Clinical Validation of a Virtual Environment Test for Safe Street Crossing in the Assessment of Acquired Brain Injury Patients with and without Neglect

Abstract

Abstract. Acquired brain injury (ABI) is a complex disease that involves loss of brain functions related to cognitive and motor capabilities and that can produce unilateral spatial neglect (USN). The heterogeneity of the symptoms of these disorders causes a lack of consensus on suitable tools for evaluation and treatment. Recently, several studies have initiated the application of virtual reality (VR) systems as an evaluation instrument for neuropsychological disorders. Our main objective was to evaluate the validity of the VR Street Crossing Test (VRSCT) as an assessment tool. Twenty-five patients with ABI were evaluated with traditional tests and with the VRSCT. The results showed significant correlations between the conventional tests and the measures obtained with the VRSCT in non-negligent patients. Moreover, the VRSCT indicated significant differences in performance of negligent and non-negligent subjects. These pilot results indicate that ABI patients with and without USN can be assessed by the therapists using the VRSCT system as a complementary tool.

Assessment and rehabilitation of neglect using virtual reality: a systematic review

“…In a similar test developed by Mesa-Gresa et al ( 2011 ), they used a conventional LCD monitor, a surround system, a navigation and interaction joystick, and an optical tracking system (TRACKIR). Head movements were detected thanks to a cap with three reflecting markers and a USB infrared camera.…”

“…Navarro et al ( 2013 ) assessed the clinical validation, usability, and convergent validity of the “Virtual Street Crossing System” (Mesa-Gresa et al, 2011 ) to find out if it could be used for rehabilitation of USN. Their sample was composed of 17 USN patients, 15 non-USN patients and 15 control subjects.…”

“…Their sample was composed of 17 USN patients, 15 non-USN patients and 15 control subjects. The rehabilitation task was the same used by Mesa-Gresa and colleagues in their study (Mesa-Gresa et al, 2011 ) and described previously. After the virtual task patients were administered a modified version of the Short Feedback Questionnaire (SFQm; Witmer and Singer, 1998 ).…”

“…Finally, all the articles analyzed suggest several methods for the assessment and rehabilitation of USN, but there are some “methodological weaknesses.” Few studies compared VR methods with conventional ones (Kim et al, 2010 , 2011 ; Mesa-Gresa et al, 2011 ; van Kessel et al, 2013 ; Aravind and Lamontagne, 2014 ; Aravind et al, 2015 ), only few studies compared the results with a control group (Kim et al, 2010 ; Peskine et al, 2011 ; Buxbaum et al, 2012 ; Navarro et al, 2013 ) and often the samples were too small to allow a generalization of the result (Peskine et al, 2011 ; Sugarman et al, 2011 ; Mainetti et al, 2013 ; Aravind and Lamontagne, 2014 ; Aravind et al, 2015 ), while controlled randomized trials testing the VR training in comparison with traditional protocol should be important. For further research, we also recommend adequate follow-up to maximize the benefits and monitor the persistence of the effect of neglect rehabilitation interventions.…”

Effectiveness of Virtual Reality for Children and Adolescents with Autism Spectrum Disorder: An Evidence-Based Systematic Review

“…This allows therapists to follow up and analyze the patient’s improvements and apply feedback or possible repetitions of the tasks. Thus, intervention based on technology could include multi-user applications in playful environments or everyday situations, which could be controlled and personalized based on the objectives of the intervention [ 53 ]. Previous studies applied to the rehabilitation of cognitive impairments have indicated that the VR interventions have high ecological validity and the learning acquired could be transferred to real life [ 54 , 55 ].…”