Duckneglect: Video-games based neglect rehabilitation

Videogame Based Neglect Rehabilitation: A Role for Spatial Remapping and Multisensory Integration?

“…Enriched environments (Risedal et al, 2002), intense practice (Nudo et al, 2001), the possibility to tailor a rehabilitation session to patient's needs, to tune the degree of difficulty to patient's competences, and to enhance interaction during rehabilitation through an immediate feedback to the patient (Sveistrup, 2004) are the most promising features of VG approaches. It has also been suggested that a scenario including meaningful objects, rather than abstract geometric targets as stimuli, could be more motivating and encouraging for patients engaged in motor recovery programs leading to positive outcomes (Laver et al, 2011b; Sedda et al, 2013; Mainetti et al, 2013). …”

“…Remapping of space (Berti and Frassinetti, 2000; Berti et al, 2001; Ansuini et al, 2006) is strongly connected to updating of the body schema representation (Neppi-Modona et al, 2007; Sedda et al, 2013; Mainetti et al, 2013), and may involve an action component which is associated with dorsal stream processing (Neppi Modona et al, 2007; Sedda and Scarpina, 2012). The concepts of near/far space and reaching/locomotion can be can be taken into account as good examples to understand why more exhaustive models that considers the above mentioned concepts are needed.…”

“…Consequently, space can be divided into within-reachable distance (near) and beyond-reachable distance (far). One peculiar feature of VG treatments is that although trained only in the far space, patients recover from neglect also in the peripersonal space (Kim et al, 2011; Sedda et al, 2013; Mainetti et al, 2013). In the past, the idea that an action could boost remapping of near-far space has been explored also with regards to locomotion (Berti et al, 2002), an action more often performed in everyday life than the grasping with tools.…”

“…Importantly, VG treatments are more and more making use of the real dynamic silhouette of patients (Kim et al, 2011; Sedda et al, 2013; Mainetti et al, 2013). Rehabilitation platforms providing patients with their own image (Kim et al, 2011; Sedda et al, 2013; Mainetti et al, 2013) instead of avatars might favor the re-adaptation of a compromised body schema in an easier way than through cognition, as humans see their mirrored body since childhood (Beis et al, 2001). The patient is able to see his upper limb reflected into the virtual environment allowing him to perceive his movements time by time, benefiting unconsciously from the spatio-temporal congruency between real and virtual arm.…”

“…One could question whether patients showing only far neglect, not having near neglect, would not show the observed remapping between far and near space. It is not known whether these patients would improve in far space, as available studies only investigated the outcome in near space (Kim et al, 2011; Sedda et al, 2013; Mainetti et al, 2013). This implies that VG inspired studies should also adopt more fine graded assessment of neglect and related impairments, and samples selected ad hoc to allow within group contrasts, aimed at verifying the suitability of paradigms across different neglect subtypes.…”