Spatial neglect treatment based on immersive virtual reality offers advantages over traditional therapies

Kessler Foundation stroke rehabilitation experts have proposed a new paradigm to improve the treatment of spatial neglect, a crippling condition that hampers recovery for at least 30% of stroke survivors. They outlined their approach in their recent paper, “Immersive Virtual Reality Processing for Spatial Negligence: A User-Centered Agile Development Process,” published online November 15, 2021 by the Annals of Physical Medicine and Rehabilitation. The authors are Peii Chen, PhD, principal investigator at the Center for Stroke Rehabilitation Research, and Denise Krch, PhD, principal investigator at the Center for Traumatic Brain Injury Research.

Spatial neglect impairs neural networks supporting spatial attention and related cognitive and motor functions. People experience altered spatial orientation, which can cause problems with balance and navigation, as well as memory, reading, and other cognitive processes. While progress has been made in detecting post-stroke spatial neglect, treatment strategies have lagged. To address the need for effective neurorehabilitation, the authors developed a treatment approach based on immersive virtual reality (VR), which enables standardized delivery of intensive and repetitive therapy in a flexible and engaging environment.

To develop the Kessler Foundation Spatial Re-Training Therapy (KF-SRT™), which uses a head-mounted display and hand-tracking technology, the Foundation team worked closely with Virtualware, a technology company Award-winning VR based in Spain. “During user testing, we were able to communicate the need for Virtualware revisions and adapt the software based on feedback from therapists and patients,” Dr. Chen said. “The resulting system has a user interface that allows for the creation of a patient profile, a calibration module, a choice of four game-like processing modules, and a spreadsheet for data collection and export, allowing therapists to review progress from session to session.”

In virtual treatment environments, patients wear a head-mounted display and hand-tracking technology to engage in a variety of challenging motor tasks. “The scoring algorithm rewards correct answers, with higher scores awarded for tasks successfully completed in the neglected space,” Dr. Krch explained.

The team reported that therapists were unanimously satisfied with the KF-SRT user interface and that patients preferred the VR experience to conventional therapy. “The next step is to conduct pilot studies of feasibility, limitations and preliminary effectiveness,” they concluded, “while continuing to update system software and technology. This will position VR technology at the at the forefront of rehabilitation options for people with spatial neglect.”

Funding sources: National Institute for Disability, Independent Living and Rehabilitation Research (NIDILRR; grant number 90IFDV0001).

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