Assessing the clinical usability and feasibility of the EyeFocus app for attention rehabilitation in ABI

An acquired brain injury (ABI) can affect the brains’ ability to interpret information. In some cases, this can make the ABI survivor lose attention to things on one side of their body. This disabling condition is called “neglect”. Neglect affects 1 in 3 ABI survivors. People affected by neglect often have poor recovery and long-term disability. They tell us: “It’s terrifying, I bump into people” and “there’s not enough support”.
 
Healthcare staff follow national stroke guidelines but currently there is no effective treatment for neglect. ABI survivors, their unpaid carers and NHS staff prioritised research into improving how the brain interprets information. They suggested focusing on conditions like neglect.

Earlier small studies show that neglect can be improved with training to look to the affected side by showing fast moving objects on a screen. However, these studies require 30-60 minutes of daily practice for a month in a clinic with a therapist always present.
 
By working closely with stroke survivors, carers, and therapists, we developed "EyeFocus", which is a new tablet app that delivers the therapy in a personalised way, without the need for a therapist to be always present. Three stroke survivors who tried this at home for 5 days told us it was easy to use, with one returning to driving, stating the app gave him his life back. In a recent project we further improved the app by incorporating feedback from many ABI survivors who tried EyeFocus in their own homes.
 
In this new project funded by NIHR i4i FAST, we propose to test how feasible EyeFocus is when applied in hospital settings. Nine stroke survivors with neglect will receive EyeFocus in addition to usual care. Usual care does not include EyeFocus. To compare the effect of the therapy we will assess patients’ neglect before the therapy starts, during the therapy and after therapy. After the therapy we will also ask patients and their therapists what they think about the app and how feasible they think it is for neglect rehabilitation. We will also record how many people completed the study and how many sessions they were able to complete. This data will be used to improve EyeFocus so it can be used in hospital settings. It will also inform the design of a future study to test if EyeFocus can improve neglect and daily life functioning.
 
We designed this research with help of stroke survivors, family/carers, and clinicians. One stroke survivor with lived experience of neglect will be our study advisor and ensure the opinions of ABI survivors are central to the research. EyeFocus will provide a therapy that people with neglect will enjoy doing, that reduces disability, improves life quality, and decreases NHS costs.