The impact of visual field loss on activities of daily living performance among adults with acute stroke: a prospective cohort study

Background: Visual field loss (VFL) is the most common visual problem following a stroke, occurring in as many as 49%. Studies have highlighted the negative impact of VFL on driving, mobility and reading with less attention paid to the impact of VFL on activities of daily living (ADL). The purpose of this study was to investigate the ADL performances of people with VFL after an acute stroke using an observation-based evaluation of ADL skills, the Assessment of Motor and Process Skills (AMPS). Objective: This study aims to illustrate what performance limitations on ADL exist for people with VFL after an acute stroke. Method: This is a prospective cohort study where a sample of 58 adults with a stroke diagnosis were recruited consecutively from admission to the In-Patient Stroke Unit, Neurology and Rapid Access Stroke Prevention Clinic, and Early Supported Discharge Service of Tallaght University Hospital (TUH) over a 13-month period. Baseline measurements included the Modified Barthel Index, Article reading subtests and the AMPS. The AMPS was the only measure administered at follow-up. Descriptive statistics and non-parametric tests were used to compare ADL performances. Results: No clinically significant differences were noted when comparing the median ADL ability scores of people post stroke with and without VFL on initial assessment and follow up. Clinically significant improvements were noted on both groups from initial assessment to follow-up at 7 weeks. Patients with a complete VFL and those with left VFL were likely to display reduced ADL performance. Conclusion: The findings of this study showed that while patients with VFL had an overall reduction in ADL performance as measured by the AMPS, the performance was similar to patients with mild to moderate disability after stroke without VFL. This information urges occupational therapists to include tools like the AMPS in measuring ADL performance of patients with VFL after a stroke.