Table 2.
Virtual reality-based technologies in a supermarket environment for assessment and rehabilitation of acquired brain injury.
| Study Design | Participants | Purpose and targeted domains | Interaction, display and level of immersion | Assessment/Rehabilitation | Outcome Measures | Conclusions | |
|---|---|---|---|---|---|---|---|
| Josman et al. (2006) | Non-experimental | 26 stroke | Assessment and Rehabilitation of Executive Functions | Desktop computer (screen + keyboard + mouse) - Non-Immersive |
VAPS: purchase seven items from a clearly defined list of products then proceed to the cashier's desk, and pay for them. | Instruments: MMSE and BADS. Performance: Total trajectory, trajectory duration, number of items purchased, number of correct actions, number of incorrect actions, number of pauses, total duration of pauses, and time to pay. |
Moderate relationships were found between performance within the VAPS and EF. The results support the use of the virtual supermarket as an EF assessment and training tool after stroke. |
| Kang et al. (2008) | Experimental | 20 stroke | Assessment of Executive Functions, Memory and Attention | HMD and Joystick - Fully Immersive |
VR shopping simulation: select and place an item in the cart according to auditory and visual stimulated stimuli, respond to unexpected events such as dropping an item, and select all items in a specified category. | Instruments: K MMSE, K-WAIS; R-KMT, K-FENT and MVPT. Performance: 1. Computer navigation interaction: total time, distance and collision, number of selected items, interaction error and performance index. 2. Memory and attention: immediate and delayed recognition, visual and auditory memory score, attention reaction time, responsiveness, selected items, and attention index. 3. Executive Functions: total time and distance, judgment and calculation score and executive index. |
Significant program-performance differences between the stroke and control groups. In the stroke group, decreased perceptive and visuospatial functions might have seriously affected participants’ performance in the VR program. |
| Raspelli et al. (2012) | Experimental | 9 stroke, 10 young and 10 older HC |
Assessment of Executive Functions | Screen and joypad - Non-Immersive |
VR version of the Multiple Errands Test based on NeuroVR software as an assessment tool for executive functions. | Instruments: MMSE, BIT, Token Test, SCT, Stroop Test, IGT, DEX, TEA, STAI, BDI, ADL and, IADL. Performance: errors, inefficiencies, rule breaks, strategies, interpretation failures, partial task failures. |
The construct validity of a virtual version of the Multiple Errands Test has been demonstrated. |
| Yip and Man (2013) | Experimental | 37 ABI | Assessment and Rehabilitation of Prospective Memory | Screen and keyboard or joystick (participants choose the input device they preferred). - Non-Immersive |
VRPM: PM training program on everyday PM. Event-based, time-based PM training tasks and ongoing tasks were arranged to occur in a virtual convenience store. | Instruments: MMSE–CV, TONI-3, SADI-CV, CAMPROMPT–CV, HKLLT, FAB, WFT–CV, CTT, CIQ–CV. Performance: VR-based test on everyday PM tasks scores and real life behavioral PM test score. |
Significantly better changes were seen in both VR-based and real-life PM outcome measures, related to frontal lobe functions and semantic fluency. |
| Sorita et al. (2014) | Non-experimental | 33 TBI and 17 stroke | Assessment of Executive Functions (planning) | Wall screen, keyboard and mouse - Semi-Immersive |
VAPS: participants have to purchase 7 items according to a shopping list. | Instruments: CIQ, CAMPROMPT, POI, WAIS-III, GB and TEA. Performance: Total duration of pauses, total duration of move, total number of errors of selection of items. |
Functional performance in VAPS offers promising information on the impact of neuropsychological diseases in daily life. |
| Josman et al. (2014) | Experimental | 24 stroke and 24 HC |
Rehabilitation of Action planning, executive functions and IADLs | Desktop computer (screen + keyboard + mouse) - Non-Immersive |
VAPS: purchase 7 items from a clearly marked list of products, to then proceed to the cashier’s desk, and to pay for them. | Instruments: BADS and OTDL-R. Performance: Trajectory, trajectory duration, items purchased, correct actions, incorrect actions, number of pauses, duration of pauses and time to pay. |
The VAPS showed adequate validity and an ability to predict IADL performance, providing support for its use in cognitive stroke rehabilitation. |
| Yin et al. (2014) | Experimental | 23 stroke | Rehabilitation of Motor: upper-limbs | Sixense and laptop - Semi-Immersive |
Virtual local Supermarket: Participants were instructed to pick a virtual fruit from a shelf and release it into a virtual basket as many times as possible within a two minute trial. |
Instruments: FMA, ARAT, MAL and FIM. |
Although additional VR training was not superior to conventional therapy alone, this study demonstrates the feasibility of VR training in early stroke. |
| Ogourtsova et al. (2018) | Experimental | 27 stroke and 9 HC | Assessment of Unilateral Spatial Neglect | Joystick - Non-Immersive |
EVENS consists of two (simple and complex) immersive, 3-D scenes, depicting grocery shopping shelves, with object-detection and navigation tasks. | Instruments: Apples Test, Line Bisection Test, and Star Cancellation Test. Performance: detection time and maximal mediolateral deviation from an ideal navigation trajectory represented by the most direct route possible from the start position to the respective target. |
Navigation and detection abilities are affected by environmental complexity of the VR scene in individuals with post-stroke USN and can be employed for USN assessment. |
| Demers and Levin (2020) | Experimental | 22 stroke 15 HC |
Assessment of Upper Limbs | Large screen and Kinect II camera - Semi-Immersive |
Grocery shopping task with two scenes representing aisles filled with typical supermarket items, to determine whether reach-to-grasp movements made in a low-cost 2D VE were kinematically similar to those made in a physical environment (PE) in healthy subjects and subjects with stroke. | Instruments: CSI; FMA; MoCA; NSA. Performance: Arm and trunk kinematics were recorded with an optoelectronic measurement system (23 markers; 120 Hz). Temporal and spatial characteristics of the endpoint trajectory, arm and trunk movement patterns were compared. |
Hand positioning at object contact time and trunk displacement were unaffected by the environment. Compared to PE, in VE, unilateral movements were less smooth and time to peak velocity was prolonged. In HC, bilateral movements were simultaneous and symmetrical in both environments. In subjects with stroke, movements were less symmetrical in VE. |
| Cogné et al. (2018) | Experimental | 40 stroke | Assessment of Executive Functions | Keyboard, mouse and headphones - Non-Immersive |
VAPS: purchase 7 items from a list of products, go to the supermarket checkout, pay for the collected items and leave the store in < 30 minutes. There was 5 conditions: 1) without additional auditory stimuli; 2) beeping sounds occurring every 25 sec; 3) sounds from living beings 4) sounds from supermarket objects and; 5) names of other products not in the supermarket. | Instruments: MMSE; GREFEX battery; and Catherine Bergego scale. Performance: Number of products purchased; total time in seconds; and time of navigation. |
The 40 stroke patients navigational performance decreased under the 4 conditions with non-contextual auditory stimuli, especially for those with dysexecutive disorders. |
| Spreij et al. (2020b) | Experimental | 88 stroke and 66 HC | Assessment of Executive Functions and Memory | HMD (Oculus Rift or HTC Vive), Computer Monitor and Xbox 360 Controller - Fully-Immersive |
The VR task consisted in passing through the entry gates, finding three products from a shopping list, and passing through the cash registers to finish. A grocery list was randomly presented over three trials, and participants were asked to recall the products. There were two different shopping lists: (1) salt, matches, sprinkles; (2) hair wax, cookies, socks. | Instruments: 1 questionnaire regarding user-experience and 1 questionnaire regarding preference. Performance: completion rate, total time needed to complete the VR-task, and total number of products found that were presented on the shopping list. |
Both stroke patients and HC reported an enhanced feeling of engagement, transportation, flow, and presence when tested with a HMD but more negative side effects were experienced. The majority of stroke patients had no preference for one interface over the other, yet younger patients tended to prefer the HMD. |
ADL, Activities of Daily Living Test; ARAT, Action Research Arm Test; BADS, Behavioral Assessment of Dysexecutive Syndrome; BDI, Beck Depression Inventory; BIT, Behavioral Inattention Test; CAMPROMPT, Cambridge Prospective Memory Test; CAMPROMPT–CV, The Cambridge Prospective Memory Test – Chinese Version; CIQ, Community Integration Questionnaire; CIQ–CV, Chinese Version of the Community Integration Questionnaire; CSI, Composite Spasticity Index; CTT, Color Trails Test; DEX, Dysexecutive Questionnaire; EVENS, Ecological VR-based Evaluation of Neglect Symptoms; FAB, Frontal Assessment Battery; FIM, Functional Independence Measure; FMA, Fugl–Meyer Assessment for the upper extremity; GB, Grober Buschke; HKLLT, Hong Kong List Learning Test; GREFEX, Groupe de réflexion pour l’évaluation des fonctions exécutives; IADL, Instrumental Activities of Daily Living Test; IGT, Iowa Gambling Task; K-FENT, Kim’s Frontal Executive Function Neuropsychological Test; KMMSE, Korean Mini-Intelligence Scale; MAL, Motor Activity Log; MCST, Modified Card Sorting Test; MMSE, Mini Mental State Examination; MMSE–CV, Chinese Version Mini Mental State Examination; MoCA, Montreal Cognitive Assessment; MVPT, Motor-Free Visual Perception Test; NSA, Nottingham Sensory Assessment; OTDL-R, Observed Tasks of Daily Living-Revised; POI, Perceptual Organization Index; R-KMT, Rey-Kim Memory Test; SADI-CV, Chinese Version of the Self-Awareness of Deficit Interview; SCT, Street’s Completion Test; STAI, State and Trait Anxiety Index; Stroop Test, Stroop Colour-Word Test; TEA, Test of Attentional Performance; TMT, Trail Making Test; TONI-3, Test of Nonverbal Intelligence – 3rd Edition; WFT–CV, Word Fluency Test – Chinese Version; WAIS-III, Working Memory Index.