Spatial neglect therapy with the augmented reality app 'Negami' for active exploration training; A randomized controlled trial

Abstract

Background: A widely applied and effective rehabilitation method in stroke patients suffering from spatial neglect is the 'visual exploration training'. Patients improve their ipsilesional bias of attention and orientation by training of exploration movements and search strategies towards the contralesional side of space. Here we investigate the effectiveness of the augmented reality (AR)-based app 'Negami' for the treatment of spatial neglect in a randomized control trial. Negami combines a visual exploration training with active, contralesionally oriented rotation of eyes, head, and trunk. Methods: Twenty patients with spatial neglect were randomly assigned to the experimental Negami group or to a group receiving standard neglect therapy. Over a period of two weeks, both groups received five training sessions per week. Each session lasted about 25 minutes. Neglect behavior was assessed weekly over a five-week period, with the Negami therapy group receiving a second follow-up assessment at one-to-two-month intervals after completion of training. Results: Both groups improved significantly. While the Negami therapy group improved in four of five neglect tests used, the standard therapy group improved in only one of these tests. We observed significantly better improvement in the Negami group already after the first week of training. This difference was also significant after the end of the training as well as one week after the end of training and remained stable one to two months after the end of treatment. Conclusion: Negami can be used as an effective alternative or addition to current standard neglect therapy, and may even be superior to it.

Competing Interest Statement

The authors have declared no competing interest.

Clinical Trial

DRKS00031446

Funding Statement

This work was supported by Hector Stiftungen, Weinheim (Project M2107).

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics committee of the Medical Faculty of Tuebingen University gave ethical approval for this work (373/2021B02).

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Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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