Training with RehAtt™, a stimulating Virtual Reality method to improve attention in stroke patients with neglect
Neglect or hemi-spatial neglect
Spatial neglect, where the patient loses the ability to be attentive regarding what is going on around them is a devastating cognitive handicap after stroke. The brain lesion from an ischemic infarct or bleeding often in the right hemisphere causes a breakdown in neuronal traffic in attention network and it causes impaired attention function. Like difficulties to be aware of and orient towards a person standing on their left side. The impairment is often called hemi spatial neglect, it seems like they neglect to be attentive and act on stimuli in half the world around them, the contra-lesional space. It also includes problems to concentrate, and to stay alert, to read and to orient and to find the route. They often bump in to objects on their left side and neglect the left side of their own body.
Effective training methods for neglect is needed
A new effective method to improve spatial attention is utterly needed because neglect severely affects the chances of whether a patient will regain independence in activities of daily living after stroke rehabilitation.
In a new study from Umea University in Sweden a new training method for neglect is evaluated. The method called RehAtt™, Rehabilitation of Attention, also includes a computerized neglect test battery, a new way to quick and easy measure spatial attention and neglect.
In a so-called virtual reality environment, intensive attention training is made in entertaining 3D games using stereo glasses. The design of each application is designed scientifically to target attention network and neuronal activity. A scanning training is enhanced by stimulating the brain with audio, visual and sensory stimuli in the 3D game. All in the aim to improve spatial attention in an effective way and give transfer of improved function to spatial attention in activities of daily living.
The robotic pen
After stroke the brain lesion often affect the motor function of the hand and in this method the paretic hand is stimulated and activated by the use of a desktop robotic device;
- A pen is connected to it and this enables the user to physically interact with the 3D objects that appear to be coming out of the screen
- The robotic pen activates and control the game, it is a training method also made for stroke patients with a paretic hand
- The objects can be physically felt; they can be touched, moved around and placed in a 3D puzzle
- The level of difficulty in the game is individualized and follow improvements.
The method could be a possibility for millions of stroke patients to improve their spatial attention.
RehAtt™ for training at home
It will be possible to use RehAtt™ for individualized training at home, this with support from OT´s using telemedicine/Skype from the hospital.
The clinical evaluation of the method also includes measurement of improved attention in activities in daily living. A truly effective neglect training is one where people with neglect after stroke can become more independent in their everyday life.
The method is now in use in rehabilitation centers for stroke in Sweden and England. Key-opinion leaders in Stroke care in US, and EU are participating in a Proof of Concept study about feasibility.
The Swedish government has via VINNOVA and Umeå University’s investment found, Umea Biotech and Almi Business Partners contributed to financing the study. Their aim is to support the process to take the RehAtt™ method to become a clinically useful product and prepare it for further evaluation in multicenter research studies.