半側無視患者のパソコンデータ入力作業におけるプリズム眼鏡の効果

Prism adaptation improves performance of digits data entry to a personal computer in patients with visiospatial hemineglect

要旨：左側の数字の見落としがある左側視空間無視患者に対してプリズム眼鏡を用いた後，パーソナルコンピューターへ数値入力課題を行いその効果を判定した．効果の検討はシングルケースデザインをABA'B'の方法で用いた．A及びA'期は見取り算の数字の入力作業を行い，B及びB'期にはプリズム後の入力作業を行った．結果は，A及びA'期では左側の数字の見落としの減少など改善傾向がみられ，B及びB'期では左側の数字の見落としが増加した．これらの理由として，プリズムによる視覚情報と体幹や上肢からの固有感覚情報を一致させるポインティングの反復によって，注意の範囲が左方向へ拡大した結果と考えられた．

　Objective: To evaluate the effect of prism adaptation for a patient with unilateral spatial neglect on performance of digits data entry to a keyboard of a personal computer. Prism glasses were put on the hrennel membrane set to a slit-shaped angle of 20 diopter on a plastic lens with an image of the object, set at one diopter, 1m away at an angle with 1cm displacement. The image shifted to the right when we put on prism glasses, and it was felt.

　After pointing 100 times toward the mark, the subject achieved feeling at the midline.

　Subject: Two cases with unilateral spatial neglect. Case 1 is a 25-year-old male and Case 2 is a 47-year-old male. Durations after onset were more than 12 months in both cases.

　Design: A single case research design, type ABA' B', was used. Baseline, intervention, and afterbaseline, intervention phases each consisted of ten sessions.

　And they achieved normal entry work without prism adaptation in A and A' periods and performed the work with prism adaptation in B and B' periods to a keyboard.

　Result: The number of neglected digits on the left significantly decreased in the prism adaptation session and increased in the prism removal session.

　Consideration: Improvement in a frame of reference shifting to the left by a prism adaptation might have resulted from repetitive adjustment between positional information mediated propriceptive sensation from the trunk and arm, thus mediating visual information.