The effect of virtual reality training on unilateral spatial neglect in stroke patients.
Kim YM, Chun MH, Yun GJ, Song YJ, Young HE -Annals of rehabilitation medicine(2011)
F1:(A) Virtual reality experimental set up (IREX system®, Vivid group, Toronto, Canada), (B) Bird-ball, (C) Coconut, (D) Conveyer.
View Article:PubMed Central - PubMed
Affiliation:Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea.
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Results
Bottom Line:There were no significant differences in the baseline characteristics and initial values between the two groups.The changes in star cancellation test results and CBS in the VR group were significantly higher than those of the control group after treatment.The changes in line bisection test score and the K-MBI in the VR group were not statistically significant.
Abstract

Objective: To investigate the effect of virtual reality training on unilateral spatial neglect in stroke patients.

Method: Twenty-four stroke patients (14 males and 10 females, mean age=64.7) who had unilateral spatial neglect as a result of right hemisphere stroke were recruited. All patients were randomly assigned to either the virtual reality (VR) group (n=12) or the control group (n=12). The VR group received VR training, which stimulated the left side of their bodies. The control group received conventional neglect therapy such as visual scanning training. Both groups received therapy for 30 minutes a day, five days per week for three weeks. Outcome measurements included star cancellation test, line bisection test, Catherine Bergego scale (CBS), and the Korean version of modified Barthel index (K-MBI). These measurements were taken before and after treatment.

Results: There were no significant differences in the baseline characteristics and initial values between the two groups. The changes in star cancellation test results and CBS in the VR group were significantly higher than those of the control group after treatment. The changes in line bisection test score and the K-MBI in the VR group were not statistically significant.

Conclusion: This study suggests that virtual reality training may be a beneficial therapeutic technique on unilateral spatial neglect in stroke patients.

Mentions
Physical therapy, occupational therapy, and cognitive therapy of the same intensity and time were applied to all patients. In addition, two occupational therapists conducted treatment for unilateral spatial neglect. One therapist conducted conventional rehabilitation programs for the control group, such as visual tracking, reading and writing, drawing and copying, and puzzles, while the other conducted the virtual reality treatment on the VR group. Such treatments were applied for thirty minutes a day, once a day and five days a week for three weeks. The VR system (IREX system®, Vivid group, Toronto, Canada) consists of a monitor, a video camera, computer-recognizing gloves, and virtual objects (Fig. 1-A). The video camera recognizes movements or position of a patient and transfers him or her to the virtual space. The computer gloves read responses of a patient to the virtual reality. All patients sat in a wheelchair because they could not be trained while standing. The VR training is composed of three programs at a time. "Bird and Ball" is a program in which a patient touches a flying ball with his or her hand and turns it into a bird (Fig. 1-B). The second program, "Coconut," is a program in which a patient catches a coconut falling from a tree while moving around (Fig. 1-C). In the third program, "Container," a patient moves a box carried in a container to the opposite side (Fig. 1-D). In the three programs, patients were told to use non-paretic right hands against the left stimulation. When patients were not able to respond to the stimuli, the therapist encouraged them to respond. Calibration was made for three minutes before the start of the training. There were 150 seconds of resting between programs and 30 seconds between treatments. Each session was repeated three times.
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