Table 6.
Virtual reality-based technologies in other everyday life environments for assessment and rehabilitation of acquired brain injury.
| Methods/Study design | Participants | Domain | Interaction and display/Instrumentation | Assessment/Treatment | Measures | Conclusions | |
|---|---|---|---|---|---|---|---|
| Matheis et al. (2007) | Experimental | 20 TBI and 20 HC | Learning and Memory | Dell laptop +5TH Dimension Technologies (5DT) 800 Series HMD | The participant had to learn 16 target items, depicted among numerous other office distracters (e.g., computer, file cabinet), during a sequence of 12 sequential exposures to the VR Office environment. | Instruments: WASI; WAIS (digit span and digit symbol-coding subtests); TMT A and B; WCST; BNT; HVOT; COWAT; CVLT; BVMT-R; and m-SSQ. Performance: Initial list acquisition, short-term recall (30 min.) and long term recall (24 h). |
VR memory testing accurately distinguished the TBI group from controls. Non-memory-impaired TBI acquired targets at the same rate as HC. There was a relationship between the VR Office and a standard measure of memory, suggesting the construct validity of the task. |
| Fong et al. (2010) | Non-experimental | 12 intracerebral hemorrhage, 6 stroke, 5 TBI and 1 brain tumor | Cognition | 27″ touch monitor that represents the actual dimensions of a real ATM. | VR-ATM | Instruments: MMSE and COGNISTAT. Performance: Success or failure in using VR-ATM real ATM (cash withdrawals, money transfers, and electronic payments); average reaction time; percentage of incorrect responses; number of cues needed; and time spent. |
Sensitivity was 100% for cash withdrawals and 83.3% for money transfers. Specificity was 83 and 75%, respectively. For cash withdrawals, average reaction time of the VR group was shorter than the conventional program group. No differences in average reaction time or accuracy between groups for money transfers, although there was improvement for the VR-ATM group. |
| Renison et al. (2012) | Experimental | 30 TBI and 30 HC | Executive Functions | An X-box and Playstation compatible handset. | VLT models the dimensions and contents of two rooms in the Library at Epworth Hospital. Participants perform several tasks associated with the day to day running of the library. |
Instruments: BADS Zoo Map and MSET; WTAR; WMS III; WAIS III (Digit span); WCST; BSAT and DEX. Performance: Task analysis, strategy generation and regulation, prospective working memory, interference and dual task management, response inhibition, time-based prospective memory and event-based prospective memory tasks scores. |
Performances on the VLT and the RLT were correlated indicating that VR performance is similar to real world performance. TBI group performed significantly worse than the control group on the VLT and the MSET but the other four measures of EF failed to differentiate the groups. Both MSET and VLT predicted everyday EF suggesting that are both ecologically valid tools for EF assessment. VLT has the advantage of providing objective measurement of EF individual components. |
| Krch et al. (2013) | Non-experimental | 7 TBI, 5 MS and 7 HC | Executive Functions | Computer and mouse | Assessim Office: respond to emails; decide whether to accept or reject real estate offers based on specific criteria; print the real estate offers that met specific criteria; retrieve printed offers from the printer and deliver them to a file box located on participants’ desk; and ensure that the conference room projector light remained on. | Instruments: WAIS III; D-KEFS; WASI Performance: emails correctly replied; correct decision, real estate offers; declined offers incorrectly printed; printed offers delivered to file box; projector light missed; redundant clicks. |
AO was well tolerated by TBI and MS samples. Performance by clinical samples on the AO was distinct from HC. Patient performance was poorer than HC across all AO tasks. Evaluation of the relationship between performance on AO tasks and EF tests revealed that there were more significant relationships within TBI group as compared with MS group. |
| Fluet et al. (2013) | Experimental | 30 stroke | Upper-limbs | Computer and CyberGlove: Subject interacted with VE with haptic guidance provided by robot. | VE activities: Reach/Touch; Placing Cups; Hammer Task; Blood Cell; Plasma Pong; Hummingbird Hunt; Piano Trainer and; Space Pong. | Instruments: UEFMA; WMFT; JTHF. Performance: Simulations and real activities performance. |
Both groups improved in UEFMA, WMT and JTHF. Gains in UEFMA maintained at follow-up. No differences at any of the three measurement times and no significant group time interactions. |
| Gerber et al. (2014) | Non-experimental | 19 TBI | Engagement in computer-based simulations of functional tasks. | Computer and a haptic device: Phantom® OmniTM. | Interactive virtual scenes in 3D space: remove tools from a workbench, compose 3 letter words, manipulate utensils to prepare a sandwich, and tool use. | Instruments: WMFT; BPS; NSI and PPT. Performance: Tool use: grabbing the tool; tool interaction with nail or screw; movement of nail or screw; and success in completing the task. Making a sandwich: grabbing an object (piece of bread or knife); moving bread; touching the jar cover; touching peanut or jelly or bread with the knife. Spelling: grabbing and releasing a letter; placing letter on the grid; and completing a three-letter word. |
Participants reported being engaged in using haptic devices that interact with 3D VEs. Haptic devices are able to capture objective data about motor and cognitive performance. |
| Gilboa et al. (2017) | Experimental | 29 ABI children and adolescents and 30 HC | Executive Functions | Computer and mouse | JEF-C: the participant has to plan, set up and run its own party through the completion of tasks. | Instruments: WASI, BADS-C and the BRIEF questionnaire (parents). Performance in 8 different cognitive constructs: planning; prioritization; selective, adaptive and creative thinking and; action, time and event-based prospective memory. |
Patients performed significantly worse than controls on most of the JEF-C subscales and total score, with 41.4% of participants with ABI classified as having severe executive dysfunction. |
| Cho and Lee (2019) | Experimental | 42 stroke | Cognitive functioning | HMD developed by Company S | Fishing: the user catches fish using upper extremities. Picture matching: the user flips cards and finds a match, the initial screen has 8 cards; the user can turn or look back to see all the cards. The user needs to place his or her hand on the card whose picture they want to check as if they reach out and touch it. RehaCom |
Instruments: CNT, LOTCA, FIM. | Virtual reality immersive training might be an affordable approach for cognitive function and activity of daily living performance recovery for patients with acute stroke. |
| Qiu et al. (2020) | Non-Experimental | 15 stroke | Upper-extremities | Laptop and Leap Motion Controller (with arm supporters) | HoVRS: 5 games (Maze, Wrist Flying, Finger Flying, Car, Fruit Catch) targeting different movement patterns (Elbow-Shoulder, Wrist, Hand, Whole Arm) |
Intruments: UEFMA Performance: six hand and arm kinematic outcomes (HOR, WPR, HRR, HOA, WPa, HRA) |
Subjects spent 13.5 h using the system at home and demonstrated an increase of 5.2 on the UEFMA, which exceeds the minimally clinically important difference of 4.25. They also improved in six measurements of hand kinematics. |
| Lorentz et al. (2021) | Non-experimental | 21 stroke, 6 TBI, 6 degenerative disease, 1 encephalitis and 1 brain tumor | Attention and Working Memory | Oculus quest with two OLED displays and two touch-controllers. | VR Traveller: each scenario is set in a different location and challenges alertness, selective attention, visual scanning and working memory. For instance, the New York City module primarily trains tonic alertness: patients are asked to press a response key as soon as a skyscraper lights up. At higher levels, visual distractions (streets, cars, and traffic lights) are added in order to place an additional cognitive load on patients’ selective attention. | Instruments: UEQ, a self-constructed feasibility questionnaire, and the VRSQ. | Patients’ ratings of the VR training in terms of acceptability and feasibility were positive. |
BADS, Behavioral Assessment of the Dysexecutive Syndrome; BPS, Boredom Propensity Scale; BSAT, Brixton Spatial Anticipation Test; BNT, Boston Naming Test; BRIEF, Behavior Rating Inventory of Executive Function; BVNTR, Brief Visuospatial Memory Test-Revised; CNT, Computerized Neurocognitive Function Test; COGNISTAT, The Neurobehavioral Cognitive Status Examination; COWAT, Controlled Oral Word Association Test; CVLT, California Verbal Learning Test; DEX, Dysexecutive Questionnaire; D-KEFS, Delis–Kaplan Executive Function System; FIM, Functional Independence Measure; HMD, Head Mount Display; HoVRS, Home based Virtual Rehabilitation System (HoVRS); HVOT, Hooper Visual Organization Test; JEF-C, Jansari assessment of Executive Functions for Children; JTHF, Jebsen Test of Hand Function; LOTCA, Loewenstein Occupational Therapy Cognitive Assessment; MMSE, Mini-Mental State Examination; MSET, Modified Six Elements Test; m-SSQ, modified Simulator Sickness Questionnaire; NSI, Neuropsychological symptom inventory; PPT, Purdue Peg Motor Test; TBI, Traumatic Brain Injury; TMT, Trail Making Test; UEFMA, Upper Extremity Fugl Meyer Assessment; UEQ, User Experience Questionnaire; VRSQ, Virtual Reality Sickness Questionnaire; WAIS-III, Wechsler Adult Intelligence Scale-Third Edition; WASI, Wechsler Abbreviated Scale of Intelligence; WCST, Wisconsin Card Sorting Test; WMFT, Wolf Motor Function Test; WMS-III, Wechsler Memory Scale – Third Edition; WTAR, Wechsler Test of Adult Reading.