Immersive trail making: Construct validity of an ecological neuropsychological test

Plotnik, Meir; Doniger, Glen M.; Bahat, Yotam; Gottleib, Amihai; Gal, Oran Ben; Arad, Evyatar; Kribus-Shmiel, Lotem; Kimel-Naor, Shani; Zeilig, Gabi; Schnaider‐Beeri, Michal; Yanovich, Ran; Ketko, Itay; Heled, Yuval

doi:10.1109/icvr.2017.8007501

Cited by 15 publications

(11 citation statements)

References 14 publications

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“…In recent years, a proliferation of use of wearable sensors is demonstrated in various fields of rehabilitation [48]. Our results highlight the importance of expanding the scope of kinematic outcomes from clinical tests when integrating them with novel technology [49,50], as well as the feasibility of merging virtual reality applications with advanced motion sensing technology [48].…”

Section: Discussionmentioning

confidence: 67%

Factors associated with dynamic balance in people with Persistent Postural Perceptual Dizziness (PPPD): a cross-sectional study using a virtual-reality Four Square Step Test

Aharoni

Lubetzky

Arie

et al. 2021

J NeuroEngineering Rehabil

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Background Persistent postural-perceptual dizziness (PPPD) is a condition characterized by chronic subjective dizziness and exacerbated by visual stimuli or upright movement. Typical balance tests do not replicate the environments known to increase symptoms in people with PPPD—crowded places with moving objects. Using a virtual reality system, we quantified dynamic balance in people with PPPD and healthy controls in diverse visual conditions. Methods Twenty-two individuals with PPPD and 29 controls performed a square-shaped fast walking task (Four-Square Step Test Virtual Reality—FSST-VR) using a head-mounted-display (HTC Vive) under 3 visual conditions (empty train platform; people moving; people and trains moving). Head kinematics was used to measure task duration, movement smoothness and anterior–posterior (AP) and medio-lateral (ML) ranges of movement (ROM). Heart rate (HR) was monitored using a chest-band. Participants also completed a functional mobility test (Timed-Up-and-Go; TUG) and questionnaires measuring anxiety (State-Trait Anxiety Inventory; STAI), balance confidence (Activities-Specific Balance Confidence; ABC), perceived disability (Dizziness Handicap Inventory) and simulator sickness (Simulator Sickness Questionnaire). Main effects of visual load and group and associations between performance, functional and self-reported outcomes were examined. Results State anxiety and simulator sickness did not increase following testing. AP-ROM and HR increased with high visual load in both groups (p < 0.05). There were no significant between-group differences in head kinematics. In the high visual load conditions, high trait anxiety and longer TUG duration were moderately associated with reduced AP and ML-ROM in the PPPD group and low ABC and high perceived disability were associated with reduced AP-ROM (|r| = 0.47 to 0.53; p < 0.05). In contrast, in controls high STAI-trait, low ABC and longer TUG duration were associated with increased AP-ROM (|r| = 0.38 to 0.46; p < 0.05) and longer TUG duration was associated with increased ML-ROM (r = 0.53, p < 0.01). Conclusions FSST-VR may shed light on movement strategies in PPPD beyond task duration. While no main effect of group was observed, the distinct associations with self-reported and functional outcomes, identified using spatial head kinematics, suggest that some people with PPPD reduce head degrees of freedom when performing a dynamic balance task. This supports a potential link between spatial perception and PPPD symptomatology.

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Section: Discussionmentioning

confidence: 67%

Factors associated with dynamic balance in people with Persistent Postural Perceptual Dizziness (PPPD): a cross-sectional study using a virtual-reality Four Square Step Test

Aharoni

Lubetzky

Arie

et al. 2021

J NeuroEngineering Rehabil

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“…The real-time walking studies can be separated into two categories, real-time walking and walking on a treadmill. In the case of a treadmill, fully immersive environments are built with a 180°/360° or a dome-shaped screen [ 42 , 76 , 83 ]. For real-time walking, VR can function as a tool allowing ADL.…”

Section: Resultsmentioning

confidence: 99%

Examining the Academic Trends in Neuropsychological Tests for Executive Functions Using Virtual Reality: Systematic Literature Review

Kim¹,

Han²,

Choi³

et al. 2021

JMIR Serious Games

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Background In neuropsychology, fully immersive virtual reality (VR) has been spotlighted as a promising tool. It is considered that VR not only overcomes the existing limitation of neuropsychological tests but is also appropriate for treating executive functions (EFs) within activities of daily living (ADL) due to its high ecological validity. While fully immersive VR offers new possibilities of neuropsychological tests, there are few studies that overview the intellectual landscape and academic trends in the research related to mainly targeted EFs with fully immersive VR. Objective The objective of this study is to get an overview of the research trends that use VR in neuropsychological tests and to analyze the research trends using fully immersive VR neuropsychological tests with experimental articles. Methods This review was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were searched in three web databases using keywords related to VR, EFs, and cognitive abilities. The study was conducted in two steps, keyword analysis and in-depth systematic review. In the web database search from 2000 to 2019, 1167 articles were initially collected, of which 234 articles in the eligibility phase were used to conduct keyword analysis and a total of 47 articles were included for systematic review. Results In keyword analysis, the number of articles focused on dementia including the keywords “MCI,” “SCD,” and “dementia” were highlighted over the period, rather than other symptoms. In addition, we identified that the use of behavioral and physiological data in virtual environments (VEs) has dramatically increased in recent studies. In the systematic review, we focused on the purpose of study, assessment, treatment, and validation of usability and structure. We found that treatment studies and uncategorized studies including presence and cybersickness issues have emerged in the recent period. In addition, the target symptoms and range of participants were diversified. Conclusions There has been a continuously increasing interest in dealing with neuropsychology by using fully immersive VR. Target cognitive abilities have been diversified, as well as target symptoms. Moreover, the concept of embodied cognition was transplanted in this research area.

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“…Large-scale VR laboratories, in particular, can potentially resolve the aforementioned shortcomings, as they enable controlled, systematic, and repeated introduction of cognitive tasks during different degrees of physical exertion (walking on a treadmill incorporated in the VR system). VR technology can also include adaptation of classic pencil-and-paper tests inspecting specific cognitive competencies (e.g., (17)). Essentially, immersion in a realistically designed VR environment (VRE) makes it possible to study behavior under ecologically valid conditions, with laboratory grade control.…”

Section: Armstrong Et Al Recently Developed a Test Battery To Measurmentioning

confidence: 99%

Developing and Validating a Virtual Reality Tool for Evaluating Cognitive and Physical Performance during a Simulated Loaded March

Ketko¹,

Naor

Yanovich³

et al. 2020

Preprint

Self Cite

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Background Athletes, soldiers, and rescue personnel must often perform intense, prolonged, and physically demanding activities while maintaining cognitive focus. As cognitive and physical functions are believed to share central nervous system resources, their simultaneous activation can cause reciprocal disruptions in the performance of both. Methods In the current study, we aimed to develop and validate a virtual reality-based experimental protocol enabling rigorous exploration of the effects of prolonged high-load physical and cognitive efforts, by comparing novel cognitive tasks presented in the context of a simulated loaded march to a battery of established neurocognitive tests. We then used this protocol in a pre-post pilot study exploring the effects of high-load physical and cognitive activity on physical and cognitive performance. Twelve participants underwent a simulated 10-km loaded march on a treadmill in our virtual reality environment, with or without integrated cognitive tasks (VR-COG). At each of three experimental visits, participants underwent pre-activity and post-activity evaluations, including the Color Trail Test, the Synthetic Work Environment (SYNWIN) battery for multitasking evaluation, and physical tests (i.e., ‘time to exhaustion’). Results In general, strong or moderate correlations (r ≥ 0.58 p ≤ 0.048) were found between VR-COG scores and scores on the validated cognitive tests. Together, VR-COG and CTT measures were able to successfully predict the effects of the combined physical and cognitive load on multitasking performance, as assessed by SYNWIN score. Conclusions As virtual environments are ideal for studying high performance professional activity in realistic but controlled settings, the novel protocol is optimal for measuring the effects of prolonged, high-load physical and cognitive activity, and can therefore contribute to our knowledge on physical-cognitive interactions.

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Immersive trail making: Construct validity of an ecological neuropsychological test

Cited by 15 publications

References 14 publications

Factors associated with dynamic balance in people with Persistent Postural Perceptual Dizziness (PPPD): a cross-sectional study using a virtual-reality Four Square Step Test

Factors associated with dynamic balance in people with Persistent Postural Perceptual Dizziness (PPPD): a cross-sectional study using a virtual-reality Four Square Step Test

Examining the Academic Trends in Neuropsychological Tests for Executive Functions Using Virtual Reality: Systematic Literature Review

Developing and Validating a Virtual Reality Tool for Evaluating Cognitive and Physical Performance during a Simulated Loaded March

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