An immersive virtual reality game to train spatial attention orientation after stroke: A feasibility study

Huygelier, Hanne; Schraepen, Brenda; Lafosse, Christophe; Vaes, Nathalie; Schillebeeckx, Fabienne; Michiels, Karla; Abeele, Vero Vanden; Ee, Raymond van; Gillebert, Céline R.

doi:10.1080/23279095.2020.1821030

Cited by 42 publications

(49 citation statements)

References 91 publications

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Section: Discussionmentioning

confidence: 99%

“…IVR in HMD is an emerging and very promising visual rehabilitation approach using high-technology devices (52)(53)(54)(55)(56). It is developed to provide perceptual learning with better ecological validity due to virtual reality, greater flexibility due to home-based stimulation protocol, and improved efficiency due to patient-tailored protocols (52,53). Our dynamic IVR audiovisual stimulation procedure based on the 3D-MOT paradigm mimics real-life, complex dynamical situations where individuals apprehend their environment using both visual and auditory information (16).…”

Section: Discussionmentioning

confidence: 99%

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Case Report: Visual Rehabilitation in Hemianopia Patients. Home-Based Visual Rehabilitation in Patients With Hemianopia Consecutive to Brain Tumor Treatment: Feasibility and Potential Effectiveness

et al. 2021

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Background/Objectives: Visual field loss is frequent in patients with brain tumors, worsening their daily life and exacerbating the burden of disease, and no supportive care strategies exist. In this case series, we sought to characterize the feasibility and potential effectiveness of a home-based visual rehabilitation program in hemianopia patients using immersive virtual-reality stimulation.Subjects/Methods: Two patients, one with homonymous hemianopia and the other with bitemporal hemianopia, consecutive to pediatric brain tumors, with no prior visual rehabilitation performed 15 min of home-based audiovisual stimulation every 2 days for 6 weeks (case 2) and 7 weeks (case 1) between February and August 2020. Patients used a virtual-reality, stand-alone, and remotely controlled device loaded with a non-commercial audiovisual stimulation program managed in real time from the laboratory. Standard visual outcomes assessed in usual care in visual rehabilitation were measured at the clinic. Following a mixed method approach in this pragmatic study of two cases, we collected quantitative and qualitative data on feasibility and potential effectiveness and compared the results pre- and post-treatment.Results: Implementation and wireless delivery of the audiovisual stimulation, remote data collection, and analysis for cases 1 and 2 who completed 19/20 and 20/20 audiovisual stimulation sessions at home, respectively, altogether indicated feasibility. Contrast sensitivity increased in both eyes for cases 1 and 2. Visual fields, measured by binocular Esterman and monocular Humphrey full-field analyses, improved in case 1. A minor increase was observed in case 2. Cases 1 and 2 enhanced reading speed. Case 2 strongly improved quality of life scores.Conclusion: This is the first report of a home-based virtual-reality visual rehabilitation program for adult patients with hemianopia consecutive to a pediatric brain tumor. We show the feasibility in real-world conditions and potential effectiveness of such technology on visual perception and quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case Report: Visual Rehabilitation in Hemianopia Patients. Home-Based Visual Rehabilitation in Patients With Hemianopia Consecutive to Brain Tumor Treatment: Feasibility and Potential Effectiveness

et al. 2021

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“…Regarding side effects, overall, only slight to none were reported. Furthermore, the nature and intensity of side effects [51,54,62]. In the group of patients with neglect, no severe side effects were reported (only 1 participant reported moderate sweating).…”

Section: Questionnaires and Feedbackmentioning

confidence: 98%

Development of a Search Task Using Immersive Virtual Reality: Proof-of-Concept Study

Knobel¹,

Kaufmann²,

Gerber³

et al. 2021

JMIR Serious Games

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Background Serious games are gaining increasing importance in neurorehabilitation since they increase motivation and adherence to therapy, thereby potentially improving its outcome. The benefits of serious games, such as the possibility to implement adaptive feedback and the calculation of comparable performance measures, can be even further improved by using immersive virtual reality (iVR), allowing a more intuitive interaction with training devices and higher ecological validity. Objective This study aimed to develop a visual search task embedded in a serious game setting for iVR, including self-adapting difficulty scaling, thus being able to adjust to the needs and ability levels of different groups of individuals. Methods In a two-step process, a serious game in iVR (bird search task) was developed and tested in healthy young (n=21) and elderly (n=23) participants and in a group of patients with impaired visual exploration behavior (ie, patients with hemispatial neglect after right-hemispheric stroke; n=11). Usability, side effects, game experience, immersion, and presence of the iVR serious game were assessed by validated questionnaires. Moreover, in the group of stroke patients, the performance in the iVR serious game was also considered with respect to hemispatial neglect severity, as assessed by established objective hemispatial neglect measures. Results In all 3 groups, reported usability of the iVR serious game was above 4.5 (on a Likert scale with scores ranging from 1 to 5) and reported side effects were infrequent and of low intensity (below 1.5 on a Likert scale with scores ranging from 1 to 4). All 3 groups equally judged the iVR serious game as highly motivating and entertaining. Performance in the game (in terms of mean search time) showed a lateralized increase in search time in patients with hemispatial neglect that varied strongly as a function of objective hemispatial neglect severity. Conclusions The developed iVR serious game, “bird search task,” was a motivating, entertaining, and immersive task, which can, due to its adaptive difficulty scaling, adjust and be played by different populations with different levels of skills, including individuals with cognitive impairments. As a complementary finding, it seems that performance in the game is able to capture typical patterns of impaired visual exploration behavior in hemispatial neglect, as there is a high correlation between performance and neglect severity as assessed with a cancellation task.

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“…For instance, cybersickness has often been considered a contra-indication to use HMDs ( Melo et al, 2018 ). Although studies using recent HMDs in older adults and stroke patients reported minimal cybersickness ( Appel et al, 2020 ; Huygelier et al, 2019 , 2020 ; Lee et al, 2020 ; Spreij et al, 2020 ), it is also known that cybersickness depends on several features of the IVR application ( Davis et al, 2015 ; Porcino et al, 2017 ; Stanney & Hash, 1998 ; Weech et al, 2019 ) and end-users ( Arns & Cerney, 2005 ).…”

Section: Discussionmentioning

confidence: 99%

“…Second, the potential of VR to increase treatment dosage in post-stroke rehabilitation depends on the ability of patients to use VR systems independently. Although some research has investigated the safety, user experience and usability of the latest generation of VR systems in stroke patients ( Huygelier et al, 2020 ; Lee et al, 2020 ; Spreij et al, 2020 ; Weber et al, 2019 ), none of these studies addressed the feasibility of independent use by patients. Third, although virtual reality offers many opportunities for rehabilitation, most studies did not address the added value nor cost-effectiveness of VR rehabilitation relative to other therapies.…”

Section: Introductionmentioning

confidence: 99%

The Use of the Term Virtual Reality in Post-Stroke Rehabilitation: A Scoping Review and Commentary

et al. 2021

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Virtual reality (VR) offers many opportunities for post-stroke rehabilitation. However, “VR” can refer to several types of computer-based rehabilitation systems. Since these systems may impact the feasibility and the efficacy of VR interventions, consistent terminology is important. In this study, we aimed to optimize the terminology for VR-based post-stroke rehabilitation by assessing whether and how review papers on this topic defined VR and what types of mixed reality systems were discussed. In addition, this review can inspire the use of consistent terminology for other researchers working with VR. We assessed the use of the term VR in review papers on post-stroke rehabilitation extracted from Scopus, Web of Science and PubMed. We also developed a taxonomy distinguishing 16 mixed reality systems based on three factors: immersive versus semi-immersive displays, the way in which real and virtual information is mixed, and the main input device. 64% of the included review papers (N = 121) explicitly defined VR and 33% of them described different subtypes of VR, with immersive and non-immersive VR as the most common distinction. The most frequently discussed input devices were motion-capture cameras and handheld devices, while regular 2D monitors were the most frequently mentioned output devices. Our analysis revealed that reviews on post-stroke VR rehabilitation did not or only broadly defined “VR” and did not focus on a specific system. Since the efficacy and feasibility of rehabilitation may depend on the specific system, we propose a new data-driven taxonomy to distinguish different systems, which is expected to facilitate communication amongst researchers and clinicians working with virtual reality.

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An immersive virtual reality game to train spatial attention orientation after stroke: A feasibility study

Cited by 42 publications

References 91 publications

Case Report: Visual Rehabilitation in Hemianopia Patients. Home-Based Visual Rehabilitation in Patients With Hemianopia Consecutive to Brain Tumor Treatment: Feasibility and Potential Effectiveness

Case Report: Visual Rehabilitation in Hemianopia Patients. Home-Based Visual Rehabilitation in Patients With Hemianopia Consecutive to Brain Tumor Treatment: Feasibility and Potential Effectiveness

Development of a Search Task Using Immersive Virtual Reality: Proof-of-Concept Study

The Use of the Term Virtual Reality in Post-Stroke Rehabilitation: A Scoping Review and Commentary

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