A virtual reality test battery for assessment and screening of spatial neglect.
BACKGROUND
There is a need for improved screening methods for spatial neglect.


OBJECTIVE
To construct a VR-test battery and evaluate its accuracy and usability in patients with acute stroke.


METHODS
VR-DiSTRO consists of a standard desktop computer, a CRT monitor and eye shutter stereoscopic glasses, a force feedback interface, and software, developed to create an interactive and immersive 3D experience. VR-tests were developed and validated to the conventional Star Cancellation test, Line bisection, Baking Tray Task (BTT), and Visual Extinction test. A construct validation to The Rivermead Behavioral Inattention Test, used as criterion of visuospatial neglect, was made. Usability was assessed according to ISO 9241-11.


RESULTS
Thirty-one patients with stroke were included, 9/31 patients had neglect. The sensitivity was 100% and the specificity 82% for the VR-DiSTRO to correctly identify neglect. VR-BTT and VR-Extinction had the highest correlation (r² = 0.64 and 0.78), as well as high sensitivity and specificity. The kappa values describing the agreement between traditional neglect tests and the corresponding virtual reality test were between 0.47-0.85. Usability was assessed by a questionnaire; 77% reported that the VR-DiSTRO was 'easy' to use. Eighty-eight percent reported that they felt 'focused', 'pleased' or 'alert'. No patient had adverse symptoms. The test session took 15 min.


CONCLUSIONS
The VR-DiSTRO quickly and with a high accuracy identified visuospatial neglect in patients with stroke in this construct validation. The usability among elderly patients with stroke was high. This VR-test battery has the potential to become an important screening instrument for neglect and a valuable adjunct to the neuropsychological assessment.
Fordell
H
H
Department of Clinical Neuroscience, Umea, Sweden. helena.fordell@neuro.umu.se
Bodin
K
K
Bucht
G
G
Malm
J
J
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards*; D010468:Perceptual Disorders / Q000175:diagnosis* / Q000209:etiology; D020521:Stroke / Q000150:complications / Q000175:diagnosis; D011795:Surveys and Questionnaires / Q000592:standards; D013647:Task Performance and Analysis; D014584:User-Computer Interface; D058609:Visual Field Tests / Q000379:methods