Functional Living Skills: A Non-Immersive Virtual Reality Training for Individuals with Major Neurocognitive Disorders

The loss of functional living skills (FLS) is an essential feature of major neurocognitive disorders (M-NCD); virtual reality training (VRT) offers many possibilities for improving FLS in people with M-NCD. The aim of our study was to verify the effectiveness of a non-immersive VRT on FLS for patients with M-NCD. VRT was carried out for 10 to 20 sessions, by means of four 3D apps developed in our institute and installed on a large touch screen. The experimental group (EG) and the control group (CG) included 24 and 18 patients with M-NCD, respectively. They were administered the in vivo test (in specific hospital places reproducing the natural environments) at T1 (pre-training) and T3 (post-training); at T2, only EG was administered VRT. Statistically significant differences between EG and CG in all the in vivo tests were found in the number of correct responses; during VRT, the number of correct responses increased, while the execution times and the number of clues decreased. The improvement in the in vivo tests appeared to be related to the specific VRT applied. The satisfaction of participants with the VRT was moderate to high

Visualization and Interaction Technologies in Serious and Exergames for Cognitive Assessment and Training: A Survey on Available Solutions and Their Validation

Exergames and serious games, based on standard personal computers, mobile devices and gaming consoles or on novel immersive Virtual and Augmented Reality techniques, have become popular in the last few years and are now applied in various research fields, among which cognitive assessment and training of heterogeneous target populations. Moreover, the adoption of Web based solutions together with the integration of Artificial Intelligence and Machine Learning algorithms could bring countless advantages, both for the patients and the clinical personnel, as allowing the early detection of some pathological conditions, improving the efficacy and adherence to rehabilitation processes, through the personalisation of training sessions, and optimizing the allocation of resources by the healthcare system. The current work proposes a systematic survey of existing solutions in the field of cognitive assessment and training. We evaluate the visualization and interaction technologies commonly adopted and the measures taken to fulfil the need of the pathological target populations. Moreover, we analyze how implemented solutions are validated, i.e. The chosen experimental designs, data collection and analysis. Finally, we consider the availability of the applications and raw data to the large community of researchers and medical professionals and the actual application of proposed solutions in the standard clinical practice. Despite the potential of these technologies, research is still at an early stage. Although the recent release of accessible immersive virtual reality headsets and the increasing interest on vision-based techniques for tracking body and hands movements, many studies still rely on non-immersive virtual reality (67.2%), mainly mobile and personal computers, and standard gaming tools for interactions (41.5%). Finally, we highlight that although the interest of research community in this field is increasingly higher, the sharing of dataset (10.6%) and implemented applications (3.8%) should be promoted and the number of healthcare structures which have successfully introduced the new technological approaches in the treatment of their host patients is limited (10.2%)

Remediace kognitivního deficitu u neuropsychiatrických poruch pomocí úloh ve virtuální realitě

Teoretická východiska: Tato práce zkoumá obecnou uplatnitelnost virtuální reality (VR) pro kognitivní remediaci u neuropsychiatrických pacientů. Hlavním cílem práce bylo vytvořit VR úlohy vhodné pro tento účel, posoudit vlastnosti různých VR platforem a stanovit validitu a efektivitu vyvinutého programu u cílové populace. Metoda: Ve studii 1 se zdraví senioři (n = 36) a mladí dospělí (n = 25) zúčastnili nově vyvinuté úlohy Virtual Supermarket Shopping Task (VSST) v imerzivní VR (IVR) nebo neimerzivní VR (non-IVR) za účelem zkoumání jejich charakteristik. Studie 2 hodnotila validitu (n = 21) a spolehlivost (n = 8) Much, nové VR úlohy zaměřené na psychomotorickou rychlost. Ve studii 3 byl VSST administrován 20 pacientům se schizofrenií (SZ) a 20 zdravým kontrolám (HC), aby se vyhodnotila jeho validita. Ve studii 4 se 28 pacientů se schizofrenií nebo depresí zúčastnilo VE programu a standardního programu tužka-papír, aby byla ověřena uplatnitelnost a efektivita obou metod. Výsledky: Ve studii 1 si senioři vedli výrazně hůře v IVR než v non-IVR, kognitivní výkon u mladých dospělých byla stabilní napříč platformami, mladí dospělí preferovali IVR před non-IVR. Studie 2 zjistila významnou korelaci mezi Mouchami a standardními kognitivními testy a test- retest reliabilita přesahovala hodnotu 0,7. Ve studii...Theoretical background: This dissertation investigates the feasibility of virtual reality (VR) for cognitive remediation in neuropsychiatric patients. The main goal was to create VR tasks appropriate for this purpose, assess the characteristics of the applied VR media, and investigate the validity and efficacy of the developed program in the target population. Method: In Study 1, healthy seniors (n = 36) and young adults (n = 25) participated in a newly developed Virtual Supermarket Shopping Task (VSST) in immersive VR (IVR) or non-immersive VR (non-IVR) to investigate their characteristics. Study 2 assessed validity (n = 21) and reliability (n = 8) of a novel VR task focused on psychomotor speed called Flies. In Study 3, VSST was administered to 20 patients with schizophrenia (SZ) and 20 healthy controls (HC) to investigate its validity. Finally, in Study 4, 28 patients with schizophrenia or depression participated in the proposed VE program and standard paper-pencil remediation approach to investigate feasibility and efficacy. Results: In Study 1, the seniors performed significantly worse in IVR than in non-IVR, cognitive performance in young adults was stable across different VR media, the young adults preferred IVR over non-IVR. Study 2 found a significant correlation between the Flies and...Department of Physiology 3FM CUÚstav fyziologie 3. LF UK3. lékařská fakultaThird Faculty of Medicin

Virtual Representations for Cybertherapy: A Relaxation Experience for Dementia Patients

The development of serious games has enabled new challenges for the healthcare sector in psychological, cognitive and motor rehabilitation. Thanks to Virtual Reality, stimulating and interactive experiences can be reproduced in a safe and controlled environment. This chapter illustrates the experimentation conducted in the hospital setting for the non-pharmacological treatment of cognitive disorders associated with Dementia. The therapy aims to relax patients of the agitation cluster through a gaming approach through the immersion in multisensory and natural settings in which sound and visual stimuli are provided. The study is supported by a technological architecture, including the Virtual Wall system for stereoscopic wall projection and rigid body tracking

Recommendations for the non-pharmacological treatment of apathy in brain disorders

Apathy is a common neuropsychiatric syndrome observed across many neurocognitive and psychiatric disorders. Although there are currently no definitive standard therapies for the treatment of apathy, non-pharmacological treatment (NPT) is often considered to be at the forefront of clinical management. However, guidelines on how to select, prescribe and administer NPT in clinical practice are lacking. Furthermore, although new Information and Communication Technologies (ICT) are beginning to be employed in NPT, their role is still unclear. The objective of the present work is to provide recommendations for the use of NPT for apathy, and to discuss the role of ICT in this domain, based on opinions gathered from experts in the field. The expert panel included 20 researchers and healthcare professionals working on brain disorders and apathy. Following a standard Delphi methodology, experts answered questions via several rounds of web-surveys, and then discussed the results in a plenary meeting. The experts suggested that NPT are useful to consider as therapy for people presenting with different neurocognitive and psychiatric diseases at all stages, with evidence of apathy across domains. The presence of a therapist and/or a caregiver is important in delivering NPT effectively, but parts of the treatment may be performed by the patient alone. NPT can be delivered both in clinical settings and at home. However, while remote treatment delivery may be cost and time-effective, it should be considered with caution, and tailored based on the patient's cognitive and physical profile and living conditions

The Use of Virtual Reality in the Science of Psychology

With the evolution of technology, digital gaming became a more holistic and realistic experience that engages all senses. This novel capacity was seized by Psychological Science. The aim of this literature review was to describe some of the usages of Virtual Reality (VR), specifically in the domains of Developmental, Clinical, Social, Organizational, Athletic Psychology and Neuropsychology. Some of the findings were that VR can promote children’s socialization and self-control in the case of Developmental Psychology. Research on Clinical Psychology has shown that VRT contributes to phobia treatment and can help analyze negative self-image in individuals with eating disorders. In the area of Social Psychology, it can reduce prejudice and enhance prosocial behavior, by providing the ability to manipulate variables and achieving high experimental control and ecological validity. Furthermore, it can enhance employees’ productivity and help them cope with stress in Organizational Psychology and boost athletes’ motivation and decision making in Athletic Psychology. In Neuropsychology, VR gives the potential of early diagnosis and rehabilitation of neuropsychological complications of Traumatic Brain Injury, Brain Stroke, Parkinson’s Disease and facilitates the reduction of Autism Index. Overall, psychological research, diagnosis and treatment via VR seems so far to be a rich and promising field for further investigation that will possibly improve different people’s quality of life

Efficacy and Moderators of Virtual Reality for Cognitive Training in People with Dementia and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

Background: Mild cognitive impairment (MCI) and dementia result in cognitive decline which can negatively impact everyday functional abilities and quality of life. Virtual reality (VR) interventions could benefit the cognitive abilities of people with MCI and dementia, but evidence is inconclusive. Objective: To investigate the efficacy of VR training on global and domain-specific cognition, activities of daily living and quality of life. To explore the influence of priori moderators (e.g., immersion type, training type) on the effects of VR training. Adverse effects of VR training were also considered. Methods: A systematic literature search was conducted on all major databases for randomized control trial studies. Two separate meta-analyses were performed on studies with people with MCI and dementia. Results: Sixteen studies with people with MCI and four studies with people with dementia were included in each meta-analysis. Results showed moderate to large effects of VR training on global cognition, attention, memory, and construction and motor performance in people with MCI. Immersion and training type were found to be significant moderators of the effect of VR training on global cognition. For people with dementia, results showed moderate to large improvements after VR training on global cognition, memory, and executive function, but a subgroup analysis was not possible. Conclusion: Our findings suggest that VR training is an effective treatment for both people with MCI and dementia. These results contribute to the establishment of practical guidelines for VR interventions for patients with cognitive decline

How immersive virtual reality methods may meet the criteria of the National Academy of Neuropsychology and American Academy of Clinical Neuropsychology:A software review of the Virtual Reality Everyday Assessment Lab (VR-EAL)

International audienceClinical tools involving immersive virtual reality (VR) may bring several advantages to cognitive neuroscience and neuropsychology. However, there are some technical and methodological pitfalls. The American Academy of Clinical Neuropsychology (AACN) and the National Academy of Neuropsychology (NAN) raised 8 key issues pertaining to Computerized Neuropsychological Assessment Devices. These issues pertain to: (1) the safety and effectivity; (2) the identity of the end-user; (3) the technical hardware and software features; (4) privacy and data security; (5) the psychometric properties; (6) examinee issues; (7) the use of reporting services; and (8) the reliability of the responses and results. The VR Everyday Assessment Lab (VR-EAL) is the first immersive VR neuropsychological battery with enhanced ecological validity for the assessment of everyday cognitive functions by offering a pleasant testing experience without inducing cybersickness. The VR-EAL meets the criteria of the NAN and AACN, addresses the methodological pitfalls, and brings advantages for neuropsychological testing. However, there are still shortcomings of the VR-EAL, which should be addressed. Future iterations should strive to improve the embodiment illusion in VR-EAL and the creation of an open access VR software library should be attempted. The discussed studies demonstrate the utility of VR methods in cognitive neuroscience and neuropsychology

Flexible Virtual Reality System for Neurorehabilitation and Quality of Life Improvement

As life expectancy is mostly increasing, the incidence of many neurological disorders is also constantly growing. For improving the physical functions affected by a neurological disorder, rehabilitation procedures are mandatory, and they must be performed regularly. Unfortunately, neurorehabilitation procedures have disadvantages in terms of costs, accessibility and a lack of therapists. This paper presents Immersive Neurorehabilitation Exercises Using Virtual Reality (INREX-VR), our innovative immersive neurorehabilitation system using virtual reality. The system is based on a thorough research methodology and is able to capture real-time user movements and evaluate joint mobility for both upper and lower limbs, record training sessions and save electromyography data. The use of the first-person perspective increases immersion, and the joint range of motion is calculated with the help of both the HTC Vive system and inverse kinematics principles applied on skeleton rigs. Tutorial exercises are demonstrated by a virtual therapist, as they were recorded with real-life physicians, and sessions can be monitored and configured through tele-medicine. Complex movements are practiced in gamified settings, encouraging self-improvement and competition. Finally, we proposed a training plan and preliminary tests which show promising results in terms of accuracy and user feedback. As future developments, we plan to improve the system's accuracy and investigate a wireless alternative based on neural networks.Comment: 47 pages, 20 figures, 17 tables (including annexes), part of the MDPI Sesnsors "Special Issue Smart Sensors and Measurements Methods for Quality of Life and Ambient Assisted Living