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Author Spotlight: Rehabilitation of Stroke Patients With a Digital Occupational Training System

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Cognitive Training With Head-Mounted Display Virtual Reality in Neurorehabilitation: Pilot Randomized Controlled

Julian Specht¹, Barbara Stegmann¹, Hanna Gross²

¹SRH University of Applied Sciences Heidelberg, Department of Applied Psychology, Heidelberg, Germany.

JMIR Serious Games

|July 21, 2023

Summary

Immersive virtual reality (VR) significantly improved cognitive functions like planning and problem-solving in stroke patients compared to standard care. This VR approach shows promise for neurorehabilitation, enhancing daily living skills.

Keywords:

cognitive rehabilitation neurorehabilitation psychology stroke virtual reality

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Area of Science:

Neuroscience
Rehabilitation Technology
Clinical Trials

Background:

Neurological rehabilitation is rapidly advancing with new technologies.
Stroke is a prevalent condition, yet cognitive rehabilitation often lags technologically.
Virtual reality (VR) offers potential to bridge the gap in cognitive rehabilitation, improving daily living preparation.

Purpose of the Study:

To investigate immersive VR for cognitive rehabilitation in inpatient neurorehabilitation.
To compare the effectiveness of a VR serious game (integrating daily activities and cognitive paradigms) against conventional computerized cognitive training.
To hypothesize VR superiority in cognitive abilities, patient-reported outcomes, and transfer to daily life.

Main Methods:

A pilot randomized controlled trial involving 42 inpatient neurorehabilitation patients with acute brain affection (Mini Mental Status Test score >20).
Participants were randomized into two groups: VR treatment (n=21) or conventional computerized cognitive training (n=21).
Intervention included daily life scenarios in VR (e.g., kitchen) focusing on executive functions, with a minimum of 18 sessions; cognitive status and quality of life were assessed pre- and post-intervention.

Main Results:

Significant improvements were observed in the VR group for planning, executive control, and problem-solving (P=.046, Bonferroni P=.02).
The VR group showed a nonsignificant trend towards improved visual speed (P=.09, Bonferroni P=.02).
No significant cognitive improvements were detected in the control group between baseline and follow-up (all P>.05).

Conclusions:

Immersive VR training demonstrated greater effectiveness than standard care for specific cognitive domains in stroke patients.
These findings support the expanded use and investigation of VR training, incorporating daily living activities, for neurological disorders with cognitive dysfunction.