Multidimensional Evaluation of Virtual Reality Paradigms in Clinical Neuropsychology: Application of the VR-Check Framework

Abstract

Virtual reality (VR) represents a key technology of the 21st century, attracting substantial interest from a wide range of scientific disciplines. With regard to clinical neuropsychology, a multitude of new VR applications are being developed to overcome the limitations of classical paradigms. Consequently, researchers increasingly face the challenge of systematically evaluating the characteristics and quality of VR applications to design the optimal paradigm for their specific research question and study population. However, the multifaceted character of contemporary VR is not adequately captured by the traditional quality criteria (ie, objectivity, reliability, validity), highlighting the need for an extended paradigm evaluation framework. To address this gap, we propose a multidimensional evaluation framework for VR applications in clinical neuropsychology, summarized as an easy-to-use checklist (VR-Check). This framework rests on 10 main evaluation dimensions encompassing cognitive domain specificity, ecological relevance, technical feasibility, user feasibility, user motivation, task adaptability, performance quantification, immersive capacities, training feasibility, and predictable pitfalls. We show how VR-Check enables systematic and comparative paradigm optimization by illustrating its application in an exemplary research project on the assessment of spatial cognition and executive functions with immersive VR. This application furthermore demonstrates how the framework allows researchers to identify across-domain trade-offs, makes deliberate design decisions explicit, and optimizes the allocation of study resources. Complementing recent approaches to standardize clinical VR studies, the VR-Check framework enables systematic and project-specific paradigm optimization for behavioral and cognitive research in neuropsychology.

User Experience of Interactive Technologies for People With Dementia: Comparative Observational Study

“…In addition, it would be interesting to re-evaluate such technologies using similar tasks as presented in this study, but in a clinical context using the VR-Check framework [ 47 ]. Thus, more detailed knowledge could be gained regarding the adequacy and therapeutic outcome when using technology and virtual reality with people with dementia.…”

“…Another framework—the virtual reality (VR)-Check framework [ 47 ]—has been proposed by Krohn et al [ 47 ], who evaluated clinical neuropsychology VR apps for cognitive domain specificity ( specifically, the cognitive domain being targeted by the VR app), ecological relevance (if the VR app focuses on activities of daily living), technical feasibility (if the VR app is compatible with the desired technologies), user feasibility (if the VR app is feasible to the target population), user motivation (if the VR app engages the users), task adaptability (if the VR app can be adjusted, for instance, in terms of difficulty), performance quantification (if the VR app can objectively quantify the participant’s performance), immersive capacities (how immersive is the VR app for participants), training feasibility (if the VR app is suitable to foster cognitive training), and predictable pitfalls (estimating resource-related costs when using the VR app).…”

Aerobic Exercise with Superimposed Virtual Reality Improves Cognitive Flexibility and Selective Attention in Young Males

“…According to Chang et al [59], tentative explanations for the exercise effect postulate that exercise allocates attention resources, influences the dorsolateral prefrontal cortex, and is implicated in exercise-induced dopamine release. Widely in use for more than half a century after the initial presentation of the WCST, there are limitations to classical tasks with VR which must be overcome [60]. Nonetheless, WCST in VR has been comprehensively used in neuropsychology clinical research [61] and in physically unhealthy older adults [24].…”

Zehn Argumente für dialogische Interaktion und kognitive Modelle als Grundlage neuropsychologischer Rehabilitation

“…Diese Aussage betriff t den gewählten Schwierigkeitsgrad und seine qualitative theoriebasierte Realisierung, d. h. insgesamt den statischen Aspekt einer geschützten kognitiven Umgebung. Krohn et al (2020) entwickelten eine Checkliste zur Beurteilung der Güte neuropsychologischer Anwendungen, die auf VR basieren. An oberster Stelle dieser Liste steht "domain specifi city", was übersetzt in die hier entwickelte Terminologie bedeutet: Verankerung in der besten kognitiven Theorie der entsprechenden Funktion (These 3).…”