From Patient to Musician: A Multi-Sensory Virtual Reality Rehabilitation Tool for Spatial Neglect

Abstract

Unilateral Spatial Neglect (USN) commonly results from a stroke or acquired brain injury. USN affects multiple modalities and results in failure to respond to stimuli on the contralesional side of space. Although USN is a heterogeneous syndrome, present-day therapy methods often fail to consider multiple modalities. Musical Neglect Therapy (MNT) is a therapy method that succeeds in incorporating multiple modalities by asking patients to make music. This research aimed to exploit the immersive and modifiable aspect of VR to translate MNT to a VR therapy tool. The tool was evaluated in a 2-week pilot study with four clinical users. These results are compared to a control group of four non-clinical users. Results indicated that patients responded to triggers in their entire environment and performance results could be clearly differentiated between clinical and non-clinical users. Moreover, patients increasingly corrected their head direction towards their neglected side. Patients stated that the use of VR increased their enjoyment of the therapy. This study contributes to the current research on rehabilitation for USN by proposing the first system to apply MNT in a VR environment. The tool shows promise as an addition to currently used rehabilitation methods. However, results are limited to a small sample size and performance metrics. Future work will focus on validating these results with a larger sample over a longer period. Moreover, future efforts should explore personalisation and gamification to tailor to the heterogeneity of the condition.

Exploring the Potential of Immersive Virtual Reality in the Treatment of Unilateral Spatial Neglect Due to Stroke: A Comprehensive Systematic Review

“…A total of 33 full-text articles were examined. As 23 studies were excluded during full-text check, 10 articles [ 20 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ] were considered eligible for the systematic review. Flow-chart of studies screening is available in Figure 1 .…”

“…Two studies used a virtual version of the line bisection test as intervention protocol [ 27 , 28 ]. In six studies, the intervention protocol was composed of more than one task/action [ 25 , 26 , 28 , 29 , 31 , 32 ]. Three studies made use of an IVR program [ 20 , 24 , 30 ].…”

“…All intervention groups performed an IVR protocol, although the included studies used different immersive systems. Most of the studies [ 20 , 24 , 26 , 28 , 29 , 30 , 31 ] used an HDM; one study [ 25 ] used a glove, another one [ 27 ] used a haptic device and another one [ 32 ] used the Mandala Gesture Xtreme VR system and the Interactive Rehabilitation Exercise (IREX) software.…”

“…Of the included studies, six [ 24 , 25 , 26 , 27 , 28 , 30 ] used a comparison protocol to verify the effects of the IVR training. Five studies [ 25 , 26 , 27 , 28 , 30 ] used the same protocol of the intervention group.…”

“…Of the included studies, six [ 24 , 25 , 26 , 27 , 28 , 30 ] used a comparison protocol to verify the effects of the IVR training. Five studies [ 25 , 26 , 27 , 28 , 30 ] used the same protocol of the intervention group. Only one study [ 24 ] used a different comparison protocol than the intervention one in which various tasks were performed, such as structured visual tracking, reading, and writing, drawing and copying, and puzzles.…”