title: RehAtt - scanning training for neglect enhanced by multi-sensory stimulation in Virtual Reality.
abstract: There is a lack of effective treatment for neglect. We have developed a new training method, RehAtt™. The objective of this study was to determine whether RehAtt™ improves spatial attention in chronic neglect after stroke.
  
  
  
  RehAtt™ consists of a computer with monitor, 3D glasses, and a force feedback interface (Robotic pen) giving sensory motor activation to the contra-lesional arm. The software combines visual scanning training with multi-sensory stimulation in 3D virtual reality (VR) game environment. Fifteen stroke patients with chronic neglect (duration > 6 month) had repeated baseline evaluations to confirm stability of symptoms. There were no test-retest effects for any of the tests. Thereafter, all patients trained 15 h in RehAtt™ (3 × 1 h for 5 weeks). A neglect test battery and Catherine Bergego Scale, CBS, were used to assess behavioral outcome after intervention. CBS was also used at a 6-month follow-up.
  
  
  
  Using repeated measurement analysis improvements due to the training were found for Star cancellation test (p = 0.006), Baking tray task (p < 0.001), and Extinction test (p = 0.05). In the Posner task improvements were seen fewer missed targets (p = 0.024). CBS showed improvements in activities of daily life immediately after training (p < 0.01). After 6 months the patients still reported improvement in CBS.
  
  
  
  RehAtt™ is a new concept for rehabilitation of neglect. Training with the VR-method improved spatial attention and showed transfer to improved spatial attention in activities of daily living in chronic neglect. Our results are promising and merit further studies.
authors.affiliation: a Department of Pharmacology and Clinical Neuroscience , Umeå University , Sweden.
authors.forename: Helena
authors.initials: H
authors.lastname: Fordell
authors.affiliation: b Department of Computing Science (HPC2N and UMIT) , Umeå University , Sweden.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Bodin
authors.affiliation: c Department of Radiation Sciences , Umeå University , Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Eklund
authors.affiliation: a Department of Pharmacology and Clinical Neuroscience , Umeå University , Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Malm
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001288:Attention / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010468:Perceptual Disorders / Q000209:etiology / Q000534:rehabilitation*; D013028:Space Perception / Q000502:physiology*; D020521:Stroke / Q000150:complications / Q000628:therapy*; D000071939:Stroke Rehabilitation / Q000295:instrumentation / Q000379:methods*; D014163:Transfer, Psychology; D000076142:Virtual Reality
keywords: Attention, treatment, virtual reality, stroke; Cognitive rehabilitation; Spatial neglect