Ann Rehabil Med.  2024 Apr;48(2):146-154. 10.5535/arm.230028.

Feasibility of Computerized Visuomotor Integration System for Visual Field Defects and Spatial Neglect in Poststroke Patients

• Hong HT
• Jeong MG
• Kim KT

• KMID: 2554790
• DOI: http://doi.org/10.5535/arm.230028

Abstract

Objective
To develop a computerized visuomotor integration system for assessment and training of visual perception impairments and evaluate its safety and feasibility in patients with a stroke. Visual field defects and spatial neglect lead to substantial poststroke impairment. Most diagnostic assessments are anchored in traditional methods, and clinical effects of rehabilitation treatments are limited.
Methods
The CoTras Vision system included two evaluations and four training modules. The evaluation modules were based on the Albert’s test and Star cancellation test, and training modules were based on visual tracking, central-peripheral integration, and visuomotor perception techniques. Bland–Altman plots for agreement with the traditional paper-and-pencil test were performed, and the modified Intrinsic Motivation Inventory, Patient Satisfaction Questionnaire, and Simulator Sickness Questionnaire were conducted.
Results
Ten patients with acute stroke completed the study. Bland–Altman plots revealed good agreements for Albert’s test (mean difference, -0.3±4.5) and Star cancellation test (mean difference, 0.3±0.7). The mean±standard deviation scores of the modified Intrinsic Motivation Inventory, Patient Satisfaction Survey, and Simulator Sickness Questionnaire were 84.7±30.6, 40.5±7.9, and 34.0±34.5 respectively.
Conclusion
The CoTras Vision system is feasible and safe in patients with stroke. Most patients had a high degree of motivation to use the system and did not experience severe adverse events. Further studies are needed to confirm its usefulness in stroke patients with visual field defects and hemineglect symptoms. Furthermore, a large, well-designed, randomized controlled trial will be needed to confirm the treatment effect of the CoTras Vision system.

Keyword

Stroke; Visual field defect; Spatial neglect; Rehabilitation; Visuomotor integration system

Figure

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  Fig. 1. Configuration of the CoTras Vision system (COTRAS).

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  Fig. 2. Functional assessments and rehabilitation training modules of the CoTras Vision system (COTRAS).

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  Fig. 3. Bland–Altman plots of comparison between the CoTras Vision (COTRAS) and paper-and-pencil test. (A) Albert’s test. (B) Star cancellation test.

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  Fig. 4. Total and symptom cluster score of Simulator Sickness Questionnaire. (A) Total score. (B) Symptom cluster score.

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