Michael Gaebler, PhD, post doc researcher
MPI for Human Cognitive & Brain Sciences
Leipzig, Magdeburg, Berlin
Where is your clinic / research institution located?
The project “Virtual worlds for digital diagnostics and cognitive rehabilitation” (VReha) is funded by the German Federal Ministry of Education and Research. It comprises scientific (MPI Human Cognitive & Brain Sciences), technical (Fraunhofer HHI, HASOMED), and clinical partners (Charité – Universitätsmedizin Berlin; University of Leipzig) in Germany’s Northeast (Leipzig, Magdeburg, Berlin).
What patient populations do you serve? How many per year?
We develop immersive VR applications to support the diagnosis and rehabilitation of cognitive impairments. For the ”immersive Virtual Memory Task” (see photo), with which one can test and train spatial memory, we’re currently establishing the feasibility in different groups of neurological patients (e.g., stroke and Alzheimer’s Disease).
What VR rehab system(s) do you have installed?
Our setup consists of an Oculus Rift head-mounted display in combination with a depth-sensing camera (Leap Motion) to track the user’s hands. In addition, we are currently porting our toolbox to the Oculus Quest.
What benefits do you gain from using this VR rehab system?
A major benefit of our system, as compared to traditional psychometric assessments, is its close link to everyday settings (e.g., household environment). It better reflects the real world’s demands on the cognitive capacities of spatial attention and depth perception than comparable screen-based (2D) or paper-and-pencil procedures. Our user interaction is based on gesture recognition—rendering the use of handheld controllers unnecessary—to enable a more naturalistic interaction. The continuously measured behavioral parameters (such as processing speed, pauses, movement directions) allow conclusions about underlying cognitive processes. These measurements are observer-independent and therefore less prone to errors.
What problems did/do you have with using these systems?
As we use commercially available hardware, we encountered some issues due to changes in the companies’ market strategies (e.g., discontinuation of the Microsoft Kinect). While rapid developments, especially in the hardware sector, allow for continuously more efficient and affordable setups, it can be challenging to quickly adapt to these changes. Unexpectedly, there were hardly any difficulties concerning cybersickness. Patients tolerated the testing well and were highly motivated to take part in the study.
Are you involved in clinical research using VR rehab systems? If so, please describe briefly.
The main aim of the VReha project is to develop, evaluate, and use virtual worlds for cognitive assessment and rehabilitation. We are currently conducting several feasibility studies in neurological patients with a wide spectrum of pathologies (vascular, traumatic, inflammatory). We are also running a larger systematic clinical study in patients with Mild Cognitive Impairment due to neurobiologically probable Alzheimer’s Disease. We also developed and currently evaluate a rehabilitation program, which is integrated with the assessment, so that, for example, difficulty levels and training strategies are adapted to the patients’ performance in the diagnostic task. We are happy to have received the best demo prize at the ICVR 2019 in Tel Aviv (see photo).
What do you see as the most important challenge for VR rehab research and development?
There are more straightforward challenges like decreasing the XR hardware costs and increasing the availability of devices, preventing or solving cybersickness, ensuring connectivity in remote regions (e.g., with 5G) as well as data security. Other challenges are bringing together (or establishing communication between) developers, scientists, and clinicians as well as properly validating XR applications (i.e., sorting what works and what doesn’t) to fully leverage XR’s potential. For example, systematic clinical trials with larger samples are needed for the standardization of paradigms and to increase the quality of scientific evidence.
(See full article in the ISVR Newsletter Issue 17)