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Abstracts from the Association of British Neurologists Annual Meeting 2011
1130 Read-right: free web-based therapy for stroke patients with alexia
  1. A Leff,
  2. Y H Ong,
  3. M M Brown,
  4. G T Plant,
  5. M Husain
  1. University College London


Introduction Hemianopic alexia is the commonest, isolated reading disorder caused by stroke, with several thousand UK patients affected per year. Behavioural therapy for hemianopic alexia exists (mass-practice reading of laterally scrolling text), and has been validated in three trials; however, this therapy has not previously been made available. We developed a web-based application that provides this therapy for free. Also included is an automated visual field test and standardised reading tests:

Method Patients logon and select reading materials which are fed into the scrolling text window. They practice when it suits them. Read-Right records the amount of time patients practice for and, after every 5 h, prompts them to test their reading speed. Data from 21 patients who fulfilled the criteria for hemianopic alexia and who practiced for 5 h or more were analysed with a repeated measures ANOVA.

Results Significant therapy effects were seen after 5 h: p=0.01 [11%]; 10 h: p=0.01 [25%]; and, 15 h of therapy: p=0.002 [53%]. The effect plateaued after 20 h. Effect sizes [52%] are commensurate with previous studies. Sub-analyses suggest that this is not caused by practice effects or the simple passage of time.

Conclusion Behavioural therapy for hemainopic alexia works. It can be translated to the internet where patients can access and run it themselves, with similar clinical effects as in controlled clinical trials. Is this the way forward to open up access to proven behavioural therapies?

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