Exploring perspectives from stroke survivors, carers and clinicians on virtual reality as a precursor to using telerehabilitation for spatial neglect post-stroke

Morse, Helen; Biggart, Laura; Pomeroy, Valerie; Rossit, Stéphanie

doi:10.1080/09602011.2020.1819827

Cited by 20 publications

(22 citation statements)

References 69 publications

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“…Table 6 presents some of the most common treatment approaches and how they can be implemented in VR and ET. Some feasibility and usability studies ( Huygelier et al, 2020 ; Morse et al, 2020 ; Chen and Krch, 2021 ), proof-of-concept studies ( Wilf et al, 2020 ), protocols for validation in healthy adults ( Cho et al, 2020 ) and controlled treatment studies ( Bourgeois et al, 2021b ; Choi et al, 2021 ), mostly focusing on implementation of prism adaptation training in VR, has been published after the literature search for this review was completed.…”

Section: Discussion and Future Perspectivesmentioning

confidence: 99%

Virtual Reality and Eye-Tracking Assessment, and Treatment of Unilateral Spatial Neglect: Systematic Review and Future Prospects

et al. 2022

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Unilateral spatial neglect (USN) is a disorder characterized by the failure to report, respond to, or orient toward the contralateral side of space to a brain lesion. Current assessment methods often fail to discover milder forms, cannot differentiate between unilateral spatial neglect subtypes and lack ecological validity. There is also a need for treatment methods that target subtypes. Immersive virtual reality (VR) systems in combination with eye-tracking (ET) have the potential to overcome these shortcomings, by providing more naturalistic environments and tasks, with sensitive and detailed measures. This systematic review examines the state of the art of research on these technologies as applied in the assessment and treatment of USN. As we found no studies that combined immersive VR and ET, we reviewed these approaches individually. The review of VR included seven articles, the ET review twelve. The reviews revealed promising results. (1) All included studies found significant group-level differences for several USN measures. In addition, several studies found asymmetric behavior in VR and ET tasks for patients who did not show signs of USN in conventional tests. Particularly promising features were multitasking in complex VR environments and detailed eye-movement analysis. (2) No VR and only a few ET studies attempted to differentiate USN subtypes, although the technologies appeared appropriate. One ET study grouped USN participants using individual heatmaps, and another differentiated between subtypes on drawing tasks. Regarding (3) ecological validity, although no studies tested the prognostic validity of their assessment methods, VR and ET studies utilized naturalistic tasks and stimuli reflecting everyday situations. Technological characteristics, such as the field of view and refresh rate of the head-mounted displays, could be improved, though, to improve ecological validity. We found (4) no studies that utilized VR or ET technologies for USN treatment up until the search date of the 26th of February 2020. In conclusion, VR-ET-based systems show great potential for USN assessment. VR-ET holds great promise for treatment, for example, by monitoring behavior and adapting and tailoring to the individual person’s needs and abilities. Future research should consider developing methods for individual subtypes and differential diagnostics to inform individual treatment programs.

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Section: Discussion and Future Perspectivesmentioning

confidence: 99%

Virtual Reality and Eye-Tracking Assessment, and Treatment of Unilateral Spatial Neglect: Systematic Review and Future Prospects

et al. 2022

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“…Within VR we can build complex environments that allow patients to engage in activities that might be impossible or unsafe for them in the real world (Farrow & Reid, 2004;Kim et al, 2007Kim et al, , 2010. These activities can be delivered and monitored by clinicians remotely via telehealth (Burdea, 2003;Morse, Biggart, Pomeroy, & Rossit, 2020;Threapleton, Drummond, & Standen, 2016). VR is readily gamified, therefore highly engaging for patients (Pietrzak, Pullman, & McGuire, 2014;Thornton et al, 2005) which may facilitate longer rehabilitation sessions, greater adherence to treatment, and better outcomes (Adlakha, Chhabra, & Shukla, 2020;Lohse, Hilderman, Cheung, Tatla, & Van Der Loos, 2014;Parker, Lord, & Needham, 2013;Huygelier, Mattheus, Vanden Abeele, Van Ee, & Gillebert, 2021).…”

Section: Classical Clinical Methods Assess Neglect Incompletelymentioning

confidence: 99%

The attention atlas virtual reality platform maps three-dimensional (3D) attention in unilateral spatial neglect patients: a protocol

et al. 2022

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Background: Deficits in visuospatial attention, known as neglect, are common following brain injury, but underdiagnosed and poorly treated, resulting in long-term cognitive disability. In clinical settings, neglect is often assessed using simple pen-and-paper tests. While convenient, these cannot characterise the full spectrum of neglect. This protocol reports a research programme that compares traditional neglect assessments with a novel virtual reality attention assessment platform: The Attention Atlas (AA). Methods/design: The AA was codesigned by researchers and clinicians to meet the clinical need for improved neglect assessment. The AA uses a visual search paradigm to map the attended space in three dimensions and seeks to identify the optimal parameters that best distinguish neglect from non-neglect, and the spectrum of neglect, by providing near-time feedback to clinicians on system-level behavioural performance. A series of experiments will address procedural, scientific, patient, and clinical feasibility domains. Results: Analyses focuses on descriptive measures of reaction time, accuracy data for target localisation, and histogram-based raycast attentional mapping analysis; which measures the individual’s orientation in space, and inter- and intra-individual variation of visuospatial attention. We will compare neglect and control data using parametric between-subjects analyses. We present example individual-level results produced in near-time during visual search. Conclusions: The development and validation of the AA is part of a new generation of translational neuroscience that exploits the latest advances in technology and brain science, including technology repurposed from the consumer gaming market. This approach to rehabilitation has the potential for highly accurate, highly engaging, personalised care.

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“…Selfadministering rehabilitation can restore the sense of self-ownership by enabling patients to carry out the rehabilitation independently. Finally, the option for at-home rehabilitation is beneficial for those with mobility issues, often the case for post-stroke patients [84,85].…”

Section: Vr For Rehabilitationmentioning

confidence: 99%

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

et al. 2022

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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.

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Exploring perspectives from stroke survivors, carers and clinicians on virtual reality as a precursor to using telerehabilitation for spatial neglect post-stroke

Cited by 20 publications

References 69 publications

Virtual Reality and Eye-Tracking Assessment, and Treatment of Unilateral Spatial Neglect: Systematic Review and Future Prospects

Virtual Reality and Eye-Tracking Assessment, and Treatment of Unilateral Spatial Neglect: Systematic Review and Future Prospects

The attention atlas virtual reality platform maps three-dimensional (3D) attention in unilateral spatial neglect patients: a protocol

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

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