Skip to main content
SpringerLink
Log in

Evaluation of a VR prototype for neuropsychological rehabilitation of attentional functions

  • S.I. : Virtual Reality for Therapy, Psychological Interventions, and Physical and Cognitive Rehabilitation
  • Published:
Virtual Reality Aims and scope Submit manuscript

Abstract

Background

Recent research has established virtual reality (VR) applications as a valid and viable tool for neuropsychological assessment. In contrast, there are only a few studies on its potential as a therapeutic program. To examine the prospects of VR as a tool for functional rehabilitation, a VR training program of attentional functions was conceptualized during a Hackathon in 2018. The prototype of the immersive VR training program takes the patient on a virtual journey around the world (VR Traveller). In different locations around the globe, patients exercise different subcomponents of attention in a visually appealing and ecologically valid environment.

Objective

To evaluate the feasibility, acceptability and tolerability of the newly developed VR Traveller prototype for neurorehabilitation training.

Method

Thirty-five patients with acquired brain injury and mild to moderate attention deficits were instructed to complete the VR Traveller training program in a 20–30 min session during inpatient neurorehabilitation. Feasibility and acceptability were assessed with the user experience questionnaire (UEQ) and a self-constructed feasibility questionnaire, and tolerability was assessed with the virtual reality sickness questionnaire (VRSQ).

Results

Analyses of the UEQ and the feasibility questionnaire yield evidence for a high acceptance among most patients. The VRSQ data suggest that symptoms of VR sickness were hardly experienced.

Conclusion

Patients’ ratings of the VR training in terms of acceptability and feasibility were positive, suggesting that VR programs represent an accepted, feasible, and well-received alternative to traditional cognitive rehabilitation approaches.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4 
Fig. 5 
Fig. 6 
Fig. 7 
Fig. 8

Similar content being viewed by others

Data availability

The fully anonymized data and material of this study are available from the corresponding author on reasonable request.

References

  • Ames SL, Wolffsohn JS, Mcbrien NA (2005) The development of a symptom questionnaire for assessing virtual reality viewing using a head-mounted display. Optom vis Sci 82(3):168–176. https://doi.org/10.1097/01.opx.0000156307.95086.6

    Article  Google Scholar 

  • Belger J, Krohn S, Finke C, Tromp J, Klotzsche F, Villringer A, Gaebler M, Chojecki P, Quinque E and Thone-Ott A. Immersive virtual reality for the assessment and training of spatial memory: feasibility in neurological patients. Proc. 13th int’l conf. on virtual rehab., WG Wright, S Subramanian, G Fluet, M Agmon, RM Proffitt, M Roberts (eds) Tel Aviv, Israel, 21–24 July 2019

  • Bioulac S, Micoulaud-Franchi J, Maire J, Bouvard MP, Rizzo A, Sagaspe P, Philip P (2020) Virtual remediation versus methylphenidate to improve distractibility in children with ADHD a controlled randomized clinical trial study. J atten disord 24(2):326–335. https://doi.org/10.1177/1087054718759751

    Article  Google Scholar 

  • Birckhead B, Khalil C, Liu X, Conovitz S, Rizzo A, Danovitch I, Bullock K, Spiegel B (2019) Recommendations for methodology of virtual reality clinical trials in health care by an international working group: Iterative study. JMIR Mental Health 6(1):e11973. https://doi.org/10.2196/11973

    Article  Google Scholar 

  • Corsi PM (1972) Human memory and the medial temporal region of the brain. Diss Abstr Int 34:819B

    Google Scholar 

  • Delis DC, Freeland J, Kramer JH, Kaplan E (1988) Integrating clinical assessment with cognitive neuroscience: Construct validation of the California Verbal Learning Test. J Consult Clin Psychol 56(1):123–130. https://doi.org/10.1037/0022-006X.56.1.123

    Article  Google Scholar 

  • Gamito P, Oliveira J, Coelho C, Morais D, Lopes P, Pacheco J, Brito R, Soares F, Santos N, Barata AF (2015) Cognitive training on stroke patients via virtual reality-based serious games. Disabil Rehabil 39(4):385–388. https://doi.org/10.3109/09638288.2014.934925

    Article  Google Scholar 

  • Gerłowska J, Skrobas U, Grabowska-Aleksandrowicz K, Korchut A, Szklener S, Szczęśniak-Stańczyk D, Tzovaras D, Rejdak K (2018) Assessment of perceived attractiveness, usability, and societal impact of a multimodal robotic assistant for aging patients with memory impairments. Front Neurol. https://doi.org/10.3389/fneur.2018.00392

    Article  Google Scholar 

  • Giaschi D, Narasimhan S, Solski A, Harrison E, Wilcox LM (2013) On the typical development of stereopsis: fine and coarse processing. Vision Res 89:65–71. https://doi.org/10.1016/j.visres.2013.07.011

    Article  Google Scholar 

  • Gilboa Y, Fogel-Grinvald H, Chevignard M (2018) Virtual Classroom assessment for children and adolescents with attention deficits. A Syst Rev Meta-Anal Measurement Prop Atten Disord. https://doi.org/10.1177/1087054718808590

    Article  Google Scholar 

  • Huygelier H, Schraepen B, Lafosse C, Vaes N, Schillebeeckx F, Michiels K, Note E, Vanden Abeele V, Van Ee R, Gillebert CR (2020) An immersive virtual reality game to train spatial attention orientation after stroke: a feasibility study. Appl Neuropsychol Adult. https://doi.org/10.1080/23279095.2020.1821030

    Article  Google Scholar 

  • Kennedy R, Lane N, Berbaum K, Lilienthal M (1993) Simulator sickness questionnaire: an enhanced method of quantifying simulator sickness. Int J Aviat Psychol 3:203–220

    Article  Google Scholar 

  • Kim W, Cho S, Ku J, Kim Y, Lee K, Hwang H, Paik N (2020) Clinical application of virtual reality for upper limb motor rehabilitation in stroke: review of technologies and clinical evidence. J Clin Med 9(10):3369. https://doi.org/10.3390/jcm9103369

    Article  Google Scholar 

  • Laugwitz B, Held T, Schrepp M (2008) Construction and evaluation of a user experience questionnaire. Lect Notes Comput Sci. https://doi.org/10.1007/978-3-540-89350-9_6

    Article  Google Scholar 

  • Lehrl S (1999) Mehrfachwahl-Wortschatz-Intelligenztest (MWT-B) [Measurement Instrument]. Balingen, Germany: Spitta.  

    Google Scholar 

  • Lorenz M, Brade J, Diamond L, Sjölie D, Busch M, Tscheligi M, Klimant P, Heyde C, Hammer N (2018) Presence and user experience in a virtual environment under the influence of ethanol: an explorative study. Scientific Rep. https://doi.org/10.1038/s41598-018-24453-5

    Article  Google Scholar 

  • Manera V, Chapoulie E, Bourgeois J, Guerchouche R, David R, Ondrej J, Drettakis G, Robert P (2016) A feasibility study with image-based rendered virtual reality in patients with mild cognitive impairment and dementia. PLoS ONE 11(3):e0151487. https://doi.org/10.1371/journal.pone.0151487

    Article  Google Scholar 

  • Matheis RJ, Schultheis MT, Tiersky LA, DeLuca J, Millis SR, Rizzo A (2007) Is learning and memory different in a virtual environment? Clin Neuropsychol 21(1):146–161. https://doi.org/10.1080/13854040601100668

    Article  Google Scholar 

  • McCleery JP, Zitter A, Solórzano R, Turnacioglu S, Miller JS, Ravindran V, Parish-Morris J (2020) Safety and feasibility of an immersive virtual reality intervention program for teaching police interaction skills to adolescents and adults with autism. Autism Res 13(8):1418–1424. https://doi.org/10.1002/aur.2352

    Article  Google Scholar 

  • Parsons TD, Bowerly T, Buckwalter JG, Rizzo A (2007) A controlled clinical comparison of attention performance in children with ADHD in a virtual reality classroom compared to standard neuropsychological methods. Child Neuropsychol: J Normal Abnormal Develop Child Adolescence 13(4):363–381. https://doi.org/10.1080/13825580600943473

    Article  Google Scholar 

  • Ponsford JL et al (2014) Longitudinal follow-up of patients with traumatic brain injury: Outcome at two, five and ten years post-injury. J Neurotrauma 31(1):64–77

    Article  Google Scholar 

  • Pourmand A, Davis S, Marchak A, Whiteside T, Sikka N (2018) Virtual reality as a clinical tool for pain management. Current Pain Headache Rep. https://doi.org/10.1007/s11916-018-0708-2

    Article  Google Scholar 

  • Riva G, Wiederhold BK, Mantovani F (2019) Neuroscience of virtual reality: from virtual exposure to embodied medicine. Cyberpsychol Behav Soc Netw 22(1):82–96. https://doi.org/10.1089/cyber.2017.29099.gri

    Article  Google Scholar 

  • Rizzo A, Koenig ST (2017) Is clinical virtual reality ready for primetime? Neuropsychology 31(8):877–899. https://doi.org/10.1037/neu0000405

    Article  Google Scholar 

  • Robertson I (1990) Does computerized cognitive rehabilitation work? A Rev Aphasiol 4(4):381–405. https://doi.org/10.1080/02687039008249090

    Article  Google Scholar 

  • Schrepp M, Hinderks A, Thomaschewski J (2017) Construction of a benchmark for the user experience questionnaire (UEQ). Int J Interact Multimedia Artif Intell 4(4):40–44

    Google Scholar 

  • Schröder J, Van Criekinge T, Embrechts E, Celis X, Van Schuppen J, Truijen S, Saeys W (2018) Combining the benefits of tele-rehabilitation and virtual reality-based balance training: a systematic review on feasibility and effectiveness. Disabil Rehabil Assist Technol 14(1):2–11. https://doi.org/10.1080/17483107.2018.1503738

    Article  Google Scholar 

  • Shipstead Z, Redick TS, Engle RW (2012) Is working memory training effective? Psychol Bull 138(4):628–654. https://doi.org/10.1037/a0027473

    Article  Google Scholar 

  • Sivan M, Neumann V, Kent R, Stroud A, Bhakta BB (2010) Pharmacotherapy for treatment of attention deficits after non-progressive acquired brain injury. A Syst Rev Clinic Rehabil 24(2):110–121. https://doi.org/10.1177/0269215509343234

    Article  Google Scholar 

  • Tennant M, McGillivray J, Youssef GJ, McCarthy M, Clark T (2020) Feasibility, acceptability and clinical implementation of an immersive virtual reality intervention to address psychological wellbeing in children and adolescents with cancer. J Pediatr Oncol Nurs 37(4):265–277. https://doi.org/10.31234/osf.io/d7jvh

    Article  Google Scholar 

  • Warland A, Paraskevopoulos I, Tsekleves E, Ryan J, Nowicky A, Griscti J, Levings H, Kilbride C (2018) The feasibility, acceptability and preliminary efficacy of a low-cost, virtual-reality based, upper-limb stroke rehabilitation device: a mixed methods study. Disabil Rehabil 41(18):2119–2134. https://doi.org/10.1080/09638288.2018.1459881

    Article  Google Scholar 

  • Wechsler D (2009) Wechsler memory scale-fourth edition (WMS-IV) [Measurement Instrument]. San Antonio, TX: Pearson

    Google Scholar 

  • Yaddaden A, Bier N, Andrée-Anne P, Lussier M, Aboujaoudé A, Gagnon-Roy M (2019) Usability questionnaires for telemonitoring and assistive technology for cognition for older adults. In: Proceedings of the 5th EAI International Conference on Smart Objects and Technologies for Social Good, vol 5, pp 102–107. https://doi.org/10.1145/3342428.3342653

  • Zimmermann P, Fimm B (2007) Testbatterie zur Aufmerksamkeitsprüfung (TAP) [Measurement Instrument]. Herzogenrath, Germany: Psytest

Download references

Acknowledgements

The development of this project was funded by the Interreg North-West Europe (NWE) program “VR4Rehab” (NWE585; www.nweurope.eu/projects-search/vr4rehab-virtual-reality-for-rehabilitation/). The prototype was conceptualized by Anita Althausen, Monika Bender, Jana Estocinova, Jana Stötzel, and Heike Warneke. Antoine Omnes, Olaf Dahncke, and Marcel Zimmermann were responsible for the programming, and Lukas Kuhlendahl, Dominica Wester, Beate Sucrow, and Janos Wokrina from Weltenweber conducted the 3D modelling.

Funding

This project was funded by the Interreg North-West Europe (NWE) program “VR4Rehab” (NWE585; www.nweurope.eu/projects-search/vr4rehab-virtual-reality-for-rehabilitation/).

Author information

Authors and Affiliations

  1. St. Mauritius Therapieklinik, Strümper Straße 111, 40670, Meerbusch, Germany

    Lukas Lorentz, Bettina Studer, Kristina Müller & Michael Lendt

  2. SRH Gesundheitszentrum Bad Wimpfen GmbH, Bad Wimpfen, Germany

    Mariella Simone & Jana Estocinova

  3. reIntegro Köln, Köln, Germany

    Marcel Zimmermann

  4. Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

    Bettina Studer

  5. Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany

    Boris Suchan

  6. Neurologisches Therapiecentrum Köln gGmbH, Köln, Germany

    Anita Althausen

Authors
  1. Lukas Lorentz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mariella Simone
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marcel Zimmermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bettina Studer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Boris Suchan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Anita Althausen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jana Estocinova
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kristina Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Michael Lendt
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The study was designed by MZ, BSt, AA, JE, KM, and ML. Data collection was done by LL and MS. Data analysis was conducted by LL. The manuscript was written by LL and BS, and critically revised by BSt, KM, MZ, and ML. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Lukas Lorentz.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethics approval

This study was approved by the independent ethics committee at the medical faculty of Heinrich-Heine University Düsseldorf (protocolnr. 2019–505-) as well as the Landesärztekammer Baden-Württemberg.

Consent to participate

All participants provided written informed consent to participate.

Consent for publication

The author transfers to Springer the non-exclusive publication rights and he warrants that his contribution is original and that he has full power to make this grant. The author signs for and accepts responsibility for releasing this material on behalf of any and all co-authors. This transfer of publication rights covers the non-exclusive right to reproduce and distribute the article, including reprints, translations, photographic reproductions, microform, electronic form (offline, online), or any other reproductions of similar nature.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lorentz, L., Simone, M., Zimmermann, M. et al. Evaluation of a VR prototype for neuropsychological rehabilitation of attentional functions. Virtual Reality 27, 187–199 (2023). https://doi.org/10.1007/s10055-021-00534-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10055-021-00534-1

Keywords

Search

Navigation