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

Abstract

After experiencing a stroke in the right hemisphere, almost 50% of patients showed Unilateral Spatial Neglect (USN). In recent decades, Virtual Reality (VR) has been used as an effective tool both for the assessment and rehabilitation of USN. Indeed, this advanced technology allows post-stroke patients to interact with ecological and engaging environments similar to real ones, but in a safe and controlled way. To provide an overview of the most recent VR applications for the assessment and rehabilitation of USN, a systematic review has been carried out. Since 2010, 13 studies have proposed and tested innovative VR tools for USN. After a wide description of the selected studies, we discuss the main features of these VR tools in order to provide crucial indications for future studies, neurorehabilitation interventions, and clinical practice.

Do Neglect Assessments Detect Neglect Differently?

“…The tenet that functional assessments may be more sensitive to neglect than paper-and-pencil assessments has support (Azouvi et al, 2006;Blini et al, 2016;Pedroli, Serino, Cipresso, Pallavicini, & Riva, 2015). Functional tasks require a person to pay attention to objects placed near the body (personal), around the body (peripersonal), and away from the body (extrapersonal).…”

Virtual Reality as an Embodied Tool to Enhance Episodic Memory in Elderly

“…The similarity between active virtual navigation and enactment is given because both procedures selectively impact item-specific processing as recognition, but not relational processing (for example semantic clustering of concepts). Following this perspective, active navigation in VR, can tap into item-specific processing (Pedroli et al, 2015), known to be more defective in older adults compared to relational processing (Dennis et al, 2007). Third, VR provides environmental enrichment by using flexible scenarios.…”

Simulated driving: The added value of dynamic testing in the assessment of visuo‐spatial neglect after stroke

“…As mentioned above, VSN is generally assessed with neuropsychological paper‐and‐pencil tasks, such as cancellation, line bisection, and copying tasks. Although these tasks are convenient and easy to administer, research has often reported a lack of ecological validity and limitations in sensitivity (Pedroli, Serino, Cipresso, Pallavicini, & Riva, ; Ten Brink, Visser‐Meily, & Nijboer, ; Tsirlin, Dupierrix, Chokron, Coquillart, & Ohlmann, ). During VSN treatment, patients are explicitly taught compensatory attentional strategies and consequently perform quite well on these static tasks with no time limit (Pedroli et al ., ; Ten Brink et al ., ).…”

“…Although these tasks are convenient and easy to administer, research has often reported a lack of ecological validity and limitations in sensitivity (Pedroli, Serino, Cipresso, Pallavicini, & Riva, 2015;Ten Brink, Visser-Meily, & Nijboer, 2017;Tsirlin, Dupierrix, Chokron, Coquillart, & Ohlmann, 2009). During VSN treatment, patients are explicitly taught compensatory attentional strategies and consequently perform quite well on these static tasks with no time limit (Pedroli et al, 2015;Ten Brink et al, 2017). These tasks, therefore, do not capture mild deficits in lateralized attention that might only occur in dynamic daily life situations (e.g., walking on a busy sidewalk).…”

“…Next to observational scales, investigators have developed ecologically valid multitasks (i.e., performing multiple operations simultaneously) conducted in the real world. As a real-world environment continuously changes, the required responses also change (Pedroli et al, 2015;Rizzo, Schultheis, Kerns, & Mateer, 2004).Thismakes a taskmoredemandingorevenincompetition -for attentionalprocesses (Ten Brink et al, 2017). An example of such a task is the Mobility Assessment Course, where participantshavetoperformawayfindingtaskinacorridorwhiledetectingtargets (TenBrink et al, 2017).…”