Table 3.
Virtual reality-based technologies in a shopping mall environment for assessment and rehabilitation.
| Study Design | Participants | Purpose and targeted domains | Interaction, display and level of immersion | Assessment/Rehabilitation | Outcome Measures | Conclusions | |
|---|---|---|---|---|---|---|---|
| Rand et al. (2007) | Experimental | 14 stroke and 93 HC from three age groups | Assessment and Rehabilitation of Upper Limbs and Executive Functions |
GestureTek (IREX system) – Semi-Immersive | VMAll four-item shopping task: the products are located in two different aisles on both the top and middle shelves. The list is written in large letters on a board. | Instruments: MMSE; FMA; SFQ; Borg’s scale of perceived exertion; SFQ- CHILD. Performance: time it took to shop for the four items; the order of products bought while shopping; and the number and type of products bought by mistake. |
VMall significantly differentiates between HC and stroke participants. The shopping task was challenging for the stroke participants, which has positive implications for treatment. |
| Rand et al. (2009a) | Non-experimental | 6 stroke | Rehabilitation of Upper Limbs and Executive Functions | GestureTek (IREX system) – Semi-Immersive |
Large supermarket in which the users can navigate and select aisles and grocery products by waving the affected hand. Complex, everyday task of shopping in which their weak upper extremity and executive functions deficits can be trained. | Instruments: MMSE; Star Cancellation and GDS. Performance: shopping time and number of mistakes. |
VMall has great potential as an intervention tool for treating the weak upper extremity of individuals with stroke while providing opportunities for practicing functional tasks. |
| Rand et al. (2009b) | Non-experimental | 4 stroke | Rehabilitation of Executive Functions | GestureTek (IREX system) – Semi-Immersive |
VMall: Virtual supermarket that encourages planning, multitasking, and problem solving while practicing an everyday shopping task. Products are virtually selected and placed in a shopping cart using upper-extremity movements. |
Instruments: MET–HV and IADL questionnaire. Performance: total number of mistakes; rule break mistakes; non-efficiency mistakes and; use of strategies mistakes. |
VMall is a motivating and effective intervention tool for post-stroke rehabilitation of multitasking deficits during the performance of daily tasks. |
| Rand et al. (2009c) | Experimental | 9 stroke, 20 young and 20 older HC | Assessment of Executive Functions | GestureTek (IREX system) – Semi-Immersive |
VMall: virtual supermarket that encourages planning, multitasking, and problem solving while practicing an everyday shopping task. Products are virtually selected and placed in a shopping cart using upper-extremity movements. |
Instruments: MET–HV; BADS (Zoo map) and IADL questionnaire. Performance: total number of mistakes; rule break mistakes; non-efficiency mistakes and; use of strategies mistakes |
VMET differentiates between two age groups of HC and between HC and post-stroke thus demonstrating that it is sensitive to brain injury and ageing. Significant correlations were found between MET and VMET for both post-stroke and older HC. |
| Hadad et al. (2012) | Experimental | 5 stroke and 6 HC | Assessment and Rehabilitation of Executive Functions | Kinect (SeeMe system) – Semi-Immersive |
VIS: a VE of a 3-store mall. A store mock-up. A Cafeteria that served as location of shopping in a real setting. | Instruments: MMSE; FIM; SFQ. Performance: time to complete the test and the number of errors (buying the wrong item or not buying an item on the list). Modified version: budget handling. |
Post-stroke group performed more slowly than control group. Both groups took longer to complete the test in the VIS than in the store mock- up and the cafeteria. Performance in the VIS, the store mock-up and the cafeteria were correlated in the post-stroke group. The VIS may be used to assess and train shopping cognitive abilities. |
| Jacoby et al. (2013) | Experimental | 12 TBI | Assessment of Executive Functions | GestureTek (IREX system) – Semi-Immersive |
VMall: a supermarket that enables training of motor and cognitive abilities during IADL practice. It enables the performance of a variety of tasks. | Instruments: MET; EFPT. Performance: Total score. |
Results show a trend towards an advantage of VR therapy compared to cognitive retraining OT without VR, as it leads to greater improvement in IADL’s. |
| Erez et al. (2013) | Experimental | 20 TBI children and 20 typically developing children | Assessment and Rehabilitation of Executive Functions | GestureTek (IREX system) – Semi-Immersive |
VMall: a supermarket that enables training of motor, cognitive and EF abilities during IADL practice. It enables the performance of a variety of tasks. | Instruments: SFQ-CHILD; Borg’s scale of perceived exertion; BADS (Zoo Map). Performance: Time to complete; number of mistakes (items bought by mistake, additional items bought, or required items not bought); and sequence of bought products. |
Good usability. Significant difference in performance between the two groups: mean shopping time and number of mistakes higher for TBI children. Poorer performance of TBI children may be due to EF deficits. |
| Okahashi et al. (2013) | Experimental | 5 Stroke, 5 TBI, 10 HC, 10 old and 10 young HC. |
Assessment of Executive Functions, Attention and Memory | Touch panel display: by touching the bottom of the screen, users could move in the virtual shopping mall, entering a shop and buying an item. – Semi-Immersive |
We set a shopping task, which asks users to buy four specific items. The user must search the shops that sell specific items and select the target item out of six items inside a shop. | Instruments: MMSE; RBMT; EMC; DEX; SDMT; SRT; Star and Letter Cancellation Task. Performance: Bag use; list use; cue use; forward movement; reverse movement; correct purchases; total time; time in shops; time on road and mean time per shop. |
VST is able to evaluate the ability of attention and everyday memory in participants with brain damage. The time of VST is increased by age. |
| Canty et al. (2014) | Experimental | 30 TBI and 24 HC | Assessment of Prospective Memory | Keyboard, computer. – Non-Immersive |
VRST: simulates the graphical perspective of the participant’s avatar and requires the participant to purchase 12 items in a pre-specified order from a selection of 20 shops. Participants were instructed to complete 3 time- and 3 event-based PM tasks. | Instruments: LDPMT; TMT A and B; HVLT-R; COWAT; LNS; HSCT; SPRS; IR; IL. Performance: Performance in cue detection. |
The performance of the TBI group was significantly poorer than that of controls on event-based PM, as measured by the LDPMT, and on time- and event-based PM as measured by the VRST. |
| Nir-Hadad et al. (2015) | Experimental | 19 stroke and 20 HC | Assessment of Executive Functions | Kinect (SeeMe system) – Semi-Immersive |
Adapted Four-Item Shopping Task in the SeeMe VIS environment with a supermarket, a toy store and a hardware store. | Instruments: SFQ; BADS (Zoo Map and the Rule Shift Cards); EFPT (Telephone Use and Bill Payment); FIM; FMA; CDT. Performance: selected products; selection time; mistakes; total cost of purchased items; and distance traversed while shopping. |
Good initial support for the validity of the Adapted Four-Item Shopping Task as an IADL assessment that requires the use of EF. |
BADS, Behavioral Assessment of the Disexecutive Syndrome; Borg’s scale of perceived exertion; CDT, Clock Drawing Test; COWAT, Controlled Oral Word Association Task; DEX, Dysexecutive Questionnaire; EFPT, Executive Function Performance Test; EFPT, Executive Function Performance Test; EMC, Everyday Memory Checklist; FIM, Functional Independence Measure; FMA, Fugl–Meyer Motor Assessment; GDS, Geriatric Depression Scale; HSCT, Hayling Sentence Completion Test; HVLT-R-TR, Total Recall on the Hopkins Verbal Learning Test-Revise; IADL Performance, Instrumental Activities of Daily Living Performance; IADL questionnaire, Instrumental Activities of Daily Living questionnaire; IL, independent living; IR, interpersonal relationships; LDPMT, Lexical decision prospective memory task; LNS, Letter Number Sequencing; MET, Multiple Errands Test; MET–HV, Multiple Errands Test–Hospital Version; MET-SV, Multiple Errands Test—Simplified Version; MMSE, Mini-Mental State Examination; RBMT, Rivermead Behavioral Memory Test; SDMT, Symbol Digit Modalities Test; SFQ-CHILD, Short Feedback Questionnaire for children; SFQ, Short Feedback Questionnaire; SPRS, Sydney Psychosocial Reintegration Scale; SRT, Simple Reaction Time Task; TMT, Trail Making Test: Parts A and B.