title: A virtual reality environment for evaluation of a daily living skill in brain injury rehabilitation: reliability and validity.
abstract: OBJECTIVE
  To establish the stability and validity of information collected in a virtual reality environment from persons with traumatic brain injury (TBI).
  
  
  METHODS
  Prospective correlation design to examine 3-week test-retest results for equivalence reliability between computer-simulated and natural environments.
  
  
  METHODS
  A residential rehabilitation center for brain injury.
  
  
  METHODS
  Fifty-four consecutive patients with TBI who received comprehensive rehabilitation services and who were at different stages of recovery.
  
  
  METHODS
  An immersive virtual kitchen was developed in which a meal preparation task involving multiple steps was performed. The subjects completed meal preparation both in a virtual reality kitchen and an actual kitchen twice over a 3-week period.
  
  
  METHODS
  Time and errors on task completion using virtual reality assessment, actual kitchen performance (analogous to the virtual reality environment), occupational therapy (OT) evaluation, and neuropsychologic tests.
  
  
  RESULTS
  The stability of performance using the simulated virtual environment was estimated with intraclass correlation coefficients (ICCs). The ICC value for total performance, based on all steps involved in the meal preparation task, was.76 (P<.01). The construct validity of the simulated environment was examined by correlating performance in the virtual environment with that in the actual kitchen (r=.63, P<.01), the OT evaluation (r=.30, P=.05 for meal preparation; r=.40, P=.01 for cognitive subskills), and neuropsychologic tests (r=.56, P<.01 for the full-scale intelligence quotient [IQ]; r=.40, P<.01 for the verbal IQ; r=.56, P<.01 for the performance IQ). Finally, a multiple regression analysis revealed that the virtual reality environment test was a good predictor for the actual assessment kitchen (beta=.35, P=.01).
  
  
  CONCLUSIONS
  The virtual reality system showed adequate reliability and validity as a method of assessment in persons with brain injury.
authors.affiliation: Division of Rehabilitation Sciences, School of Allied Health Sciences, University of Texas Medical Branch, Galveston, TX 77555, USA.
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.forename: Beatriz C
authors.initials: BC
authors.lastname: Abreu
authors.forename: Gary S
authors.initials: GS
authors.lastname: Seale
authors.forename: Brent
authors.initials: B
authors.lastname: Masel
authors.forename: Charles H
authors.initials: CH
authors.lastname: Christiansen
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Ottenbacher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001925:Brain Damage, Chronic / Q000209:etiology / Q000534:rehabilitation*; D001930:Brain Injuries / Q000150:complications / Q000534:rehabilitation*; D003072:Cognition Disorders / Q000209:etiology / Q000534:rehabilitation*; D003198:Computer Simulation; D003194:Computer-Assisted Instruction / Q000379:methods; D004185:Disability Evaluation; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009788:Occupational Therapy / Q000379:methods*; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014584:User-Computer Interface