title: Navigation strategy training using virtual reality in six chronic stroke patients: A novel and explorative approach to the rehabilitation of navigation impairment.
abstract: Recent studies have shown that navigation impairment is a common complaint after brain injury. Effective training programmes aiming to improve navigation ability in neurological patients are, however, scarce. The few reported programmes are merely focused on recalling specific routes rather than encouraging brain-damaged patients to use an alternative navigation strategy, applicable to any route. Our aim was therefore to investigate the feasibility of a (virtual reality) navigation training as a tool to instruct chronic stroke patients to adopt an alternative navigation strategy. Navigation ability was systematically assessed before the training. The training approach was then determined based on the individual pattern of navigation deficits of each patient. The use of virtual reality in the navigation strategy training in six middle-aged stroke patients was found to be highly feasible. Furthermore, five patients learned to (partially) apply an alternative navigation strategy in the virtual environment, suggesting that navigation strategies are mouldable rather than static. In the evaluation of their training experiences, the patients judged the training as valuable and proposed some suggestions for further improvement. The notion that the navigation strategy people use can be influenced after a short training procedure is a novel finding and initiates a direction for future studies.
authors.affiliation: a Experimental Psychology , Helmholtz Institute, Utrecht University , Utrecht , The Netherlands.|b Brain Centre Rudolf Magnus and Centre of Excellence for Rehabilitation Medicine , University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht , The Netherlands.
authors.forename: Michiel H G
authors.initials: MH
authors.lastname: Claessen
authors.affiliation: a Experimental Psychology , Helmholtz Institute, Utrecht University , Utrecht , The Netherlands.
authors.forename: Ineke J M
authors.initials: IJ
authors.lastname: van der Ham
authors.affiliation: c De Hoogstraat Rehabilitation , Utrecht , The Netherlands.
authors.forename: Elbrich
authors.initials: E
authors.lastname: Jagersma
authors.affiliation: b Brain Centre Rudolf Magnus and Centre of Excellence for Rehabilitation Medicine , University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht , The Netherlands.
authors.forename: Johanna M A
authors.initials: JM
authors.lastname: Visser-Meily
mesh_terms: D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D065854:Spatial Navigation; D020521:Stroke / Q000503:physiopathology* / Q000523:psychology; D000071939:Stroke Rehabilitation / Q000379:methods*; D013813:Therapy, Computer-Assisted / Q000379:methods; D014584:User-Computer Interface
keywords: Navigation strategy training; Neuropsychological rehabilitation; Route and survey knowledge; Stroke patients; Virtual reality