Performance within a virtual supermarket and its relationship to executive functions in post-stroke patients

Executive functions are defined as higher-order functions that are needed for performing complex or non-routine tasks. People who have had a stroke often suffer from impairments in executive functions which have implications for their ability to return to full participation in their everyday activities and occupations. During the rehabilitation process clinicians seek opportunities, which will not be time consuming or expensive, to engage patients in complex functional activities, in order to train and improve deficits in executive functions. One solution for this is using functional virtual environments. The objectives of this study were to examine the feasibility of using a virtual supermarket to assess and treat executive function deficits for people who have had a stroke, and to explore the relationships between performance within the virtual supermarket and executive functions. The virtual supermarket used in this study runs on a desktop computer and is easy to operate in typical clinical settings. Twenty-six people, aged 31 to 65 years, who had a stroke participated in the study. Participants were tested with the virtual supermarket where they were asked to buy seven products from a prepared list. Each participant was also tested with the behavioral assessment of the dysexecutive syndrome. The results showed a large variance of performance within the virtual supermarket. In addition, moderate relationships were found between performance within the virtual supermarket and executive functions. The results point to the potential of the virtual supermarket to be used as an assessment and training tool for executive functions of people who have had a stroke

[1]  H. Ring,et al.  Functional disability and rehabilitation outcome in right hemisphere damaged patients with and without unilateral spatial neglect. , 1999, Archives of physical medicine and rehabilitation.

[2]  G.C. Burdea,et al.  Virtual reality-enhanced stroke rehabilitation , 2001, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[3]  Tim Shallice,et al.  HIGHER-ORDER COGNITIVE IMPAIRMENTS AND FRONTAL-LOBE LESIONS IN MAN , 1991 .

[4]  P L Weiss,et al.  Interactive virtual environment training for safe street crossing of right hemisphere stroke patients with Unilateral Spatial Neglect , 2005, Disability and rehabilitation.

[5]  S. Adamovich,et al.  Virtual reality-augmented rehabilitation for patients following stroke. , 2002, Physical therapy.

[6]  M. Kaste,et al.  Post‐stroke depression, executive dysfunction and functional outcome , 2002, European journal of neurology.

[7]  P. Weiss,et al.  Design and testing of a virtual environment to train stroke patients with unilateral spatial neglect to cross a street safely. , 2003, Occupational therapy international.

[8]  T. Shallice,et al.  The cognitive and neuroanatomical correlates of multitasking , 2000, Neuropsychologia.

[9]  T. Shallice,et al.  Deficits in strategy application following frontal lobe damage in man. , 1991, Brain : a journal of neurology.

[10]  H. Nakayama,et al.  Orientation in the acute and chronic stroke patient: impact on ADL and social activities. The Copenhagen Stroke Study. , 1996, Archives of physical medicine and rehabilitation.

[11]  C. Braun,et al.  Cognitive Structure of Executive Deficits in Frontally Lesioned Head Trauma Patients Performing Activities of Daily Living , 2003, Cortex.

[12]  Bruno Dubois,et al.  An Ecological Approach to Planning Dysfunction: Script Execution , 2000, Cortex.

[13]  Jurgen Broeren,et al.  Virtual Reality and Haptics as an Assessment Device in the Postacute Phase after Stroke , 2002, Cyberpsychology Behav. Soc. Netw..

[14]  G. Burdea,et al.  Low-cost Virtual Rehabilitation of the Hand for Patients Post-Stroke , 2006, 2006 International Workshop on Virtual Rehabilitation.

[15]  Evelyne Klinger,et al.  Virtual Action Planning in Parkinson's Disease: AControl Study , 2006, Cyberpsychology Behav. Soc. Netw..

[16]  H. Ring,et al.  Functional measures of first-stroke rehabilitation inpatients: usefulness of the Functional Independence Measure total score with a clinical rationale. , 1997, Archives of physical medicine and rehabilitation.

[17]  P. Tonin,et al.  Virtual Reality as an assessment tool for arm motor deficits after brain lesions. , 2001, Studies in health technology and informatics.

[18]  M. Kaste,et al.  MRI correlates of executive dysfunction in patients with ischaemic stroke , 2003, European journal of neurology.

[19]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[20]  O. Godefroy,et al.  Frontal syndrome and disorders of executive functions , 2003, Journal of Neurology.

[21]  Olivier Godefroy,et al.  Syndromes frontaux et dysexécutifs , 2004 .

[22]  M. Lezak Neuropsychological assessment, 3rd ed. , 1995 .