Helena Fordell1, Kenneth Bodin2, Anders Eklund3, Jan Malm1. 1. a Department of Pharmacology and Clinical Neuroscience , Umeå University , Sweden. 2. b Department of Computing Science (HPC2N and UMIT) , Umeå University , Sweden. 3. c Department of Radiation Sciences , Umeå University , Sweden.
Abstract
BACKGROUND: There is a lack of effective treatment for neglect. We have developed a new training method, RehAtt™. The objective of this study was to determine whether RehAtt™ improves spatial attention in chronic neglect after stroke. METHODS: RehAtt™ consists of a computer with monitor, 3D glasses, and a force feedback interface (Robotic pen) giving sensory motor activation to the contra-lesional arm. The software combines visual scanning training with multi-sensory stimulation in 3D virtual reality (VR) game environment. Fifteen stroke patients with chronic neglect (duration > 6 month) had repeated baseline evaluations to confirm stability of symptoms. There were no test-retest effects for any of the tests. Thereafter, all patients trained 15 h in RehAtt™ (3 × 1 h for 5 weeks). A neglect test battery and Catherine Bergego Scale, CBS, were used to assess behavioral outcome after intervention. CBS was also used at a 6-month follow-up. RESULTS: Using repeated measurement analysis improvements due to the training were found for Star cancellation test (p = 0.006), Baking tray task (p < 0.001), and Extinction test (p = 0.05). In the Posner task improvements were seen fewer missed targets (p = 0.024). CBS showed improvements in activities of daily life immediately after training (p < 0.01). After 6 months the patients still reported improvement in CBS. CONCLUSION: RehAtt™ is a new concept for rehabilitation of neglect. Training with the VR-method improved spatial attention and showed transfer to improved spatial attention in activities of daily living in chronic neglect. Our results are promising and merit further studies.
BACKGROUND: There is a lack of effective treatment for neglect. We have developed a new training method, RehAtt™. The objective of this study was to determine whether RehAtt™ improves spatial attention in chronic neglect after stroke. METHODS: RehAtt™ consists of a computer with monitor, 3D glasses, and a force feedback interface (Robotic pen) giving sensory motor activation to the contra-lesional arm. The software combines visual scanning training with multi-sensory stimulation in 3D virtual reality (VR) game environment. Fifteen strokepatients with chronic neglect (duration > 6 month) had repeated baseline evaluations to confirm stability of symptoms. There were no test-retest effects for any of the tests. Thereafter, all patients trained 15 h in RehAtt™ (3 × 1 h for 5 weeks). A neglect test battery and Catherine Bergego Scale, CBS, were used to assess behavioral outcome after intervention. CBS was also used at a 6-month follow-up. RESULTS: Using repeated measurement analysis improvements due to the training were found for Star cancellation test (p = 0.006), Baking tray task (p < 0.001), and Extinction test (p = 0.05). In the Posner task improvements were seen fewer missed targets (p = 0.024). CBS showed improvements in activities of daily life immediately after training (p < 0.01). After 6 months the patients still reported improvement in CBS. CONCLUSION: RehAtt™ is a new concept for rehabilitation of neglect. Training with the VR-method improved spatial attention and showed transfer to improved spatial attention in activities of daily living in chronic neglect. Our results are promising and merit further studies.
Authors: Bernadette C Tobler-Ammann; Elif Surer; Eling D de Bruin; Marco Rabuffetti; N Alberto Borghese; Renato Mainetti; Michele Pirovano; Lia Wittwer; Ruud H Knols Journal: JMIR Serious Games Date: 2017-08-25 Impact factor: 4.143