Virtual reality in neurorehabilitation: a review of its effects on multiple cognitive domains

ABSTRACT

Introduction

Neurological diseases frequently cause adult-onset disability and have increased the demand for rehabilitative interventions. Neurorehabilitation has been progressively relying on computer-assisted programs and, more recently, on virtual reality (VR). Current reviews explore VR-based neurorehabilitation for assessing and treating the most common neurological pathologies. However, none of them explored specifically the impact of VR on multiple cognitive domains.

Areas covered

The present work is a review of 6 years of literature (2015-2020) on VR in neurorehabilitation with the purpose of analyzing its effects on memory, attention, executive functions, language, and visuospatial ability.

Expert opinion

Our review suggests that VR-based neurorehabilitation showed encouraging results for executive functions and visuospatial abilities particularly for both acute and neurodegenerative conditions. Conversely, memory, and attention outcomes are conflicting, and language did not show significant improvements following VR-based rehabilitation. Within five years, it is plausible that VR-based intervention would be provided in standalone and mobile-based platforms that won’t need a PC to work, with reduced latency and improved user interaction.

Keywords:

• Virtual reality
• cognitive rehabilitation
• neurorehabilitation
• memory
• attention
• executive functions
• language
• visuospatial ability

Article Highlights

• Virtual Reality is a promising approach to neurorehabilitation, as documented by several studies over the last 20 years - The heterogeneity of the VR devices, protocols and population of neurological diseases are currently hindering the clear results of VR-based neurorehabilitation

• VR-based neurorehabilitation showed encouraging results for executive functions and visuospatial abilities in both acute and neurodegenerative conditions.

• Several plausible explanations for VR efficacy include neural plasticity, mirror neurons system, embodied simulation, and neurotransmission.

• Currently, different barriers limit a wider dissemination of VR in neurorehabilitation: complex technical set-up, simulation sickness, design and development of 3D interfaces.

• We expect that, in the next 5 years, these barriers will be removed by the diffusion of standalone and mobile-based VR platforms that do not need a PC to work.

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This paper was supported by the Italian Ministry of Health research project “High-end and Low-End Virtual Reality Systems for the Rehabilitation of Frailty in the Elderly” (PE-2013-0235594).