Alex Martino Cinnera (IRCSS Sanata Lucia Foundation, 00179, Rome)
Valeria Verna (IRCSS Sanata Lucia Foundation, 00179, Rome)
Aurora Tavernese (IRCSS Sanata Lucia Foundation, 00179, Rome)
Luisa Magnotti (IRCSS Sanata Lucia Foundation, 00179, Rome)
Alessandro Matano (IRCSS Sanata Lucia Foundation, 00179, Rome)
Viviana Betti (IRCSS Sanata Lucia Foundation, 00179, Rome)
Stefano Paolucci (IRCSS Sanata Lucia Foundation, 00179, Rome)
Matteo Marucci (Braintrends Limited, Applied Neuroscience, 00192 Rome)
Giovanni Morone (Department of Life, Health and Environmental Sciences, university of L’Aqiola, 67100 L’Aquila , Italy)
Marco Tramontano (Unit of Occupational Medicine, IRCSS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy)
About one-third of stroke survivors present unilateral spatial neglect (USN) that
negatively impacts the rehabilitation outcome. We reported the study protocol and usability results
of an eye-tracking (ET) biofeedback immersive virtual reality (iVR) protocol. Healthy controls and
stroke patients with and without USN underwent a single session of the three iVR tasks. The
system usability scale (SUS), adverse events (AEs), and ET data were collected and analyzed via
parametric analysis. Twelve healthy controls (six young adults and six older adults) and seven
patients with a diagnosis of single ischemic stroke (four without USN and three with confirmed
diagnosis of USN) completed the usability investigation. SUS results showed good acceptability of
the system for healthy controls and stroke patients without USN. ET results showed a lower
performance for patients with USN concerning healthy controls and stroke patients without USN, in
particular in the exploration of the left visual field. The results showed that the proposed iVR-ET
biofeedback protocol is a safe and well-tolerated technique in patients with USN. The real-time
feedback can induce a performance response supporting its investigation such as a treatment
approach.
We reported the study protocol and usability results of an eye-tracking (ET) biofeedback immersive virtual reality (iVR) protocol. Healthy controls and stroke patients with-and-without USN underwent a single session of the three iVR tasks. The system usability scale (SUS), adverse events (AEs) and ET data were collected and analysed via parametric analysis.
12 healthy controls (6 young and 6 adults) and 7 patients with diagnosis of single ischemic stroke (4 without USN and 3 with confirmed diagnosis of USN) completed the usability investigation. Only one patient with USN reported minor AEs (neck stiffness). SUS results showed a good acceptability of the system for healthy controls and stroke patients without USN, and marginal for USN patients without statistical differences [F(3)=1.33, p=0.4]. ET results showed a lower performance for patients with USN with respect to controls and stroke patients without USN (TASK 1, p<0.001 with respect to each other group and TASK 2, p=0.05 and p=0.03, with respect to young and adult healthy controls, respectively), in particular in the exploration of left visual field (p<0.001 with respect to each other group).
The usability and ET results of the present study suggested that proposed ET biofeedback iVR protocol is a safe and well tolerated technique for the treatment of USN. Despite a single case of neck stiffness due to seating discomfort, no major or minor AEs were encountered. The differences recorded in the ET results across healthy control and stroke patients with-and-without USN support the efficiency of ET biofeedback to induce a performance response and a top-down stimulation of the central nervous system. Finally, ET data can be used also to measure the progress in VF exploration like in usual clinical tools.
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