Assessment and rehabilitation of neglect using virtual reality: a systematic review (original) (raw)
Related papers
2009
Unilateral spatial neglect is a disabling condition frequently occurring after stroke. People with neglect suffer from various spatial deficits in several modalities, which in many cases impair everyday functioning. A successful treatment is yet to be found. Several techniques have been proposed in the last decades, but only a few showed long-lasting effects and none could completely rehabilitate the condition. Diagnostic methods of neglect could be improved as well. The disorder is normally diagnosed with pen-and-paper methods, which generally do not assess patients in everyday tasks and do not address some forms of the disorder. Recently, promising new methods based on virtual reality have emerged. Virtual reality technologies hold great opportunities for the development of effective assessment and treatment techniques for neglect because they provide rich, multimodal, and highly controllable environments. In order to stimulate advancements in this domain, we present a review and an analysis of the current work. We describe past and ongoing research of virtual reality applications for unilateral neglect and discuss the existing problems and new directions for development.
Virtual Reality Technology In the Assessment and Rehabilitation of Unilateral Visual Neglect
Proc. 1 st European …, 1996
Unilateral visual neglect affects a very large proportion of patients immediately after stroke. The presence of neglect has been found to be the major determinant of recovery of everyday function (Denes, Semenza, Stoppa & Lis, 1982). Interventions for the rehabilitation of neglect are not very effective. Picking up from the suggestions of Robertson, Halligan & Marshall (1993) potential ways forward employing VR technology are discussed.
Journal of NeuroEngineering and Rehabilitation
Background Unilateral spatial neglect (USN) is a debilitating neuropsychological syndrome that often follows brain injury, in particular a stroke affecting the right hemisphere. In current clinical practice, the assessment of neglect is based on old-fashioned paper-and-pencil and behavioral tasks, and sometimes relies on the examiner’s subjective judgment. Therefore, there is a need for more exhaustive, objective and ecological assessments of USN. Methods In this paper, we present two tasks in immersive virtual reality to assess peripersonal and extrapersonal USN. The tasks are designed with several levels of difficulty to increase sensitivity of the assessment. We then validate the feasibility of both assessments in a group of healthy adult participants. Results We report data from a study with a group of neurologically unimpaired participants (N = 39). The results yield positive feedback on comfort, usability and design of the tasks. We propose new objective scores based on partic...
Spatial neglect is a common and severe cognitive consequence of stroke, yet there is currently no effective rehabilitation tool. Virtual Reality (VR) telerehabilitation tools have the potential to provide multisensory and enjoyable neuropsychological therapies and remotely monitor adherence without the presence of a therapist at all times. In order to inform the development of these tools researchers and industry need to better understand end-user perspectives about these technologies to ensure these are acceptable and user-friendly to ultimately optimize adherence and efficacy. Therefore, this study explored end-user perspectives on the use of self-administered VR telerehabilitation for spatial neglect. We used a mixed-method design including focus groups, self-administered questionnaires and individual interviews with stroke survivors (N = 7), their carers (N = 3) and stroke clinicians (N = 6). End-user perspectives identified clarity of instructions, equipment (cost, available re...
Frontiers in Psychology
Unilateral spatial neglect (USN) is a disorder characterized by the failure to report, respond to, or orient toward the contralateral side of space to a brain lesion. Current assessment methods often fail to discover milder forms, cannot differentiate between unilateral spatial neglect subtypes and lack ecological validity. There is also a need for treatment methods that target subtypes. Immersive virtual reality (VR) systems in combination with eye-tracking (ET) have the potential to overcome these shortcomings, by providing more naturalistic environments and tasks, with sensitive and detailed measures. This systematic review examines the state of the art of research on these technologies as applied in the assessment and treatment of USN. As we found no studies that combined immersive VR and ET, we reviewed these approaches individually. The review of VR included seven articles, the ET review twelve. The reviews revealed promising results. (1) All included studies found significant...
Neurorehabilitation and neural repair, 2018
Unilateral spatial neglect (USN) is a highly prevalent and disabling poststroke impairment. USN is traditionally assessed with paper-and-pencil tests that lack ecological validity, generalization to real-life situations and are easily compensated for in chronic stages. Virtual reality (VR) can, however, counteract these limitations. We aimed to examine the feasibility of a novel assessment of USN symptoms in a functional shopping activity, the Ecological VR-based Evaluation of Neglect Symptoms (EVENS). EVENS is immersive and consists of simple and complex 3-dimensional scenes depicting grocery shopping shelves, where joystick-based object detection and navigation tasks are performed while seated. Effects of virtual scene complexity on navigational and detection abilities in patients with (USN+, n = 12) and without (USN-, n = 15) USN following a right hemisphere stroke and in age-matched healthy controls (HC, n = 9) were determined. Longer detection times, larger mediolateral deviati...
BACKGROUND: Unilateral Spatial Neglect, or neglect, is a common behavioral syndrome in patients following unilateral brain damage, such as stroke. In recent years, new technologies, such as computer-based tools and virtual reality have been used in order to solve some limitations of the traditional neglect evaluation. Within this perspective, also mobile devices such as tablets seems to be promising tools, being able to support interactive virtual environments and, at the same time, allowing to easily reproduce traditional paper-and-pencil test. OBJECTIVE: In this context, the aim of our study was to investigate the potentiality of a new mobile application (Neglect App) designed and developed for tablet (iPad) for screening neglect symptoms. METHODS: To address this objective, we divided a sample of 16 right-damaged patients according to the presence or absence of neglect and we administered assessment test in their traditional and Neglect App version. RESULTS: Results showed that the cancellation tests developed within Neglect App were equally effective to traditional paper- and-pencil tests (Line cancellation test and Star Cancellation test) in detecting neglect symptoms. Secondly, according to our results, the Neglect App Card Dealing task was more sensitive in detecting neglect symptoms than traditional functional task. CONCLUSIONS: Globally, results gives preliminary evidences supporting the feasibility of Neglect App for the screening of USN symptoms.
2004
The goal of this study was to determine whether non immersive interactive virtual environments are an effective medium for training individuals who suffer from Unilateral Spatial Neglect (USN) as a result of a right hemisphere stroke. Participants included 19 patients with stroke in two groups, an experimental group we were given VR-based street crossing training and a control group who were given computer based visual scanning tasks, both for a total of twelve sessions over four weeks. The results achieved by the VR street crossing intervention equalled those achieved by conventional visual scanning tasks. For some measures, the VR intervention even surpassed the scanning tasks in effectiveness. Despite several limitations in this study the present results support further development of the program.
Journal of neuroengineering and rehabilitation, 2018
Unilateral spatial neglect (USN), a highly prevalent and disabling post-stroke impairment, has been shown to affect the recovery of locomotor and navigation skills needed for community mobility. We recently found that USN alters goal-directed locomotion in conditions of different cognitive/perceptual demands. However, sensorimotor post-stroke dysfunction (e.g. decreased walking speed) could have influenced the results. Analogous to a previously used goal-directed locomotor paradigm, a seated, joystick-driven navigation experiment, minimizing locomotor demands, was employed in individuals with and without post-stroke USN (USN+ and USN-, respectively) and healthy controls (HC). Participants (n = 15 per group) performed a seated, joystick-driven navigation and detection time task to targets 7 m away at 0°, ±15°/30° in actual (visually-guided), remembered (memory-guided) and shifting (visually-guided with representational updating component) conditions while immersed in a 3D virtual rea...
Neglect assessment as an application of virtual reality
Acta Neurologica Scandinavica, 2007
Objective – In this study a cancellation task in a virtual environment was applied to describe the pattern of search and the kinematics of hand movements in eight patients with right hemisphere stroke.Methods – Four of these patients had visual neglect and four had recovered clinically from initial symptoms of neglect. The performance of the patients was compared with that of a control group consisting of eight subjects with no history of neurological deficits.Results – Patients with neglect as well as patients clinically recovered from neglect showed aberrant search performance in the virtual reality (VR) task, such as mixed search pattern, repeated target pressures and deviating hand movements. The results indicate that in patients with a right hemispheric stroke, this VR application can provide an additional tool for assessment that can identify small variations otherwise not detectable with standard paper-and-pencil tests.Conclusion – VR technology seems to be well suited for the assessment of visually guided manual exploration in space.