Acceptance of immersive head-mounted display virtual reality in stroke patients

Specht, Julian; Schroeder, Hélène; Krakow, Karsten; Meinhardt, Günter; Stegmann, Barbara; Meinhardt‐Injac, Bozana

doi:10.1016/j.chbr.2021.100141

Cited by 14 publications

(14 citation statements)

References 19 publications

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“…Of the 21 patients in the VR group, none reported problems with motion sickness or associated nausea, and no treatment had to be stopped due to motion sickness or nausea. This is congruent with the results of our feasibility trial with patients with stroke and healthy older adults, where we demonstrated that applying specific principles in VR development, such as having complete control of all motions in VR, reduces the risk of experiencing motion sickness and is feasible for use in special needs groups such as patients with stroke [ 16 ]. Patients in the control group using CCT reported no negative side effects.…”

Section: Resultssupporting

confidence: 86%

“…However, after the first treatment session, those problems were solved without further external intervention. Overall, the acceptance and usability of both technologies were observably high, which, in terms of the VR experience, is congruent with the results of our feasibility study using an earlier version of the software used in this trial [ 16 ].…”

Section: Discussionsupporting

confidence: 86%

“…This tutorial demonstrated the interaction with the VR environment, virtual objects, and the handling of the entire experience. The tutorial was developed and tested with stroke patients, leading to high acceptance in a group of patients with stroke and healthy older adults, indicating that it is suitable for introducing this critical user group to immersive VR [ 16 ]. In addition, the familiarization phase helps reduce possible effects due to unawareness about the technology and negative attitudes toward it [ 29 ].…”

Section: Methodsmentioning

confidence: 99%

“…VR enables a combination of principles from occupational therapy, neuropsychology, and ADL, resulting in an ecologically valid training setting for many individuals with neurological impairments who want to regain their ability to participate in daily activities. Although insights exist concerning the acceptance of immersive HMD-VR in patients with stroke [ 16 ] or older adults [ 17 ], knowledge about the processes of cognitive rehabilitation facilitated by immersive VR needs to be expanded.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive Training With Head-Mounted Display Virtual Reality in Neurorehabilitation: Pilot Randomized Controlled Trial

Specht¹,

Stegmann²,

Gross³

et al. 2023

JMIR Serious Games

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Background Neurological rehabilitation is technologically evolving rapidly, resulting in new treatments for patients. Stroke, one of the most prevalent conditions in neurorehabilitation, has been a particular focus in recent years. However, patients often need help with physical and cognitive constraints, whereby the cognitive domain in neurorehabilitation does not technologically exploit existing potential. Usually, cognitive rehabilitation is performed with pen and paper or on a computer, which leads to limitations in preparation for activities of daily living. Technologies such as virtual reality (VR) can bridge this gap. Objective This pilot study investigated the use of immersive VR in cognitive rehabilitation for patients undergoing inpatient neurorehabilitation. The goal was to determine the difference in rehabilitation effectiveness between a VR serious game that combines everyday activities with cognitive paradigms and conventional computerized cognitive training. We hypothesized the superiority of the VR serious game regarding cognitive abilities and patient-reported outcomes as well as transfer to daily life. Methods We recruited 42 patients with acute brain affection from a German neurorehabilitation clinic in inpatient care with a Mini Mental Status Test score >20 to participate in this randomized controlled trial. Participants were randomly assigned to 2 groups, with 1 receiving the experimental VR treatment (n=21). VR training consisted of daily life scenarios, for example, in a kitchen, focusing on treating executive functions such as planning and problem-solving. The control group (n=21) received conventional computerized cognitive training. Each participant received a minimum of 18 treatment sessions in their respective group. Patients were tested for cognitive status, subjective health, and quality of life before and after the intervention (Alters-Konzentrations-Test, Wechsler Memory Scale—Revised, Trail Making Test A and B, Tower of London—German version, Short Form 36, European Quality of Life 5 Dimensions visual analog scale, and Fragebogen zur Erfassung der Performance in VR). Results Repeated-measures ANOVA revealed several significant main effects in the cognitive tests: Tower of London—German version (P=.046), Trail Making Test A (P=.01), and Wechsler Memory Scale—Revised (P=.006). However, post hoc tests revealed that the VR group showed significant improvement in the planning, executive control, and problem-solving domains (P=.046, Bonferroni P=.02). In contrast, no significant improvement in the control group between t0 and t1 was detected (all P>.05). Furthermore, a nonsignificant trend was observed in visual speed in the VR group (P=.09, Bonferroni P=.02). Conclusions The results of this pilot randomized controlled trial showed that immersive VR training in cognitive rehabilitation had greater effectiveness than the standard of care in treating patients experiencing stroke in some cognitive domains . These findings support the further use and study of VR training incorporating activities of daily living in other neurological disorders involving cognitive dysfunction. Trial Registration Federal Registry of Clinical Trials of Germany (DRKS) DRKS00023605; https://drks.de/search/de/trial/DRKS00023605

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Section: Resultssupporting

confidence: 86%

Section: Discussionsupporting

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cognitive Training With Head-Mounted Display Virtual Reality in Neurorehabilitation: Pilot Randomized Controlled Trial

Specht¹,

Stegmann²,

Gross³

et al. 2023

JMIR Serious Games

Self Cite

View full text Add to dashboard Cite

show abstract

“…The presence of cybersickness often concerns investigators when using fully immersive technologies. Yet, it has been found, not only for stroke patients but also for older adults, that immersion causes minimal cybersickness ( Despoti et al, 2022 ) and led to a positive attitude toward this intervention ( Huygelier et al, 2019 ; Specht et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of immersive virtual reality in physical recovery of stroke patients: A systematic review

Patsaki

Dimitriadi

Despoti

et al. 2022

Front. Syst. Neurosci.

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BackgroundOver the past few years, technological innovations have been increasingly employed to augment the rehabilitation of stroke patients. Virtual reality (VR) has gained attention through its ability to deliver a customized training session and to increase patients’ engagement. Virtual reality rehabilitation programs allow the patient to perform a therapeutic program tailored to his/her needs while interacting with a computer-simulated environment.PurposeThis study aims to investigate the effectiveness of a fully immersive rehabilitation program using a commercially available head-mounted display in stroke patients.MethodsA systematic search was conducted in three databases, namely, PubMed, Google Scholar, and PEDro. Four hundred thirty-two references were identified. The keywords used for the literature search were in English, which are given as follows: immersive, virtual reality, neurorehabilitation, stroke, and head-mounted display. Additionally, applicable articles were identified through screening reference lists of relevant articles.ResultsOnly 12 studies used head-mounted display for immersing the patient into the virtual world. Apart from the feasibility of this new technology, a range of benefits were identified, especially in terms of functional ability as measured by FIM or Barthel, the Action Research arm Test, Box and Block Test, Fugl-Meyer assessment of physical performance, strength, and balance outcomes.ConclusionThe results from this review support the potential beneficial effect of fully immersive virtual reality in the rehabilitation of stroke patients, maximizing recovery through increased motivation and adherence.

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A review of the application of virtual and augmented reality in physical and occupational therapy

Luckykumar Dwarkadas,

Talasila,

Challa

et al. 2024

Softw Pract Exp

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This paper includes a research review in five bibliographic databases on using the application of virtual reality (VR) and augmented reality (AR) in physical and occupational therapy (POT). This literature review addresses five research questions and two sub‐research questions. A total of 36 relevant studies were selected in the review based on the defined keywords and inclusion‐exclusion criteria. The primary motivation for using the application of VR and AR in POT is that it is accurate, involves higher patient participation, and requires less therapy recovery time. The standard software tool used is the Unity 3D game engine, and the common device used is the Oculus Rift HMD. Various applications of VR and AR consist of different VR environments and AR contents used in POT. Post‐stroke rehabilitation, rehabilitation exercises, pain management, mental and behavioral disorders, and autism in children are the main aspects addressed through the VR and AR environments. Literature review indicates that questionnaires, interviews, and observation are the primary metrics for measuring therapy's effectiveness. The study's findings show positive results such as reduced treatment time, nervousness, pain, hospitalization period, making therapy enjoyable and encouraging, improved quality of life, and focus on using the application of VR and AR in POT. This review will be relevant to researchers, VR and AR application designers, doctors, and patients using the application of VR and AR in POT. Further research addressing multiple participants with clinical trials, adding new VR environments and AR content in VR and AR applications, including follow‐up sessions, and increasing training sessions while using the application of VR and AR in POT are recommended.

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Acceptance of immersive head-mounted display virtual reality in stroke patients

Cited by 14 publications

References 19 publications

Cognitive Training With Head-Mounted Display Virtual Reality in Neurorehabilitation: Pilot Randomized Controlled Trial

Cognitive Training With Head-Mounted Display Virtual Reality in Neurorehabilitation: Pilot Randomized Controlled Trial

The effectiveness of immersive virtual reality in physical recovery of stroke patients: A systematic review

A review of the application of virtual and augmented reality in physical and occupational therapy

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