Outcomes and Optimization of Two Reading Training Protocols for Individuals with Homonymous Visual Field Defects

Individuals with Homonymous Visual Field Defects (HVFDs) after brain injury often experience difficulty in reading. This can be debilitating, as reading is an important aspect of daily life. The current study aims to explore the potential outcomes of two reading trainings for individuals with HVFDs. One training, the Vistra reading training, aims at compensating for the HVFD by practicing adjusted reading eye movements. The second training is the Rotated Reading training, which aims to utilize the intact visual field by practicing to read rotated text in a personalized angle. Next to assessing the potential outcomes of the Vistra and Rotated Reading trainings on a group and individual level, this study aims to investigate patient experiences with the trainings. Using a Partially Randomized Patient Preferred Controlled Trial, participants were assigned to one of three groups: Vistra, Rotated Reading or a waiting list control group. There were 5 participants included in both the Vistra and Rotated Reading groups, and 10 in the control group. Assessments were conducted before(T1), after(T2) and 3 months after(T3) training or the waiting period, including reading speed, self-reported reading efficacy, attitude, skills, and objects, and quality of life. Results showed significant group-level improvements following Vistra training on reading speed, self-reported reading skills and reading objects. Furthermore, within some Vistra participants, significant individual changes were observed on reading speed, self-reported reading efficacy, reading objects and quality of life. No significant group effects were found for Rotated Reading training, but some individuals demonstrated significant individual changes on self-reported reading efficacy and reading skills. Qualitative analysis identified five key themes of reading training outcome: reading objects, reading skills, reading enjoyment, reading certainty and non-reading related outcomes. Participants reported adopting specific reading strategies and emphasized perceived improvement as a key motivator for continued use. Feedback highlighted the wish for personalized training approaches.