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A “virtually minimal” visuo-haptic training of attention in severe traumatic brain injury

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Title: A “virtually minimal” visuo-haptic training of attention in severe traumatic brain injury
Author(s): Dvorkin, Assaf Y; Ramaiya, Milan; Larson, Eric B; Zollman, Felise S; Hsu, Nancy; Pacini, Sonia; Shah, Amit; Patton, James L
Subject(s): Virtual reality Robotics Attention
Abstract: Background: Although common during the early stages of recovery from severe traumatic brain injury (TBI), attention deficits have been scarcely investigated. Encouraging evidence suggests beneficial effects of attention training in more chronic and higher functioning patients. Interactive technology may provide new opportunities for rehabilitation in inpatients who are earlier in their recovery. Methods: We designed a “virtually minimal” approach using robot-rendered haptics in a virtual environment to train severely injured inpatients in the early stages of recovery to sustain attention to a visuo-motor task. 21 inpatients with severe TBI completed repetitive reaching toward targets that were both seen and felt. Patients were tested over two consecutive days, experiencing 3 conditions (no haptic feedback, a break-through force, and haptic nudge) in 12 successive, 4-minute blocks. Results: The interactive visuo-haptic environments were well-tolerated and engaging. Patients typically remained attentive to the task. However, patients exhibited attention loss both before (prolonged initiation) and during (pauses during motion) a movement. Compared to no haptic feedback, patients benefited from haptic nudge cues but not break-through forces. As training progressed, patients increased the number of targets acquired and spontaneously improved from one day to the next. Conclusions: Interactive visuo-haptic environments could be beneficial for attention training for severe TBI patients in the early stages of recovery and warrants further and more prolonged clinical testing.
Issue Date: 2013-08
Publisher: BioMed Central
Citation Info: Dvorkin, A. Y., Ramaiya, M., Larson, E. B., Zollman, F. S., Hsu, N., Pacini, S., Shah, A. and Patton, J. L. A "virtually minimal" visuo-haptic training of attention in severe traumatic brain injury. Journal of Neuroengineering and Rehabilitation. 2013. 10:92. doi: 10.1186/1743-0003-10-92
Type: Article
Description: © 2013 by BioMed Central, Journal of NeuroEngineering and Rehabilitation. © 2013 Dvorkin et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ISSN: 1743-0003
Sponsor: This work was supported by the US Department of Education, National Institute on Disability and Rehabilitation Research (Grant #H133A080045A).
Date Available in INDIGO: 2014-02-19

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