Effects of a Stimulus Response Task Using Virtual Reality on Unilateral Spatial Neglect: A Randomized Controlled Trial

Kazuya Motomura; Kazu Amimoto; Taku Numao; Fuminari Kaneko

doi:10.1016/j.apmr.2024.05.009

Effects of a Stimulus Response Task Using Virtual Reality on Unilateral Spatial Neglect: A Randomized Controlled Trial

Arch Phys Med Rehabil. 2024 May 13:S0003-9993(24)00997-3. doi: 10.1016/j.apmr.2024.05.009. Online ahead of print.

Authors

Kazuya Motomura¹, Kazu Amimoto², Taku Numao³, Fuminari Kaneko⁴

Affiliations

¹ Department of Rehabilitation, Mishuku Hospital, Meguro, Tokyo, Japan; Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan. Electronic address: k.motomura128@gmail.com.
² Department of Rehabilitation Sciences, Sendai Seiyo Gakuin College, Sendai, Miyagi, Japan.
³ Department of Physical Therapy, Japanese School of Technology for Social Medicine, Koganei, Tokyo, Japan.
⁴ Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, Tokyo, Japan.

PMID: 38750715
DOI: 10.1016/j.apmr.2024.05.009

Abstract

Objective: To investigate the effects of a stimulus response task using virtual reality (VR) for unilateral spatial neglect (USN).

Design: Double-blind randomized controlled trial.

Setting: Acute phase hospital where stroke patients are hospitalized.

Participants: The participants were 42 patients (N=42) with right-hemisphere cerebral damage who had been experiencing USN in their daily lives. They were randomly assigned to 3 groups: a stimulus response task with a background shift (SR+BS group), a stimulus response task without a background shift (SR group), and an object gazing task (control group).

Interventions: The stimulus response task was to search for balloons that suddenly appeared on the VR screen. A background shift was added to highlight the search in the neglected space. The control task was to maintain a controlled gaze on a balloon that appeared on the VR screen. The intervention period was 5 days.

Main outcome measures: The primary outcome was the participants' scores on a stimulus-driven attention test (SAT) using the reaction time. The stimuli of the SAT were divided into 6 blocks of 3 lines on each side (-3 to +3). The secondary outcomes were their scores on the Behavioral Intention Test conventional, Catherine Bergego Scale, and straight ahead pointing tests.

Results: In the SAT, there were significant interaction effects of reaction time between time and group factors in left-2, right+2, and right+3. The SR+BS and SR groups showed significant improvements in the reaction time of left-2 and right+3 compared with the control group. Moreover, the SR+BS group showed a significant improvement in the reaction time of left-2, which was the neglected space, compared with the SR group. However, there were no significant interaction effects of Behavioral Intention Test conventional, Catherine Bergego Scale, and straight ahead pointing.

Conclusions: Our results suggest that the use of stimulus response tasks using VR combined with background shifts may improve left-sided USN.

Keywords: Hemispatial neglect; Rehabilitation; Stroke; Virtual reality; Virtual reality exposure therapy.