perceptual map literature review

Positioning – a literature review

PSU Research Review

ISSN : 2399-1747

Article publication date: 11 July 2020

Issue publication date: 10 September 2021

The purpose of this paper is to review state-of-the-art literature on product/brand positioning to re-examine the positioning concept and developing a more comprehensive definition from a theoretical viewpoint.

Design/methodology/approach

A systematic review of positioning was conducted. The review conformed to a rigorous set of core principles: it was systematic (organized according to a method designed to address the review questions), transparent (explicitly stated), reproducible and updatable and synthesized (summarized the evidence relating to the review question).

The literature review reveals that there is lack of coherent definition for positioning, and there is no mutual agreement among marketing scholars and practitioners about the exact meaning of the concept. Therefore, comprehensive definition of positioning encompassing the five underlying positioning perspectives (competition; empty slot/mind; consumers’ perception, differentiation and competitive advantage) is suggested.

Research limitations/implications

This paper will be useful for academicians to analyze the current nature of academic research in this area and will provide an added advantage to managers to design and implement positioning strategies for their product/brands that will allow their organizations to gain competitive advantage. This study acknowledges limitations with respect to its exclusive search criteria, which might affect its generalizability.

Social implications

Position and positioning is of relevance in society in broad terms, e.g. in sports, politics and culture. Positioning strategy is discussed and implemented in different industries (business-to-business and consumer), for all kinds of brands (including, for instance, corporate brands) and for “brands” in the very widest sense (such as places or people).

Originality/value

This is the first systematic review of positioning that provides a detailed understanding of the current state of positioning research on a single platform and also draws a comprehensive positioning conceptualization.

Literature review
Product and positioning

Saqib, N. (2021), "Positioning – a literature review", PSU Research Review , Vol. 5 No. 2, pp. 141-169. https://doi.org/10.1108/PRR-06-2019-0016

Emerald Publishing Limited

Published in PSU Research Review . Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

1. Introduction

Positioning has received much attention over the past decade and has emerged as a highly influential marketing management paradigm. It is generally accepted that theoretically, practically and strategically positioning has become one of the key components in modern marketing management, both from the academic point of view ( Aaker and Shansby, 1982 ; Arnott , 1992, 1994 ; Blankson and Kalafatis, 2004 ; Boatswain, 2015 ; Crawford et al. , 1983 ; Day et al. ,1990 ; Diwan and Bodla, 2011 ; Fuchs and Diamantopoulos, 2012 ; Hooley et al. , 2012 ; Kapferer, 2012 ; Kotler, 2003 ; Porter, 1996 ; Sengupta, 2005 ; Soundararaj and Rengamani, 2002 ; Urde and Koch, 2014 ; Wind, 1982 ) and from the practical or business point of view ( Oglivy, 1983 ; Ries and Trout, 1981 ; Trout and Rivkin, 1996 ). The importance of positioning is emphasized by various authors ( Aaker and Shansby, 1982 ; Arnott, 1992 ; Blankson and Kalafatis, 2004 ; Boatswain, 2015 ; Diwan and Bodla, 2011 ; Sengupta, 2005 ) who note that positioning decisions determine the direction of a firm’s overall marketing strategy and that an effective marketing mix can only be developed once a company has crafted a distinct positioning strategy. By making the wrong positioning decision, a company could develop a misguided marketing mix and thus go down an undesirable path.

Moreover, because of its inevitable effect on profitability and long-term success of the firm it has been applied to consumer products ( Boatswain, 2015 ; Crawford, 1985 ; Diwan and Bodla, 2011 ; Fuchs and Diamantopoulos, 2010 ), industrial products ( Simkin et al. , 1985 ; Iyer et al. , 2018 ; Jalkala and Keranen, 2014 ; Pandaa et al. , 2018 ), financial services ( Burton and Easingwood, 2006 ; Easingwood and Mahajan, 1989 ; Kim and Mauborgne, 2000 ; Shostack, 1987 ), retail services ( Abril et al. , 2009 ; Auken and Lonial,1991 ; Corstjens and Doyle, 1989 ; Holmes, 1974 ) and tourism services ( Botha et al. , 1999 ; Gartner, 1989 ; Javalgi et al. , 1995 ; Pike and Page, 2014 ). Thus, the wide use of the positioning concept underlines its importance, usefulness and applicability.

The literature is full of statements emphasizing the importance of positioning. Aaker and Shansby (1982) claim that product positioning is so central and critical that it should be considered at the level of a mission statement. Dovel (1990) considers positioning as the essence of a business and backbone of a business plan. While Johansson and Thorelli (1985) , Keller (2009) , Perreault and McCarthy (1996) , Wilson and Fenwick (1978) and Wind (1980) believe that product positioning is the foundation of the firms marketing strategy. More specifically, Maggard (1976) points out that positioning can make a real contribution as a conceptual vehicle through which various marketing concepts (market segmentation, product differentiation, consumer preference, target market and the like) might be synchronized more effectively. Crawford (1985) believes that positioning is meant to drive the entire marketing programme of the organization and sees positioning as an ingredient of total strategy, not just an advertising ploy, product, brand, price, promotion and distribution must all be consistent with the positioning statement. Richarme (2007) argues that marketers should adopt positioning as their fifth “P” and use it in conjunction with the other four “Ps”. To a large degree, it is a higher-order “P” that rides on the base of the other four “Ps” and at the same time serves as a bridge to corporate strategy.

Ries and Trout (1986) acknowledge positioning to be the tool of competitive warfare. It helps customers to know the real differences among competing products ( DiMingo, 1988 ) and helps in creating a distinctive image of the brand in consumers’ minds ( Wells and Prensky, 1996 ) or brand value by shaping of customers perceptions ( Park et al. , 1986 ; Devlin et al. , 1995 ). Schouten and McAlexander (1989) contend that a key benefit of a successful positioning strategy is the partial insulation it gives from the competitive pressures of other firm. Therefore, positioning is an important source of competitive advantage ( Cronshaw et al. , 1990 ; Gwin and Gwin, 2003 ; Sengupta, 2005 ).

In today’s over-communicated and product-saturated consumer world, effective positioning is critical to brand success ( Marsden, 2002 ). There is a positive relationship between the positioning related decision and the brand success that is the success of brand moves around the pivot of positioning decision ( Fuchs and Diamantopoulos, 2010 ; Pham and Muthukrishnan, 2002 ; Punj and Moon, 2002 ). This not true for only a new brand, it is also of relevance for existing brands when enlarging one’s own market potential or when differentiating a brand from its competitors by repositioning ( Trommsdorf, 2002 ). Therefore, branding and positioning are interrelated and positioning is also the cornerstone of brand management ( Blankson and Kalafatis, 2007 ; de Chernatony, 2009 ; Esch, 2010 ).

Several authors ( Brooksbank, 1994 ; Day et al. , 1990 ; Fisher, 1991 ; Mazanec, 1995 ; Porter, 1996 ; Urban and Hauser, 1993 ) are of the view that long-term success of companies and their products depend on how well they are positioned in the marketplace. Positioning has an impact on important consumer-based outcome variables such as higher consumer loyalty, higher brand equity and value ( Hartmann et al. , 2005 ; Kalra and Goodstein, 1998 ; Knox, 2004 ), less customer vulnerability ( Romaniuk, 2001 ), positively shaped preferences and beliefs about brand value, greater willingness to search for the brand ( Schiffman and Kanuk, 2007 ; Trommsdorf and Paulssen, 2005 ; DiMingo, 1988 ), perceived price sensitivity ( Kalra and Goodstein, 1998 ), brand affect ( Jewell, 2007 ) and brand salience and recall ( Alba and Chattopadhyay, 1986 ).

In addition to non-financial customer-centred indicators, literature has examined positioning effectiveness in terms of financial performance indicators. Cravens and Piercy (2009) claim that effective positioning of the firm’s products is essential in gaining and sustaining superior performance. More specifically, several authors ( Blankson et al. , 2008 ; Blankson and Crawford, 2012 ; Brooksbank, 1994 ; Clement and Werner-Grotemeyer, 1990 ; Day et al. , 1990 ; Devlin et al. , 1995 ; Ennew and Mirza, 1995 ; Fisher, 1991 ; Kalafatis et al. , 2000 ; Kalra and Goodstein, 1998 ; Lee and Liao, 2009 ; Suzuki, 2000 ) claim that positioning has an impact on the financial performance of a company. Hence, the most important decision firm will ever make about its product is how it should position its product.

This article presents an exhaustive examination of research on positioning, particularly research that addresses the problem of conceptualizing and defining positioning. The basis of the article is a literature review of positioning research published in academic journals between 1969 and 2017. These articles range across such disciplines as marketing, strategic marketing and management. The study uses network analysis and text mining to identify how research defines positioning and discusses how the definitions of positioning have been developed on different perspectives.

2. Concept of positioning

The concept of positioning can be traced back to the 1960s when positioning was popularized in consumer product marketing by pioneers such as Alpert and Gatty (1969) they identified positioning as the differentiation of brands according to consumer perceptions they studied differences in consumers perceptions of the organizations products brands when these were positioned differently using technology as the differentiating dimension over similar products in the market place. However, contemporary writers on the subject of positioning ( Hooley et al. , 1998 ; Kotler, 2003 ; Blankson and Kalafatis, 2004 ) sustain Ries and Trout were among the first to define positioning and its origins lie in their article “Positioning is a game people play in today’s me-too market place” published in the Industrial Marketing journal in 1969. In their seminal article, they defined positioning as “as a strategy for ‘staking out turf’ or ‘filling a slot’ in the mind of target customers”. They then made the concept popular by publishing a series of articles in Advertising Age in 1972. “The Positioning Era Cometh”, a three-part article series published in Advertising Age magazine. The groundbreaking series illustrated perceptual positioning related to the concept of positioning and triggered a profound paradigm shift in how people viewed advertising and marketing and how firms advertised their products. Back in 1982, Ries and Trout published their book, Positioning: The Battle for Your Mind, which placed an entirely different spin on the concept. Ries and Trout (1986) , however, consider “Positioning within the context of perceiving the product, merchandise, a service, a company, an institution, or even a person”. They noted that positioning is not what is done to the product/service, but rather what is done to the mind of the customer/consumer. According to the authors, the key issue is to position the offering in the mind of the consumer/customer such that positioning shifts the importance of marketing from the product to the battle for your mind. They further stated that the basic approach of positioning is not to create something new and different, but to manipulate what’s already up there in the mind, to retie the connections that already exist.

2.1 Issues in positioning research

Although there is a vast amount of literature on positioning, and this inquisitive verb is in great favour among marketing experts, it is one of the most convoluted concept and is still subject to incomprehension. The concept of positioning is subject to considerable differences in interpretation ( Maggard, 1976 ). It is perhaps one of the thorniest and most complex concepts in marketing ( Bhat and Reddy, 1998 ). One of the reasons for this circumstance is the issue that there is no mutual agreement among marketing scholars and practitioners about the exact meaning of the concept. It is, however, important to note that the lack of coherent definitions ( Arnott, 1992 ; Blankson and Kalafatis, 2004 ; Crosier, 1981 ; DiMingo, 1988 ; Holmes, 1973 ; Maggard, 1976 and Smith and Lusch, 1976 ) and the difficulties involved in the implementation of the positioning process by practitioners ( de Chernatony, 1994 ) has invariably given rise to comments about the lack of appreciation of the positioning concept ( Pollay, 1985 ). Such dilemma was first expressed in the writings of Aaker and Shansby (1982) who stated that: “positioning means different things to different people”. To some, it means the segmentation decision. To others it is an image question. To still others it means selecting which product features to emphasize, and it still holds true today. The foregoing is summarized by Bainsfair (1990) who states that positioning is one of those words which everybody uses but few people understand. According to Rigger (1995) , the absence of a rigorous definition is inhibiting both practitioner and academic scholars in developing appropriate means of measuring the operationalization of positioning. Blankson and Kalafatis (2004) highlighted that there has been no single universally accepted definition of the concept of positioning. Specifically, the boundaries of the concept are often not clearly defined – the question what exactly falls under the scope of positioning has not been sufficiently answered in literature and is still subject to heavy debate in the marketing community. This state of affairs has given rise to several varying terms associated with the concept, i.e. positioning, position, product positioning, market positioning, etc., but as stated by Arnott (1994) , the various terminologies are simply “several sides of the same coin” and complement each other. Further according to Smith and Lusch (1976) , product position and brand position are different in scope; product position refers to the objective attributes in relation to other products and brand position refers to subjective attributes in relation to competing brands and this perceived image of the brand does not belong to the product but is the property of consumers perceptions of a brand. However, in broader terms, the terms product positioning and brand positioning usually mean the same thing ( Kazmi, 2007 ).

Urde and Koch (2014) in their review of positioning also claim that there is surprising vagueness of the concept, the lack of the holistic view and the dominance of the market oriented approach. According to Fuchs (2008) , positioning is an important, rich and a difficult area for future research. Marketers have developed an impressive variety of highly valuable research techniques and models in positioning research. However, on the conceptual and empirical front, research on positioning is scarce and lagging behind. Chew (2005) also claims that there are little theoretical/conceptual frameworks to guide positioning research and also, the extant positioning literature is largely normative and the issues discussed tend to be subjective. Nevertheless, more research is needed to obtain a better general understanding of the positioning concept. In the following section, the present review and analysis of definitions of positioning used in articles from 1969 to 2017 are presented.

3. Research method

This study used a systematic literature review to identify articles that define or conceptualize the concept of positioning. Systematic review has its origins in the medical field and has been developed through the Cochrane Collaboration. Some of the features of this approach have been adopted in the social sciences. More recently, the approach has been closely scrutinized to determine its appropriateness in the management field and conclusions indicate that “for practitioners/managers, systematic review helps develop a reliable knowledge base by accumulating knowledge from a range of studies ( Brown and Oplatka, 2006 ).

A systematic literature review is neither a formal full-length literature review nor a meta-analysis, as it conforms to a rigorous set of core principles. It has to be systematic (organized according to a method designed to address the review questions), transparent (explicitly stated), reproducible and updatable and synthesized (summarizes the evidence relating to the review question) ( Briner and Denyer, 2012 ). In other words, it is an essential tool for an evidence-based practice ( Briner and Denyer, 2012 ) that differs from traditional narrative reviews by adopting a replicable, scientific and transparent process ( Tranfield et al. , 2003 ). In line with MacInnis’s (2011) framework for conceptual contributions in marketing, our analysis involves identifying how entities (definitions) are different by revealing the underlying key perspectives in various positioning definitions. The present study examines not only how these definitions are different but also what they have in common.

3.1 Search strategy

The review identified relevant articles, which enabled a transparent, documented research process with criteria for including and excluding articles. The systematic review involved the following steps: State research questions develop guidelines for collecting literature, decide on inclusion and exclusion criteria, develop a comprehensive search plan for finding literature, develop a codebook for classifying and describing literature, code the literature and synthesize the literature ( Tranfield et al. , 2003 ; Witell et al. , 2016 ). The present study explores the various ways in which positioning has been defined in the literature to determine whether these definitions are different and also what they have in common.

The main search strategy identified research articles that defined the concept of positioning. To capture this, inclusion and exclusion criteria were developed. The initial inclusion criteria were broad to ensure that all relevant articles were identified, were peer-reviewed empirical or conceptual articles, were published in English and had the definition of positioning. To achieve the mentioned objective, five dominant academic databases including Scopus, Emerald, EBSCOS, Wiley Online Library and Science Direct were explored to identify articles on positioning. This paper reviews literature spanning from 1969 to 2017. Articles were identified in the “article title, abstract, and keywords” section of the said databases using keywords as “positioning”; “product positioning”; and “brand positioning”. To keep the search process specific to the objectives of this study, above keywords were used with the subject limits of “Business, management and accounting”; “Social Sciences”; and “Psychology”.

3.2 Sample selection

The initial search yielded 1,557 empirical or conceptual articles, 1,502 of which were in English. Figure 1 provides an overview of the selection process

All articles were scanned for relevance, which revealed two clear trends. First, although many of the articles used the term “positioning” in the abstract, few actually defined, conceptualized, or emphasized the term. Second, many of those articles that did specifically focus on positioning did not provide a specific definition of the concept. This lack of a definition provides further merit to our claim that a clear understanding of positioning is missing in the literature. In total, 354 articles that had a clear focus on positioning were selected for further analysis.

Two authors independently read the selected 354 articles to ensure that they met the inclusion criteria and to identify those that defined or conceptualized positioning. Those authors compared and discussed the results; in cases of disagreement, a third author was consulted. The final sample included 152 articles that provided at least one of the following: a clear definition, a conceptualization or an explicit referral to a specific definition or conceptualization of positioning.

3.3 Data analysis

To analyze the sample of articles, a combination of qualitative content analysis and quantitative analysis was used, which is a method for systematically and objectively evaluating texts ( Lombard et al. , 2002 ). The analysis was conducted in three steps – classification, coding and text analysis – using qualitative text mining ( Feldman and Sanger, 2007 ). Researchers often face the question of how to summarize text and determine what words and concepts are more significant than others. To go further than merely summarize, quantitative text analysis was used so that our review would be more than just descriptive statistics and qualitatively comparing and present definitions. Textmining, also known as text data mining or knowledge discovery from textual databases, refers to the process of extracting interesting and non-trivial patterns or knowledge from text documents ( Feldman and Sanger, 2007 ; Witell et al. , 2016 ). The rationale for this process builds on social network theory, which describes linkages among social entities or nodes in a network and the implications of these linkages and can be used on text to determine which words are significant ( Xie, 2005 ; Witell et al. , 2016 ).

All selected articles were downloaded and definitions were captured in digital plain-text format. Each article was then coded according to several predetermined variables, such as context, definitions, approach and type of study (for example, empirical, conceptual) to describe the characteristics of the sample. The study analyzed the specific definition of positioning offered in each article; by “cleaning” the definitions from “positioning is defined as […]” and focusing only on the words included in the actual definition of the concept. In addition, all common words such as “and” or “of” were removed. All text were stemmed, a procedure that involves reducing all words with the same stem to a common form (Lovins, 1968; Witell et al. , 2016 ). By using this method, the five key perspectives were identified in the pool of positioning definitions.

4. Analysis and results

This section begins by describing the year-wise and journal-wise distribution of the 47 identified journal articles. The section then describes the conceptualizations of positioning proposed by previous studies.

4.1 Journal-wise distribution of articles

This classification was done to observe where positioning research is being published. Articles related to positioning were found to be published in 33 reputed peer-reviewed journals in different time periods ( Table 1 ). This number is encouraging for academicians concerned about identifying and selecting a channel for their positioning manuscripts. Among these reputed journals, the dominant outlet of positioning research have been the Journal of Marketing , Journal of Product and Innovation Management and Business Horizon.

4.2 Year-wise distribution of articles

Articles were classified based on their year of publication from 1969 to 2019 to identify the longitudinal pattern of academic research. Figure 2 shows that the emergence of publications on positioning started in 1969, followed by steady growth up until 1989. From 1990 onwards, it is clear from the figure that there is exponential growth till 2009. However, the trend line also indicates a decreasing pattern after 2010, which implies that the literature on positioning is decreasing. After 2010, only six papers were published, which is the lowest number of papers as compared to previous years. This concludes that there is a need for increasing concerns and interests on the positioning topic.

4.3 Conceptualization of positioning in the marketing discipline

Most of the authors have based their definitions on Ries and Trouts (1969) original description of positioning, i.e. they have made minor adjustments, but constructed their basic reasoning upon the words of Ries and Trout.

There are many diverse interpretations of positioning as each author has preferred his/her own definition and has viewed positioning through different perspectives. The various perspectives from which positioning are viewed by most of the authors are listed in Table 2 . It provides a description of each perspective, and denotes how many times each perspective is found in the pool of positioning definitions.

Although these core perspectives all represent fundamental elements of the concept that delineates positioning, they were not all captured by every definition. Each perspective is discussed in turn.

4.3.1 P1 – Competition.

The “Competition” (P1) perspective as already mentioned is found in 56 of the 152 (39%) definitions listed in Appendix . This perspective underlies the idea that positioning helps in creating an image for the product in relative to separate or apart from competitors. The perspective (P1) is clearly articulated in several of the definitions, and in particular, that offered by Kapferer (2004) , “Positioning means emphasizing the distinctive characteristics that make it different from its competitors and appealing to the public”. Similarly, Kotler (2003) defined “Positioning as an act of designing a company’s offering and image so that they occupy a meaningful and distinct competitive position in the target market’s minds”. Many others (including Aaker and Shansby, 1982 ; Belch and Belch, 1995 ; Kotler and Anderson, 1996 ; Lovelock et al. , 2014 ; McIntyre, 1975 ) also included this perspective in their definitions.

4.3.2 P2 – Empty slot/mind.

The perspective “Empty slot/Mind” (P2) captures the idea that the act of positioning seeks to find and fill an empty slot/window in the minds of the prospective buyers. P2 is evident in several definitions as listed in Appendix . This perspective is also dominant as it was identified in 55 of the 152 (36%) positioning definitions. The “Empty slot/Mind” perspective is rooted in Ries and Trout’s (1969) seminal work on positioning and in particular, the popularity of the phrase “filling a slot in the minds of the target customers”. P2 is clearly asserted in several definitions, for instance, in Crawford et al. (1983) “Product positioning is the act of creating and altering product perceptions in customers’ minds”. Similarly, P2 is asserted in Wright’s (1997) definition stating “Positioning involves and owning a territory in the mind of the consumer it’s not just occupying the position, but owning it”, and in Boone and Kurtz’s (2009) definition stating “Positioning is placing at a certain point or location within a market in the minds of prospective buyers”.

4.3.3 P3 – consumers’ perception.

The perspective “Consumers’ perception” (P3) captures the idea that the act of positioning seeks to purposefully establish or evoke changes in consumers’ minds regarding offering. P3 is evident in several definitions as listed in Appendix . This perspective was identified in 34 of the 152 (22 %) positioning definitions. P3 is clearly expressed in several of the definitions, and in particular, that offered by Sengupta (1990) “Positioning is the concept of perceptual space and consumers mind is regarded as a geometric perceptual space with product categories and brands occupying different points in that space”. Similarly, P3 is expressed in Arnott (1994) “Positioning is the deliberate, proactive, iterative process of defining, modifying and monitoring consumer perceptions of a marketable object”.

4.3.4 P4 – Differentiation.

The “Differentiation” (P4) perspective is evidenced in 19 of the 152 (13%) positioning definitions as listed in Appendix . This perspective captures the notion that creating meaningful differentiation in an offering represents a key aspect of the concept of positioning. P4 is clearly captured in Myers (1996) definition “Positioning refers to the problem of differentiating one’s own product/service from other competing entries in the market place”. Likewise, Zikmund and D’Amico (1989) define “Positioning as a process to identify salient product characteristics that differentiate the brand from competitive brands”. P4 is consistent with the widely accepted view that differentiating an offering is a cornerstone to the positioning of a product, and therein, the success of the brand in the marketplace ( Wind, 1982 ; Bhat and Reddy, 1998 ; Hooley et al. , 1998 ).

4.3.5 P5 – Competitive advantage.

The “Competitive advantage” perspective, is evident only in 5 of the 152 (3%) of the definitions. This perspective underlies the idea that positioning helps in gaining a competitive advantage by implementing a value creating strategy not simultaneously being implemented by any current or potential competitors. P5 is clearly articulated in several of the definitions as listed in Appendix , and in particular, that offered by Palmer (1994) “Positioning is an attempt by the organization to distinguish its offerings from those of its competitors in order to give it a competitive advantage within the market”. Hooley et al. (1998) also articulated the same in their definition, “Positioning is the act of designing the company’s offering and image so that they occupy a meaningful and distinct competitive advantage”. P6 is consistent with the widely accepted view that a well-positioned brand enhances the overall competitiveness of the brand and generates a sustainable competitive advantage for the firm Aaker and McLoughlin (2007) , Blankson et al. (2013) , Ghodeshwar (2008) , Hooley et al. (2012) , Kotler (2003) , Porter (1996) . Accepting the view that competitive advantage represents the cornerstone of the positioning concept, the researcher found it surprising that only five definitions from the pool captured this perspective.

Based on (1) the core perspectives as discussed in the foregoing Section (2) the recognized need for an universally-accepted definition of positioning (3) the inconsistencies of the core meaning of the positioning construct and the researcher’s conviction that marketing research begins with a clear underlying meaning of the phenomenon in question, following definition of positioning encompassing the five underlying positioning perspectives is suggested:

Positioning is a strategy of finding the desired consumer perception of product/brand and filling an empty slot/window in the minds of the target customers by creating and communicating an image which differentiates its unique position from competitor to gain a competitive advantage in the market.

5. Research implications

On the theoretical front, this review makes multiple contributions. First, the study presents a comprehensive systematic review of 152 identified articles in the marketing discipline to reveal how researchers have explored this concept so far and presents a route for future research. Second, this review makes a contribution to understanding what positioning is. Specifically, this research contributes by identifying the key perspectives in definitions of positioning. Gaining insights from existing conceptualizations of the construct and supporting that by the theoretical foundations, a concise definition, broad in scope and perspective, has been derived, the suggested definition will provide clearer comprehension of the concept of positioning and a base on which to advance empirical research on positioning. Third, by providing the distribution schema of customer engagement articles based on different criteria, this study is believed to serve as a valuable tool for researchers to understand the current scenario of positioning research in the marketing discipline and aid in moving the field forward. On the practical front, this study exhibits the favorable outcomes organizations can derive by having a proper definition of positioning. Developing and implementing an organization’s positioning is seen as a crucial element of an organization’s strategic orientation to markets. The more an organization knows about positioning, the better adept it will be to enact so. Therefore, understanding positioning is imperative in that regard; this review will help organizations comprehend that better. Further, understanding how various perspectives are connected with positioning will help managers to design and implement positioning strategies for their products/brands and allow organizations to gain competitive advantage.

6. Conclusion and limitations

The goal of this systematic review was to review state-of-the-art literature on product/brand positioning to re-examine the positioning concept and developing a more comprehensive definition from a theoretical viewpoint. Positioning has been defined in several nuanced ways. This fragmentation can be misleading, and a systematic review can provide a useful analysis to highlight the fragmentation and propose boundaries to better define positioning. However, a systematic review also has its own methodological limitations, including the level of precision. To tackle this limitation, we started broadly and then focused on specific databases and research terms. Although some dimensions might have been missed, we believe our conclusions obtained a reasonable level of redundancy in the databases that we used for this study. We also wanted to contribute to the literature and hope that further research on this important strategic concept will refine and clarify our results. This systematic review presented the results of an analysis and synthesis of the broader positioning literature. A review of 152 published positioning studies from the literatures identified the various perspectives from which positioning are viewed by most of the authors. The five most frequently identified perspectives were competition, empty slot/mind, consumers’ perception, differentiation and competitive advantage. Importantly, the findings of this review confirm that despite the relatively established body of literature, there is there is lack of coherent definition for positioning, and there is no mutual agreement among marketing scholars and practitioners about the exact meaning of the concept.

Flow diagram of article selection process

Number of positioning (definition) related articles (1969–2017)

Journal-wise distribution of articles

Core perspectives of positioning

Overview of positioning definitions

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Statistical perceptual maps: using confidence region ellipses to enhance the interpretations of brand positions in multidimensional scaling

Original Article
Published: 02 November 2017
Volume 5 , pages 81–98, ( 2017 )

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Dawn Iacobucci 1 ,
Doug Grisaffe 2 &
Wayne DeSarbo 3

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Positioning is among a marketer’s preeminent strategic responsibilities. Positioning helps to clarify brand strengths among competitors and identify potential challenges of similar brands and possible substitutability. Assessments of positioning, from initial marketplace efforts to resources directed at modifications and re-positioning, are frequently assisted by the graphical representations of brands in multidimensional space. Such perceptual maps are constructed to reflect the closeness of brands and therefore the extent to which they are seen as interchangeable, versus distances between brands representing their relative positioning distinctiveness. To create perceptual maps, data are frequently obtained that comprise a sample of respondents rating a series of brands with respect to their perceived similarities and differences, as well as the status of each brand along multiple attributes. This research uses the variability inherent in such three-dimensional data to construct confidence regions around point estimates in perceptual maps. Current maps tend to be simply descriptive, with positions reflected by point estimates, but multivariate models including multidimensional scaling and multi-mode factor analysis can be modified to extract the subject heterogeneity and derive inferential perceptual maps. Confidence regions that overlap will indicate more clearly an inference of brand similarity, whereas non-overlapping regions imply statistically differentiated brand perceptions.

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Adaptive Multidimensional Scaling: Brand Positioning Based on Decision Sets and Dissimilarity Judgments

Tammo H.A. Bijmolt, Michel Wedel & Wayne S. DeSarbo

Perceptual maps via enhanced correspondence analysis: representing confidence regions to clarify brand positions

Dawn Iacobucci & Doug Grisaffe

An Attempt to Validate Nonmetric Multidimensional Scaling Maps

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Department of Marketing, Owen Graduate School of Management, Vanderbilt University, 401 21st Avenue South, Nashville, TN, 37203, USA

Dawn Iacobucci

Department of Marketing, College of Business, University of Texas at Arlington, 701 S. Nedderman Dr, Arlington, TX, 76019, USA

Doug Grisaffe

Department of Marketing, Smeal College of Business, Pennsylvania State University, Business Building, University Park, PA, 16802, USA

Wayne DeSarbo

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Appendix A: Stimuli and rating scales for cars

Note: These photos are public domain, obtained via an image search on Google with the option of “usage rights” set to “free to use or share, even commercially.”

Appendix B: Stimuli and rating scales for cities

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Iacobucci, D., Grisaffe, D. & DeSarbo, W. Statistical perceptual maps: using confidence region ellipses to enhance the interpretations of brand positions in multidimensional scaling. J Market Anal 5 , 81–98 (2017). https://doi.org/10.1057/s41270-017-0022-6

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Published : 02 November 2017

Issue Date : December 2017

DOI : https://doi.org/10.1057/s41270-017-0022-6

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Perceptual Disorders After Stroke: A Scoping Review of Interventions

Christine hazelton.

1 Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, United Kingdom (C.H., K.M., P.C., A.T.-B., K.T., M.C.B.).

Kris McGill

Pauline campbell, alex todhunter-brown, katie thomson, donald j. nicolson.

2 Stroke Survivor Representative, United Kingdom (D.J.N.).

Joshua D. Cheyne

3 Cochrane Stroke Group, University of Edinburgh, United Kingdom (J.D.C.).

Charlie Chung

4 Queen Margaret Hospital, National Health Service (NHS) Fife, United Kingdom (C.C.).

Liam Dorris

5 Paediatric Neurosciences, Royal Hospital for Children, NHS Greater Glasgow and Clyde, United Kingdom (L.D.).

David C. Gillespie

6 Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, NHS Lothian, United Kingdom (D.C.G.).

Susan M. Hunter

7 School of Allied Health Professions, Keele University, United Kingdom (S.M.H.).

Marian C. Brady

Associated data.

Perceptual disorders relating to hearing, smell, somatosensation, taste, touch, and vision commonly impair stroke survivors’ ability to interpret sensory information, impacting on their ability to interact with the world. We aimed to identify and summarize the existing evidence for perceptual disorder interventions poststroke and identify evidence gaps. We searched 13 electronic databases including MEDLINE and Embase and Grey literature and performed citation tracking. Two authors independently applied a priori–defined selection criteria; studies involving stroke survivors with perceptual impairments and interventions addressing those impairments were included. We extracted data on study design, population, perceptual disorders, interventions, and outcomes. Data were tabulated and synthesized narratively. Stroke survivors, carers, and clinicians were involved in agreeing definitions and organizing and interpreting data. From 91 869 records, 80 studies were identified (888 adults and 5 children); participant numbers were small (median, 3.5; range, 1–80), with a broad range of stroke types and time points. Primarily focused on vision (34/80, 42.5%) and somatosensation (28/80; 35.0%), included studies were often case reports (36/80; 45.0%) or randomized controlled trials (22/80; 27.5%). Rehabilitation approaches (78/93; 83.9%), primarily aimed to restore function, and were delivered by clinicians (30/78; 38.5%) or technology (28/78; 35.9%; including robotic interventions for somatosensory disorders). Pharmacological (6/93; 6.5%) and noninvasive brain stimulation (7/93; 7.5%) approaches were also evident. Intervention delivery was poorly reported, but most were delivered in hospital settings (56/93; 60.2%). Study outcomes failed to assess the transfer of training to daily life. Interventions for stroke-related perceptual disorders are underresearched, particularly for pediatric populations. Evidence gaps include interventions for disorders of hearing, taste, touch, and smell perception. Future studies must involve key stakeholders and report this fully. Optimization of intervention design, evaluation, and reporting is required, to support the development of effective, acceptable, and implementable interventions.

Registration:

URL: https://www.crd.york.ac.uk/PROSPERO/ ; Unique identifier: CRD42019160270.

Perception is our ability to understand and organize information from our sensory systems: hearing, smell, somatosensation, taste, touch, and vision. Perceptual disorders are frequently undetected 1 , 2 but may affect up to 74% of stroke survivors 3 – 5 and persist for months or years post-onset. 3 , 6 , 7 Perceptual disorders impact on stroke survivors’ ability to make sense of and interact with their environment, through recognition, differentiation, organization, and integration of sensory information, 8 , 9 impeding recovery and rehabilitation, 10 self-care, 11 and independence in everyday activities. 3 , 12

Assessment and management of perceptual problems poststroke is complex, due to the range of sensory systems and specialisms involved. Significant variability exists in care provision, 13 pathways, 1 , 13 and stroke team training on perception and terminology. 2 , 14 While stroke guidelines refer to perception, treatment recommendations focus on specific domains, and guidance on intervention selection or delivery is limited. 15 – 17 Intervention research is a priority for stroke survivors, carers, and health care professionals. 18 , 19

Previous intervention evidence reviews are fragmented, addressing single sensory domains, 20 specific anatomic areas, 21 individual perceptual disorders, 22 or specific interventions, 23 while others include mixed populations inclusive of nonperceptual disorders or nonstroke etiologies. 24 , 25 An accessible, comprehensive, up-to-date evidence review relevant to stroke survivors, carers, and clinicians is required. We aimed to identify, map, and synthesize evidence relating to perceptual disorder interventions poststroke in a scoping review, providing a broad overview of the evidence and identifying research gaps.

There is much variation in the meaning assigned to the term perception: it varies in relation to definition, delineation from sensation and cognition, and included disorders; it also varies across senses, clinical specialisms, and time. We defined perception as “specific mental functions of recognizing and interpreting sensory stimuli” 26 and applied it across disorders relating to hearing, smell, somatosensation (including proprioception), taste, touch, and vision (including visuospatial; see Methods S1 for definitions).

Our scoping review followed a predefined protocol (CRD42019160270), established methodology, 27 , 28 and relevant reporting guidelines. 29 Scoping review methodology provides a structured, rigorous approach to providing an overview of a range of evidence, research gaps, and future research priorities. 27 , 28 Thirteen databases (including MEDLINE, Embase, and CINAHL), specialized resources, and trial registers were searched (inception to February 7, 2020). To address the breadth of included sensory domains and complex perceptual terminology, our multidisciplinary research team worked with stakeholders (stroke survivors and carers, n=5; experienced clinicians with expertise in perceptual disorders, n=4) and an information specialist to develop a peer-reviewed search 30 ( Methods S1 ). Extensive supplementary searching included backward and forward citation tracking (last search: November 24, 2020; Methods S1 ). No language or date limitations were applied. We included studies where participants had poststroke perceptual disorders and explored interventions that targeted that disorder. We included all age groups, stroke types, and settings.

Two reviewers independently screened abstracts and full texts. We anticipated challenges in the application of our perceptual disorder inclusion criteria: where uncertainties arose, a third (clinical expert) reviewer was consulted. Data were charted and categorized by 1 reviewer using predefined, piloted forms and checked by a second, with input from clinical experts as required. Extracted data included study design, participant demographics, intervention details (using the Template for Intervention Description and Replication [TIDieR] checklist), 31 and outcome measurements. Where studies recruited mixed participant populations, stroke- and perception-specific data were extracted, where possible. Extensive data categorization profiled the complex disorders and interventions’ distinguishing features ( Table S1 ). Intervention categorization used an established taxonomy, 32 , 33 including pharmacological, noninvasive brain stimulation (NIBS; such as transcranial direct current stimulation), or rehabilitation. Rehabilitation interventions were subcategorized as restitution (direct training of the impaired function), compensation (via training of or using a spared function), substitution (use of an external device or modification), 34 or a combination of these approaches. All categorizations were checked by a third reviewer and considered the body functions (impairments) the intervention targeted, as stated by the primary research teams; we made no assumptions about biological mechanisms at play.

We categorized outcomes used by the primary researchers to measure intervention effectiveness. We extracted verbatim summaries of individual study findings. As the aim was to provide an overview of the scope of research, rather than judge the quality of evidence for a specific intervention, no assessment of methodological quality or detailed aggregation of findings was conducted. 27

Data were collated and tabulated. A narrative account was organized by sense and intervention approach. Our stakeholder group contributed to this process and data interpretation 35 , 36 ( Methods S2 ). The appropriate guidance was used to report the review ( Methods S3 ). The review data are available from the corresponding author upon reasonable request.

Results of the Search

Of 91 869 titles identified, 80 (893 participants; 869 poststroke perceptual disorders) met our inclusion criteria (Figure (Figure1; 1 ; Table S2 ). Interventions and participants were summarized by perceptual disorder: vision (Table (Table1), 1 ), somatosensation (Table (Table2), 2 ), and other sensory domains (Table (Table3 3 ).

Visual Perceptual Disorders: Details of Studies, Population, and Interventions

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Somatosensation Perceptual Disorders: Details of Studies, Population, and Interventions

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Hearing, Touch, and Mixed Perceptual Disorders: Details of Studies, Population, and Interventions

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PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram for scoping review literature identification.

Included Studies

Case reports (36/80; 45.0%) and randomized controlled trials (RCTs; 22/80; 27.5%) were common, with RCTs accounting for most participants (630/893; 70.5%). Study sample sizes ranged from 1 to 80 participants (median, 3.5; interquartile range, 1–16.5). Most were based in Asia (27/80; 33.8%) or Europe (26/80; 32.5%). Study numbers are increasing with time (Figure (Figure2A); 2 A); of RCTs, 54.5% (12/22) were conducted 2015 to 2020. Involvement of stakeholders, such as stroke survivors, carers, or clinicians, in the research development and delivery (as opposed to as participants) was not reported in any included studies.

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Study and participant data. A , The number of different study designs used, by year of publication. B , The total number of participants included in studies for each sense (inner ring) and each perceptual disorder (outer ring). C , The percentage of different study designs used for each sense. D , The number of interventions using a specific intervention approach, for each sense. *The categorization of perceptual deficit signified that study participants had a range of different perceptual issues or who were diagnosed using a test that did not specify the nature of the disorder.

Time point poststroke ranged between <1 month (19/80; 23.8%), 1 to 6 months (25/80; 31.3%), and >6 months (20/80; 25.0%). Right hemisphere lesions were common (39/80 studies [48.8%] recruited >60% participants with right-sided lesions), and the mean proportion of women was 34.8% (SD, 33.8). Stroke severity was rarely reported (13/80; 16.3%). Young people (<18 year olds) were represented by 5 single case reports, all describing visual perceptual disorders; the remaining study participants were most commonly aged 18 to 65 years (43/80; 53.8%; Table S3 ).

Nature of Perceptual Disorder

Vision (34/80; 42.5% studies; n=357/893; 40.0%) and somatosensation disorders (28/80; 35.0% studies; n=303/893; 33.9%) were most frequently reported. Common disorders included Pusher syndrome 37 (24 studies), visual perceptual deficits (16 studies), and visual hallucination (8 studies; Figure Figure2B; 2 B; disorder definitions in Table S4 ).

There was variation in study designs addressing each sense (Figure (Figure2C). 2 C). Some clusters emerged, with specific designs and interventions for specific perceptual disorders; 5 pharmacological intervention case studies examined visual/audiovisual hallucinations; 6 RCTs addressed Pusher syndrome rehabilitation interventions.

Interventions

Ninety-three perceptual disorder interventions were described across 80 studies ( Table S5 ). Rehabilitation interventions were common (78/93; 83.9%) and primarily restitutive in nature (45/93; 48.4%). Other interventions included NIBS (7/93; 7.5%) and pharmacological interventions (6/93; 6.5%; Figure Figure2D). 2 D). Surgical and assessment-based interventions were absent.

Overview of the Interventions and Intervention Provider

Interventions often involved therapeutic input from a health care practitioner (HCP; 30/93; 32.3%), such as training and support during specific physical activities, rather than physical materials. Technology-based (robotics or computer) tasks were common (28/93; 30.1%), followed by other specialist tools (13/93; 14.0%; eg, training blocks of different colors and sizes).

Descriptions of intervention delivery procedures (55/93; 59.1%) and providers (54/93; 58.1%) were limited or unclear. Where reported, interventions were predominantly delivered in hospital (56/93; 60.2%) on a one-to-one basis (76/93; 81.7%) lasting ≤1 month (42/93; 45.2%). Three (3.2%) were delivered within a participant’s home. Few interventions lasted >3 months (4.3%; 4/93).

Interventions for Individual Sensory Domains

Visual perception disorder interventions used the widest range of approaches: rehabilitation (restitution, 15/37; mixed, 8/37) and pharmacological (5/37; Table Table1). 1 ). Restitution interventions used technology (10/15), often interactive computer-based training of visual skills, while HCP-led interventions taught compensatory skills in real-world simulation tasks. Pharmacological interventions exclusively addressed hallucinations but were solely reported in case reports, with limited details. Vision studies were lacking information on who delivered interventions, where, and for how long.

Four somatosensory disorder intervention approaches were used: rehabilitation (restitution, 24/35; mixed, 6/35), NIBS (3/35), and rehabilitation+NIBS (2/35; Table Table2). 2 ). Most often, interventions were HCP led (17/35), involving physical activities to retrain postural control, with technology-based interventions (9/35) often providing robot-assisted gait training. Interventions were predominantly delivered on a one-to-one basis (32/35), in an inpatient setting (18/35), for ≤1 month (25/35).

Hearing perception disorder intervention reports all describe rehabilitation approaches, primarily technology based (hearing aids; 5/7). Tactile perception disorder interventions (n=7) involved rehabilitation (n=5) or NIBS (n=2). HCPs were less involved in interventions for this disorder, using technology (n=1/5; vibrotactile stimulation) or equipment (n=4/5; tasks with different textures or hardness).

We identified no interventions targeting individual smell or taste perceptual disorders.

Outcomes Measured

The most frequently measured outcomes were perceptual function (60/80; 75.0%), motor/sensorimotor (32/80; 40%), activities of daily living (18/80; 22.5%), and sensory outcomes (12/80; 15%; Table Table4). 4 ). Outcomes were captured immediately (31/80; 38.8%), ≤1 month (9/80; 11.3%), 1 to 3 months (9/80; 11.3%), and >3 months (12/80; 15.0%) after intervention.

Outcome Measure Domains Reported

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Verbatim summaries of study findings are given in Table S6 .

Summary of Findings

Our scoping review scoped the breadth and nature of perceptual disorder interventions poststroke, highlighting gaps in the evidence base. We identified 80 studies that explored predominantly visual or somatosensory perceptual problems, typically using a case report design. Interventions were frequently rehabilitative, with an approach that targeted improvements in the impaired function. Interventions most often involved direct training by an HCP, as well as those using technology-based devices and specialist equipment. Interventions reported were typically hospital based, lasting up to 4 weeks. Few captured outcomes beyond initial postintervention training effects. Perceptual and motor/sensorimotor skills were the most common outcomes reported. We noted an encouraging upward trajectory in the number of perceptual disorder (especially somatosensation) research reports, particularly RCT designs, since 2015.

Gaps in the Evidence

Our scoping review reveals the paucity of evidence informing perceptual disorder interventions poststroke. Key gaps include lack of research addressing perceptual disorders in pediatric populations; interventions for stroke-related hearing, taste, touch, and smell disorders; RCTs; and stakeholder-informed research. While a range of study designs are needed in early-stage intervention development, high-quality RCTs are important in building the evidence base related to treatment effectiveness. Of the 80 studies in this review, only 22 were RCTs; this is significantly lower than, for example, the 65 current trials in neglect found in a recent review. 38

Perception Terminology

The range and complexity of perceptual terminology continues to be a challenge. 25 Despite achieving agreement on our definitions and included senses/disorders, we encountered challenges applying our a priori inclusion and exclusion criteria. Perception was inadequately reported, thus determining whether disorders affected perception, cognition, sensation, attention, or a mix of these was difficult. Inconsistent terms for similar conditions across pediatric and adult populations, and across senses, plus use of complex, Latinate terminology hindered transparency and clarity of interpretation. Clear statements of the nature of disorders, and how intervention rationale or mechanisms relate to perception, are needed. International, multidisciplinary consensus on the terminology used would serve to progress the field of research and improve awareness, multidisciplinary identification, and intervention for those affected.

Pediatric Perceptual Disorders

Five pediatric case reports on stroke survivors with visual perceptual problems were identified; this is in keeping with the extremely limited evidence base for pediatric stroke clinicians. 39 Some additional studies that addressed visual perception or cerebral/cortical visual impairment were identified, but as it was unclear whether impairments were stroke related, they were excluded from our review. Demographic information for both neonatal and later childhood perceptual impairment studies is required to support transparency, interpretation, and implementation of emerging research findings.

The limited intervention research involving pediatric stroke populations may reflect the conflicting evidence about the nature, extent, 40 and expectations of recovery due to neurodevelopmental plasticity. 41 Evidence of perceptual deficit persistence, and factors associated with pediatric resilience and recovery across sensory modalities, needs greater prominence.

Lack of Studies of Hearing, Taste, Touch, and Smell

Interventions for perceptual disorders relating to hearing, taste, touch, and smell were rarely identified; this may reflect stroke survivors’ limited access to specialists, training, and consequently limited awareness of the frequency and impact of these disorders. Assessment and management of visual and somatosensory disorders are more established components of poststroke rehabilitation, giving the impetus to provide evidence to underpin care. 15 Establishing evidence of the prevalence, presentation, recovery, and impact of hearing, taste, touch, and smell perception disorders after stroke is required to inform clinical care and further research in this field.

High Proportion of Case Report Designs

Case reports and RCTs were the most frequent study designs included in this scoping review. Case reports described personalized interventions to individuals with multifaceted perceptual disorders, making their clinical relevance and representativeness difficult to establish. The recent growth in RCT reports is welcome and in keeping with other areas of stroke rehabilitation. 42 Trial participant numbers were low, however, raising questions about sufficient statistical power to determine clinical and cost-effectiveness. Inadequate reporting of treatment feasibility, fidelity, and outcome measures in RCTs and a lack of cohort and n-of-1 studies were evident. The use of a structured development process for perceptual disorder interventions would support exploration of mechanisms of action, dosage, and target group, informing the development and conduct of RCTs. 43 , 44

Limited Involvement of Stakeholders

No included study reported the involvement of stroke survivors, carers, clinicians, or other stakeholders in the study design or conduct (as opposed to as participants). Similarly, we identified no qualitative studies exploring experiences of stroke survivors, carers, or clinicians. Other areas of concern were a lack of real-world, community-based studies; feasibility or economic outcomes; follow-up post-initial posttreatment evaluations; and outcomes capturing transfer of intervention effects to daily life. The benefits of stakeholder involvement are well recognized 45 and would enhance the relevance, implementation, and impact of future research.

Strengths and Limitations

Our scoping review used a broad and rigorous search of electronic databases and Grey literature, adopting a comprehensive definition of perceptual disorders. Despite these efforts, due to the complex nature of the topic and terminology, some relevant articles may have been missed. Our multidisciplinary clinician-research team had expertise in review methodologies, stakeholder involvement, stroke rehabilitation, cognitive disorders, psychology (adult and pediatric), and hearing, taste, smell, somatosensory, and vision disorders. In addition, involvement of our stakeholder group maximized the relevance and accessibility of our findings. In the absence of a universally accepted intervention categorization, we utilized an existing method to support categorization consistency, relevant to perceptual disorder research 34 but which may not necessarily directly align with other categorization approaches. 44 As a scoping review, we did not conduct quality appraisal, and thus comment on quality or generalizability of study findings was not possible.

Conclusions

Our review provides a comprehensive overview of the evidence relating to interventions for perceptual disorders following adult and childhood stroke. Interventions are under-researched, and the terminology used is a barrier to understanding. Key evidence gaps include interventions for pediatric populations, and for stroke-related hearing, taste, touch and smell perception disorders. Rigorous study design, conduct, and reporting, incorporating fuller involvement of stroke survivors, carers, and clinicians, is needed to address perceptual disorders after stroke.

Article Information

Acknowledgments.

We would like to acknowledge the invaluable contribution of our clinical and lived-experience stakeholders. This included Graham Esson, Prof Carl Philpott, Dr Gera de Haan, Dr Christine Johnson, and Dr Kathleen Vancleef. We would like to thank Dr Julie Duncan Miller for her assistance in screening studies.

Sources of Funding

This project is funded by the National Institute for Health Research (NIHR; NIHR Health Technology Assessment [NIHR 128829]) and will be published in full in the NIHR Journals Library. Further information is available at https://fundingawards.nihr.ac.uk/award/NIHR128829 . This report presents independent research commissioned by the NIHR. Dr Hazelton is funded by the Stroke Association (TSA), UK (SA L-NC 20\100003); NMAHP RU and Dr Brady is funded by the Chief Scientist Office (CSO), Health and Social Care Directorates, United Kingdom. The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the National Health Service (NHS), the NIHR, Medical Research Council, Clinical Commissioning Facility, NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC), TSA, CSO, the NIHR Health Technology Assessment (NIHR 128829) program or the Department of Health, United Kingdom.

Disclosures

Dr Brady has disclosed grants from the National Institute for Health Research Health Services and Delivery Research UK including the Health Technology Assessment Programme, Glasgow Caledonian University studentships, and grants from the Tavistock Trust for Aphasia. Dr Nicolson has disclosed a contract from the Metix Medical and conference expenses from the Association for Borderlands Studies World Conference. Dr Hazelton has disclosed funding from the Stroke Association (lectureship SA L-NC 20\100003). The other authors report no conflicts.

Supplemental Material

Supplemental Methods S1–S3

Tables S1–S6

Supplementary Material

Supplemental Material is available at https://www.ahajournals.org/doi/suppl/10.1161/STROKEAHA.121.035671 .

For Sources of Funding and Disclosures, see page 1785–1786.

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Positioning – a literature review

Design/methodology/approach

Research limitations/implications

Social implications

Originality/value

1. Introduction

2. Concept of positioning

2.1 Issues in positioning research

3. Research method

3.1 Search strategy

3.2 Sample selection

3.3 Data analysis

4. Analysis and results

4.1 Journal-wise distribution of articles

4.2 Year-wise distribution of articles

4.3 Conceptualization of positioning in the marketing discipline

4.3.1 P1 – Competition.

4.3.2 P2 – Empty slot/mind.

4.3.3 P3 – consumers’ perception.

4.3.4 P4 – Differentiation.

4.3.5 P5 – Competitive advantage.

5. Research implications

6. Conclusion and limitations

Further reading

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Appendix B: Stimuli and rating scales for cities

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Perceptual Disorders After Stroke: A Scoping Review of Interventions

Kris McGill

Joshua D. Cheyne

Charlie Chung

Liam Dorris

David C. Gillespie

Susan M. Hunter

Marian C. Brady

Registration:

Results of the Search

Included Studies

Nature of Perceptual Disorder

Interventions

Overview of the Interventions and Intervention Provider

Interventions for Individual Sensory Domains

Outcomes Measured

Summary of Findings

Gaps in the Evidence

Perception Terminology

Pediatric Perceptual Disorders

Lack of Studies of Hearing, Taste, Touch, and Smell

High Proportion of Case Report Designs

Limited Involvement of Stakeholders

Strengths and Limitations

Conclusions

Article Information

Sources of Funding

Disclosures

Supplemental Material

Supplementary Material

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