Eye Gaze Correlates of Motor Impairment in VR Observation of Motor Actions

Virtual Reality and Eye-Tracking Assessment, and Treatment of Unilateral Spatial Neglect: Systematic Review and Future Prospects

Unilateral spatial neglect (USN) is a disorder characterized by the failure to report, respond to, or orient toward the contralateral side of space to a brain lesion. Current assessment methods often fail to discover milder forms, cannot differentiate between unilateral spatial neglect subtypes and lack ecological validity. There is also a need for treatment methods that target subtypes. Immersive virtual reality (VR) systems in combination with eye-tracking (ET) have the potential to overcome these shortcomings, by providing more naturalistic environments and tasks, with sensitive and detailed measures. This systematic review examines the state of the art of research on these technologies as applied in the assessment and treatment of USN. As we found no studies that combined immersive VR and ET, we reviewed these approaches individually. The review of VR included seven articles, the ET review twelve. The reviews revealed promising results. (1) All included studies found significant group-level differences for several USN measures. In addition, several studies found asymmetric behavior in VR and ET tasks for patients who did not show signs of USN in conventional tests. Particularly promising features were multitasking in complex VR environments and detailed eye-movement analysis. (2) No VR and only a few ET studies attempted to differentiate USN subtypes, although the technologies appeared appropriate. One ET study grouped USN participants using individual heatmaps, and another differentiated between subtypes on drawing tasks. Regarding (3) ecological validity, although no studies tested the prognostic validity of their assessment methods, VR and ET studies utilized naturalistic tasks and stimuli reflecting everyday situations. Technological characteristics, such as the field of view and refresh rate of the head-mounted displays, could be improved, though, to improve ecological validity. We found (4) no studies that utilized VR or ET technologies for USN treatment up until the search date of the 26th of February 2020. In conclusion, VR-ET-based systems show great potential for USN assessment. VR-ET holds great promise for treatment, for example, by monitoring behavior and adapting and tailoring to the individual person's needs and abilities. Future research should consider developing methods for individual subtypes and differential diagnostics to inform individual treatment programs.

Improving Haptic Response for Contextual Human Robot Interaction

For haptic interaction, a user in a virtual environment needs to interact with proxies attached to a robot. The device must be at the exact location defined in the virtual environment in time. However, due to device limitations, delays are always unavoidable. One of the solutions to improve the device response is to infer human intended motion and move the robot at the earliest time possible to the desired goal. This paper presents an experimental study to improve the prediction time and reduce the robot time taken to reach the desired position. We developed motion strategies based on the hand motion and eye-gaze direction to determine the point of user interaction in a virtual environment. To assess the performance of the strategies, we conducted a subject-based experiment using an exergame for reach and grab tasks designed for upper limb rehabilitation training. The experimental results in this study revealed that eye-gaze-based prediction significantly improved the detection time by 37% and the robot time taken to reach the target by 27%. Further analysis provided more insight on the effect of the eye-gaze window and the hand threshold on the device response for the experimental task.

The impact of positive, negative and neutral stimuli in a virtual reality cognitive-motor rehabilitation task: a pilot study with stroke patients

Background

Virtual Reality (VR) based methods for stroke rehabilitation have mainly focused on motor rehabilitation, but there is increasing interest in integrating motor and cognitive training to increase similarity to real-world settings. Unfortunately, more research is needed for the definition of which type of content should be used in the design of these tools. One possibility is the use of emotional stimuli, which are known to enhance attentional processes. According to the Socioemotional Selectivity Theory, as people age, the emotional salience arises for positive and neutral, but not for negative stimuli.

Methods

For this study we developed a cognitive-motor VR task involving attention and short-term memory, and we investigated the impact of using emotional images of varying valence. The task consisted of finding a target image, shown for only two seconds, among fourteen neutral distractors, and selecting it through arm movements. After performing the VR task, a recall task took place and the patients had to identify the target images among a valence-matched number of distractors. Ten stroke patients participated in a within-subjects experiment with three conditions based on the valence of the images: positive, negative and neutral. Eye movements were recorded during VR task performance with an eye tracking system.

Results

Our results show decreased attention for negative stimuli in the VR task performance when compared to neutral stimuli. The recall task shows significantly more wrongly identified images (false memories) for negative stimuli than for neutral. Regression and correlation analyses with the Montreal Cognitive Assessment and the Geriatric Depression Scale revealed differential effects of cognitive function and depressive symptomatology in the encoding and recall of positive, negative and neutral images. Further, eye movement data shows reduced search patterns for wrongly selected stimuli containing emotional content.

Conclusions

The results of this study suggest that it is feasible to use emotional content in a VR based cognitive-motor task for attention and memory training after stroke. Stroke survivors showed less attention towards negative information, exhibiting reduced visual search patterns and more false memories. We have also shown that the use of emotional stimuli in a VR task can provide additional information regarding patient’s mood and cognitive status.

Methodologies, Models and Algorithms for Patients Rehabilitation

INTRODUCTION

This editorial is part of the Focus Theme of Methods of Information in Medicine on "Methodologies, Models and Algorithms for Patients Rehabilitation".

OBJECTIVE

The objective of this focus theme is to present current solutions by means of technologies and human factors related to the use of Information and Communication Technologies (ICT) for improving patient rehabilitation.

METHODS

The focus theme examines distinctive measurements of strengthening methodologies, models and algorithms for disabled people in terms of rehabilitation and health care, and to explore the extent to which ICT is a useful tool in this process.

RESULTS

The focus theme records a set of solutions for ICT systems developed to improve the rehabilitation process of disabled people and to help them in carrying out their daily life.

CONCLUSIONS

The development and subsequent setting up of computers for the patients' rehabilitation process is of continuous interest and growth.