The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, 170 Kessels Rd, Nathan, QLD, 4111, Australia.
School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia.
J Neuroeng Rehabil. 2023 Nov 23;20(1):161. doi: 10.1186/s12984-023-01283-9.
In neurorehabilitation, problems with visuospatial attention, including unilateral spatial neglect, are prevalent and routinely assessed by pen-and-paper tests, which are limited in accuracy and sensitivity. Immersive virtual reality (VR), which motivates a much wider (more intuitive) spatial behaviour, promises new futures for identifying visuospatial atypicality in multiple measures, which reflects cognitive and motor diversity across individuals with brain injuries.
In this pilot study, we had 9 clinician controls (mean age 43 years; 4 males) and 13 neurorehabilitation inpatients (mean age 59 years; 9 males) recruited a mean of 41 days post-injury play a VR visual search game. Primary injuries included 7 stroke, 4 traumatic brain injury, 2 other acquired brain injury. Three patients were identified as having left sided neglect prior to taking part in the VR. Response accuracy, reaction time, and headset and controller raycast orientation quantified gameplay. Normative modelling identified the typical gameplay bounds, and visuospatial atypicality was defined as gameplay beyond these bounds.
The study found VR to be feasible, with only minor instances of motion sickness, positive user experiences, and satisfactory system usability. Crucially, the analytical method, which emphasized identifying 'visuospatial atypicality,' proved effective. Visuospatial atypicality was more commonly observed in patients compared to controls and was prevalent in both groups of patients-those with and without neglect.
Our research indicates that normative modelling of VR gameplay is a promising tool for identifying visuospatial atypicality after acute brain injury. This approach holds potential for a detailed examination of neglect.
在神经康复中，视空间注意存在问题，包括单侧空间忽略，这是普遍存在的，并通过纸笔测试进行常规评估，但这些测试的准确性和敏感性有限。沉浸式虚拟现实（VR）可以激发更广泛（更直观）的空间行为，有望在多种测量中识别出视空间异常，从而反映出脑损伤患者认知和运动的多样性。
在这项初步研究中，我们招募了 9 名临床医生对照者（平均年龄 43 岁；4 名男性）和 13 名神经康复住院患者（平均年龄 59 岁；9 名男性），他们在受伤后平均 41 天进行了 VR 视觉搜索游戏。主要损伤包括 7 例中风、4 例创伤性脑损伤、2 例其他获得性脑损伤。在参与 VR 之前，有 3 名患者被确定为左侧忽略。反应准确性、反应时间、头戴式设备和控制器射线投射方向量化了游戏玩法。规范建模确定了典型的游戏玩法边界，视空间异常被定义为超出这些边界的游戏玩法。
研究发现 VR 是可行的，只有少数人出现运动病，用户体验积极，系统可用性令人满意。至关重要的是，强调识别“视空间异常”的分析方法被证明是有效的。与对照组相比，患者中更常见视空间异常，且有和没有忽略的两组患者都存在这种情况。
我们的研究表明，VR 游戏玩法的规范建模是识别急性脑损伤后视空间异常的一种很有前途的工具。这种方法有可能对忽略进行详细检查。
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