Assessment of Spatial Neglect with a Virtual Wheelchair Navigation Task

Abstract

We report data from 9 participants with right hemisphere stroke on a new virtual reality (VR) wheelchair navigation test designed to assess lateralized spatial attention and neglect. The test consists of a virtual winding path along which participants must navigate (or be navigated by an experimenter) as they name objects encountered along the way. There are 4 VR task conditions, obtained by crossing the factors array complexity (simple, complex) and driver (participant, experimenter). Participants performed the VR task, a real-life wheelchair navigation task, and a battery of tests assessing arousal, visual attention under secondary task demands, and neglect. The VR test showed sensitivity to both array complexity and driver, with best performance occurring in the experimenter-navigated, simple array condition. The VR test also showed high correlations with the wheelchair navigation test, and these correlations were in many instances higher than those between traditional clinical neglect tests and the wheelchair navigation task. Moreover, the VR test detected lateralized attention deficits in participants whose performance was within the normal range on other neglect tests. We conclude that the VR task is sensitive to factors likely to affect the severity of neglect in the daily environment, and shows promise as an efficient, easily administered measure of real-life wheelchair navigation