Shin Joon-Ho, Kim Mingyu, Lee Ji-Yeong, Kim Mi-Young, Jeon Yu-Jin, Kim Kwanguk
Department of Rehabilitation Medicine, National Rehabilitation Center, Ministry of Health and Welfare, Seoul, Republic of Korea.
Department of Computer Science, Hanyang University, Seoul, Republic of Korea.
Front Neurosci. 2023 Apr 20;17:1142663. doi: 10.3389/fnins.2023.1142663. eCollection 2023.
Hemispatial neglect (HSN) was diagnosed using a virtual reality-based test (FOPR test) that explores the field of perception (FOP) and field of regard (FOR). Here, we developed virtual reality-visual exploration therapy (VR-VET) combining elements from the FOPR test and visual exploration therapy (VET) and examined its efficacy for HSN rehabilitation following stroke.
Eleven participants were randomly assigned to different groups, training with VR-VET first then waiting without VR-VET training (TW), or vice versa (WT). The TW group completed 20 sessions of a VR-VET program using a head-mounted display followed by 4 weeks of waiting, while the WT group completed the opposite regimen. Clinical HSN measurements [line bisection test (LBT), star cancellation test (SCT), Catherine Bergego Scale (CBS), CBS perceptual-attentional (CBS-PA), and CBS motor-explanatory (CBS-ME)] and FOPR tests [response time (RT), success rate (SR), and head movement (HM) for both FOP and FOR] were assessed by blinded face-to-face assessments.
Five and six participants were allocated to the TW and WT groups, respectively, and no dropout occurred throughout the study. VR-VET considerably improved LBT scores, FOR variables (FOR-RT, FOR-SR), FOP-LEFT variables (FOP-LEFT-RT, FOP-LEFT-SR), and FOR-LEFT variables (FOR-LEFT-RT, FOR-LEFT-SR) compared to waiting without VR-VET. Additionally, VR-VET extensively improved FOP-SR, CBS, and CBS-PA, where waiting failed to make a significant change. The VR-VET made more improvements in the left hemispace than in the right hemispace in FOP-RT, FOP-SR, FOR-RT, and FOR-SR.
The observed improvements in clinical assessments and FOPR tests represent the translatability of these improvements to real-world function and the multi-dimensional effects of VR-VET training.
https://clinicaltrials.gov/ct2/show/NCT03463122, identifier NCT03463122.
采用基于虚拟现实的测试（FOPR测试）来诊断半侧空间忽视（HSN），该测试可探索感知域（FOP）和注视域（FOR）。在此，我们开发了结合FOPR测试和视觉探索疗法（VET）要素的虚拟现实视觉探索疗法（VR-VET），并研究其对中风后HSN康复的疗效。
11名参与者被随机分配到不同组，先接受VR-VET训练然后无VR-VET训练等待（TW组），或反之（WT组）。TW组使用头戴式显示器完成20节VR-VET课程，随后等待4周，而WT组完成相反的方案。通过盲法面对面评估来评估临床HSN测量指标[线段二等分测试（LBT）、星形删除测试（SCT）、凯瑟琳·贝热戈量表（CBS）、CBS感知-注意力（CBS-PA）和CBS运动-解释（CBS-ME）]以及FOPR测试[FOP和FOR的反应时间（RT）、成功率（SR）和头部运动（HM）]。
分别有5名和6名参与者被分配到TW组和WT组，整个研究过程中无脱落情况。与无VR-VET训练等待相比，VR-VET显著改善了LBT分数、FOR变量（FOR-RT、FOR-SR）、FOP-LEFT变量（FOP-LEFT-RT、FOP-LEFT-SR）和FOR-LEFT变量（FOR-LEFT-RT、FOR-LEFT-SR）。此外，VR-VET广泛改善了FOP-SR、CBS和CBS-PA，而等待未产生显著变化。在FOP-RT、FOP-SR、FOR-RT和FOR-SR方面，VR-VET在左半空间的改善比右半空间更多。
临床评估和FOPR测试中观察到的改善表明这些改善可转化为现实世界功能，以及VR-VET训练的多维度效应。
https://clinicaltrials.gov/ct2/show/NCT03463122，标识符NCT03463122。
