Poster Session 04 Program Schedule
02/15/2024
12:00 pm - 01:15 pm
Room: Majestic Complex (Posters 61-120)
Poster Session 04: Neuroimaging | Neurostimulation/Neuromodulation | Teleneuropsychology/Technology
Final Abstract #93
Development of Virtual Reality Based Smooth Eye Pursuit Exercise for Spatial Neglect in People with Traumatic Brain Injury
Suchir Pongurlekar, Kessler Foundation, West Orange, United States
Megan Rusco, Kessler Foundation, West Orange, United States
Maria Mawhinney, Kessler Foundation, West Orange, United States
Emma Kaplan, Kessler Foundation, West Orange, United States
Peii Chen, Kessler Foundation, West Orange, United States
Category: Visuospatial Functions/Neglect/Agnosia
Keyword 1: visuospatial neglect
Keyword 2: traumatic brain injury
Keyword 3: technology
Objective:
People who suffer from a unilateral brain injury may attend less to their contralesional side and more to their ipsilesional side, which is spatial neglect (SN). As SN is primarily studied in stroke survivors, it is questionable whether treatments developed with stroke survivors are effective for people with traumatic brain injury (TBI). The smooth eye pursuit exercise may be promising, which is supported by evidence from randomized controlled clinical trials in the stroke population. This treatment involves constant supervision of the patient’s eyes watching moving objects projected on a computer screen, which is quite laborious. We aimed to develop a smooth eye pursuit exercise program using virtual reality (VR) technology combined with eye tracking technology. The present study is to determine the feasibility of the VR-based program to be used by TBI survivors with SN.
Participants and Methods:
Individuals who sustained moderate-to-severe TBI participated in the study. We assessed 16 participants for SN using the following assessments: Bells Test, Apples Test, Line Bisection, Scene Copying, Clock Drawing, Rey-O Complex Figure Copying, Single Word Reading, Passage Reading, and 3’s Spreadsheet. Participants who were scored below cutoffs in at least 2 tests were determined to have SN. 3 participants were found having left-sided SN and thus enrolled to the VR session using a VR headset with built-in eye tracking function. The 3 participants were all male. Their ages ranged 32 – 49 years and time post-injury ranged 34 - 281 months.
Before and after the VR session, participants completed a line bisection task and the 3’s Spreadsheet. The VR session started with a two-step eye calibration process, followed by three 5-min blocks of smooth eye pursuit exercise with 2-minute breaks between blocks. The exercise involved the participant following a single dot among many dots moving from right to left (i.e., from the non-neglected to neglected side of space). The breaks consisted of observing pictures of nature to relax the eyes. The Simulator Sickness Questionnaire (SSQ) was administered along with an interview with open-ended questions.
Results:
Participants 1, 2, and 3 completed 117, 19, and 135 pursuits, respectively. Nonetheless, Participant 2 showed immediate improvement of their SN while the other did not, which might be related to the fact that Participant 2 had more severe SN than the other participants. All participants were able to use the VR system properly and reported that the sound and visual effects synchronized well to aid in following the instructions correctly. No adverse effects were reported. Two participants expressed that the exercise was boring and wished it were more interactive and entertaining. Two participants conveyed that although there was merit to using VR as a therapy, they would not want to use it at home.
Conclusions:
VR combined with eye tracking appears to reduce the burden of supervision while delivering the evidence-based treatment of smooth eye pursuit. Adjustments to the VR program exercise based on participant recommendations would be favorable towards further development. A larger sample is needed to determine the treatment efficacy.
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