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Virtual reality training for stroke
patients with navigation impairment
Michiel Claessen
Anne Visser-Meily
Elbrich Jagersma
Ineke van der Ham
Navigation ability:
“The cognitive processes needed to find your way around
in familiar and unfamiliar environments.”
From a cognitive point of view:
Navigation is a complex construct
• Landmarks and their position
• Place-action associations
• Memory for order
• Sense of direction
• Cognitive map
• …
Navigation ability
• Brain damage (i.e. stroke) can result in navigation
impairment
• Navigation ability is positively correlated to quality of life,
mobility, and autonomy
• Usually not impaired on all aspects of navigation ability
– Pattern of strengths and weaknesses
Navigation ability
Impact of navigation impairment
Van der Ham et al., 2010
- Navigation training should be based on each
patient’s navigational strengths and weaknesses
Navigation training
• Assessment of navigational strengths and weaknesses
• Virtual environment of German city Tübingen
• 6 stroke patients
• 3 to 5 one-hour sessions
• Exercises
Example of an exercise:
Draw the route into this map of Virtual Tübingen
Movie of a route:
Another example of an exercise:
Plan a route using the map:
Follow the route in Virtual Tübingen:*
Results
Three types of findings:
• 1 patient: improvement on 9 out of 10 subtasks
• 4 patients: partial improvement, mostly on trained subtasks
• 1 patient: improvement on 1 subtask
Results
• Navigation strategy can be influenced or changed
• Feasibility of the dynamic virtual environment was high
• Virtual Tübingen was judged as realistic by the patients
Future research
• Practice independently at home
• Extensive virtual environment
• Navigation (training) game:
– Assessment
– Selection of appropriate exercises
– Provide feedback
– Track progress
