F. D. Rose

Training in virtual environments: transfer to real world tasks and equivalence to real task training

Virtual environments (VEs) are extensively used in training but there have been few rigorous scientific investigations of whether and how skills learned in a VE are transferred to the real world. This research aimed to measure and evaluate what is transferring from training a simple sensorimotor task in a VE to real world performance. In experiment 1, real world performances after virtual training, real training and no training were compared. Virtual and real training resulted in equivalent levels of post-training performance, both of which significantly exceeded task performance without training. Experiments 2 and 3 investigated whether virtual and real trained real world performances differed in their susceptibility to cognitive and motor interfering tasks (experiment 2) and in terms of spare attentional capacity to respond to stimuli and instructions which were not directly related to the task (experiment 3). The only significant difference found was that real task performance after training in a VE was less affected by concurrently performed interference tasks than was real task performance after training on the real task. This finding is discussed in terms of the cognitive load characteristics of virtual training. Virtual training therefore resulted in equivalent or even better real world performance than real training in this simple sensorimotor task, but this finding may not apply to other training tasks. Future research should be directed towards establishing a comprehensive knowledge of what is being transferred to real world performance in other tasks currently being trained in VEs and investigating the equivalence of virtual and real trained performances in these situations.

Social and behavioural effects of traumatic brain injury in children

Traumatic brain injury (TBI) is the leading cause of death and permanent disability in children and adolescents. Although cognitive and behavioural effects have now been reported for all degrees of TBI severity in children, other aspects of functioning which might be related (such as psychosocial adjustment), have been neglected. In the present study the social and behavioural effects of TBI were assessed by comparing 27 TBI children with 27 controls. TBI children demonstrated significantly lower levels of self-esteem and adaptive behaviour, and higher levels of loneliness, maladaptive behaviour and aggressive/antisocial behaviour. These findings confirm the previously demonstrated detrimental effects of TBI on childrens behavioural functioning and offer new evidence for the detrimental effects of TBI on childrens social functioning.

VIRTUAL REALITY : AN ASSISTIVE TECHNOLOGY IN NEUROLOGICAL REHABILITATION

The need for improved neurological rehabilitation strategies is self-evident. Recent developments in the computer technology of virtual reality hold the promise of exciting progress in this area. In this paper four areas of potential application of virtual reality to neurological rehabilitation are reviewed.

A preliminary investigation into the use of virtual environments in memory retraining after vascular brain injury: indications for future strategy?

PURPOSE In a preliminary investigation of the use of Virtual Environments (VEs) in neurorehabilitation, this study compares the effects of active and passive experience of a VE on two types of memory in vascular brain injury patients and controls. METHOD Forty-eight patients with vascular brain injury and 48 non-impaired control participants were randomly assigned to active and passive VE conditions. The active participants explored a virtual bungalow seeking a particular object; the passive participants observed, but did not control movement through the VE, also seeking the object. Afterwards, both active and passive participants completed spatial recognition and object recognition tests. RESULTS Expectedly, the patients were impaired relative to the controls but were able to perform the virtual tasks. Active participation in the VE enhanced memory for its spatial layout in both patients and controls. On object recognition, active and passive patients performed similarly, but passive controls performed better than active controls. CONCLUSIONS The findings are discussed in relation to their implications for memory rehabilitation strategies.

Assessing stroke patients' prospective memory using virtual reality.

There is a dearth of empirical evidence about prospective memory (remembering to perform actions in the future) in stroke patients. A probable reason for this is that it is difficult to perform a realistic and controlled assessment of prospective memory ability in a rehabilitation setting. Virtual reality may provide a solution to this difficulty by allowing prospective memory to be tested in a simulation of a real-life situation whilst retaining a laboratory level of scientific control. This exploratory study assessed the performance of stroke patients and age-matched control participants on event-, time- and activity-based prospective memory retrieval tasks in a personal computer-based virtual environment. Stroke patients were severely impaired at the event- and activity-based tasks compared with age-matched controls, but only marginally impaired at the time-based task. The additional knowledge gained from this form of assessment could direct rehabilitation more effectively towards specific impairments of individual patients.

The role of virtual reality technology in the assessment and training of inexperienced powered wheelchair users

Purpose : The current paper provides quantitative and qualitative data concerning the application of two virtual environments to the assessment and training of inexperienced powered wheelchair users, both in terms of the ability to control the chair accurately without hitting objects in the environment (manoeuvrability) and in terms of being able to find ones way around a complex environment without becoming lost (route-finding). Method : Six novice powered wheelchair users participated in the project, completing either the manoeuvrability or route finding components of the study. Performance measures were taken in real life pre and post training and throughout virtual reality sessions. Participants also completed a questionnaire regarding the aesthetics of the virtual environments and aspects of the powered wheelchair simulation. Results : The participants rated the aesthetics of the virtual environments positively and engaged well with the virtual system. However, they found the manoeuvrability tasks considerably more difficult in virtual reality (VR) than in real life. Some difficulties with controlling the simulated wheelchair were apparent. Some improvements on virtual and real life manoeuvrability tasks and route finding were noted following conventional and virtual training. Conclusions : The study indicated that the two virtual environments represent a potentially useful means of assessing and training novice powered wheelchair users. The virtual environments however must become less challenging if they are to represent a motivating and effective means of improving performance. Further development of the way in which wheelchair movement is controlled and simulated represents a key element in this multi stage project.

An evaluation of the efficacy of training people with learning disabilities in a virtual environment.

Purpose : To evaluate the efficacy of using a virtual kitchen for vocational training of people with learning disabilities. Method : Twenty four catering students with learning disabilities participated in the study. Half the students were currently being trained in the kitchen on which the virtual kitchen was modelled but the remaining students were unfamiliar with this kitchen. Students were first pre-tested on four food preparation tasks and identification of 12 hazards in their own training kitchens. They were subsequently trained on one food preparation task and three hazards in their own training kitchens, one food preparation task and three hazards in the virtual kitchen, and one food preparation task and three hazards in specially designed workbooks. They were then retested in their own training kitchens on all the food preparation tasks and all the hazards. Results : Virtual training was found to be as beneficial as real training and more beneficial than workbook and no training in the food preparation tasks. However, virtual, real and workbook training were found to be equally beneficial in the hazard identification task. Students who were unfamiliar with the kitchen on which the virtual kitchen was modelled benefited from virtual training to the same extent as students who were familiar with the kitchen. Conclusions : Vocational students with learning disabilities were able to use the virtual environment and were motivated to learn using this training method. Depending on the task being trained, virtual training had a more beneficial effect on real task performance than workbook training, even when the virtual kitchen was not modelled on the real training kitchen.

An exploratory investigation into the usability and usefulness of training people with learning disabilities in a virtual environment.

Purpose : Two studies sought to answer the following questions. Are people with learning disabilities capable of using a virtual environment? Are they motivated to learn using this training method? Do they show any benefit from using a virtual environment? Does any benefit transfer to improved real world performance? Method : In the first study, 30 students with learning disabilities were sequentially allocated to an active or a passive experimental group. Active participants explored a virtual bungalow searching for a toy car. Passive participants watched the exploration undertaken by the preceding active participant and searched for the toy car. All participants then performed spatial and object recognition tests of their knowledge of the virtual environment. In the second study, the errors of 45 participants on a real steadiness tester task were noted before they were randomly allocated to three groups--a real training group, a virtual training group and a no training group. After training, the participants performed a second test trial on the real steadiness tester. Results : The students were capable of using a virtual environment and were motivated to use this training method. Active exploration of a virtual environment was found to enhance their memory of the spatial layout of the bungalow but not their memory of the virtual objects. In the second study, virtual training was found to transfer to real task performance. Conclusions : These two laboratory-based studies provide answers to four important questions concerning virtual training of people with learning disabilities. Hopefully, the findings will encourage this training aid to be used more widely.

Virtual enriched environments in paediatric neuropsychological rehabilitation following traumatic brain injury: Feasibility, benefits and challenges

A frequent consequence of traumatic brain injury (TBI) is a significant reduction in patients’ cerebral activation/arousal, which clinicians agree is not conducive to optimal rehabilitation outcomes. In the context of paediatric rehabilitation, sustained periods of inactivity are particularly undesirable, as contemporary research has increasingly called into question the Kennard principle that youth inherently promotes greater neural plasticity and functional recovery following TBI. Therefore, the onus to create rehabilitation conditions most conducive to harnessing plasticity falls squarely on the shoulders of clinicians. Having noted the efficacy of environmental enrichment in promoting neural plasticity and positive functional outcomes in the animal literature, some researchers have suggested that the emerging technology of Virtual Reality (VR) could provide the means to increase patients’ cerebral activation levels via the use of enriched Virtual Environments (VEs). However, 10 years on, this intuitively appealing concept has received almost no attention from researchers and clinicians alike. This paper overviews recent research on the benefits of enriched environments in the injured brain and identifies the potential and challenges associated with implementing VR-based enrichment in paediatric neuropsychological rehabilitation.

Virtual Reality: A new prosthesis for brain injury rehabilitation

Virtual Reality (VR) technology is a relatively new application to rehabilitation medicine, yet it offers considerable potential to achieve significant successes in assessment, treatment and improved outcome, thereby increasing our knowledge of neuroplasticity. The capabilities of VR are especially evident in neurological rehabilitation, where cognitive and behavioural problems often interact with physical impairments to reduce the overall level of functioning and interaction. The need for effective interventions in neurological rehabilitation demands communication and collaboration between disciplines. This paper presents some of the current areas of the clinical applications of VR, emphasising the link between experimental evidence on recovery after brain damage and the clinical problems encountered in a ward setting.