Injury in an Acute Care Hospital: A Single-Case Experimental Design

Abstract

Statement of the problem: We conducted a systematic review on oculomotor rehabilitation for patients with brain injuries; however, an appropriate study design was not used and was inadequate for the evaluation of effect. Thus, in this study, we aimed to verify the benefits of our previously developed oculomotor rehabilitation program for patients with brain injury hospitalized in an acute care hospital.

Methods: This report presents the case of a 50-year-old female patient hospitalized in an acute care hospital for disturbed consciousness and limb dysfunction due to subarachnoid hemorrhage and cerebral stroke. The patient showed abducens nerve palsy of the right eye and right-sided gaze palsy. She received our oculomotor rehabilitation program. An ABAB design was used: Phase A involved basic rehabilitation only, and Phase B involved basic rehabilitation plus the oculomotor rehabilitation program. The program comprised training to promote pursuit, fixation, saccade, and vergence. Starting from day 40 of admission, the patient completed five 20-min sessions per week for 4 weeks forming Phases A1, B1, A2, and B2. The oculomotor range of the right eye was measured during each phase.

Results: The patient did not exhibit fluctuation of vital signs or any adverse events following the oculomotor rehabilitation program. The mean expanded mobility ranges were 1.49 mm in Phase A and 4.91 mm in Phase B (p < 0.05).

Conclusion: Implementation of the oculomotor rehabilitation program promoted shortening of the extraocular muscles, resulting in improvement of the oculomotor mobility range.