Technical University of Munich, Georg-Brauchle Ring 60/62, 80992, Munich, Germany.
Schoen Clinic Bad Aibling, Kolbermoorer Strasse 72, 83043, Bad Aibling, Germany.
J Neuroeng Rehabil. 2021 Aug 21;18(1):127. doi: 10.1186/s12984-021-00920-5.
Augmented Reality (AR)-based interventions are applied in neurorehabilitation with increasing frequency. Depth perception is required for the intended interaction within AR environments. Until now, however, it is unclear whether patients after stroke with impaired visuospatial perception (VSP) are able to perceive depth in the AR environment.
Different aspects of VSP (stereovision and spatial localization/visuoconstruction) were assessed in 20 patients after stroke (mean age: 64 ± 14 years) and 20 healthy subjects (HS, mean age: 28 ± 8 years) using clinical tests. The group of HS was recruited to assess the validity of the developed AR tasks in testing stereovision. To measure perception of holographic objects, three distance judgment tasks and one three-dimensionality task were designed. The effect of impaired stereovision on performance in each AR task was analyzed. AR task performance was modeled by aspects of VSP using separate regression analyses for HS and for patients.
In HS, stereovision had a significant effect on the performance in all AR distance judgment tasks (p = 0.021, p = 0.002, p = 0.046) and in the three-dimensionality task (p = 0.003). Individual quality of stereovision significantly predicted the accuracy in each distance judgment task and was highly related to the ability to perceive holograms as three-dimensional (p = 0.001). In stroke-survivors, impaired stereovision had a specific deterioration effect on only one distance judgment task (p = 0.042), whereas the three-dimensionality task was unaffected (p = 0.317). Regression analyses confirmed a lacking impact of patients' quality of stereovision on AR task performance, while spatial localization/visuoconstruction significantly prognosticated the accuracy in distance estimation of geometric objects in two AR tasks.
Impairments in VSP reduce the ability to estimate distance and to perceive three-dimensionality in an AR environment. While stereovision is key for task performance in HS, spatial localization/visuoconstruction is predominant in patients. Since impairments in VSP are present after stroke, these findings might be crucial when AR is applied for neurorehabilitative treatment. In order to maximize the therapy outcome, the design of AR games should be adapted to patients' impaired VSP. Trial registration: The trial was not registered, as it was an observational study.
基于增强现实（AR）的干预措施在神经康复中应用越来越频繁。在 AR 环境中进行预期交互需要深度感知。然而，到目前为止，还不清楚患有空间视觉感知（VSP）受损的中风患者是否能够在 AR 环境中感知深度。
使用临床测试评估 20 名中风后患者（平均年龄：64±14 岁）和 20 名健康受试者（HS，平均年龄：28±8 岁）的 VSP（立体视觉和空间定位/视觉构建）的不同方面。HS 组的招募是为了评估开发的 AR 任务在测试立体视觉方面的有效性。为了测量全息物体的感知，设计了三个距离判断任务和一个三维任务。分析了立体视觉受损对每个 AR 任务表现的影响。使用单独的回归分析，分别针对 HS 和患者，对 VSP 的各个方面进行 AR 任务表现建模。
在 HS 中，立体视觉对所有 AR 距离判断任务（p=0.021，p=0.002，p=0.046）和三维任务（p=0.003）的表现均有显著影响。个体立体视觉质量显著预测了每个距离判断任务的准确性，与感知全息图为三维的能力高度相关（p=0.001）。在中风幸存者中，立体视觉受损仅对一个距离判断任务有特定的恶化影响（p=0.042），而三维任务则不受影响（p=0.317）。回归分析证实，患者立体视觉质量对 AR 任务表现没有影响，而空间定位/视觉构建则显著预测了两个 AR 任务中对几何物体距离估计的准确性。
VSP 受损会降低在 AR 环境中估计距离和感知三维的能力。在 HS 中，立体视觉是任务表现的关键，而在患者中，空间定位/视觉构建则更为重要。由于中风后会出现 VSP 受损，因此当 AR 应用于神经康复治疗时，这些发现可能至关重要。为了最大限度地提高治疗效果，AR 游戏的设计应适应患者受损的 VSP。
该试验未进行注册，因为它是一项观察性研究。
