Virtual exercises to promote cognitive recovery in stroke patients: The comparison between head mounted displays versus screen exposure methods

The cognitive rehabilitation of stroke is often related to improvement of executive functioning through repeated and systematic training of memory and attention exercises, in which virtual reality may be a valid approach. Several devices have been used as visual outputs. Head mounted displays (HMD) and desktop screens displays are among them. HMDs are usually perceived as being more immersive than screens. However, the HMD presents several shortcomings if a widespread use is the objective. In this way, this study aims to assess the prospect of opting for screen displays as an alternative to HMD within virtual reality (VR)-based applications to rehabilitate memory and attention impairments in stroke patients. A sample of 17 patients with memory and attention deficits resulting from stroke were recruited from the hospital Centro de Medicina da Reabilitação do Alcoitão. The patients were randomly assigned to two different groups: a) HMD-based VR; and b) desktop screen-based VR. The patients in the experimental groups underwent a VR training program with 12 sessions of memory and attention exercises. These patients were assessed before and after the VR training sessions with the Wechsler Memory Scale for memory and the Toulouse-Piéron for attention functioning. The results showed increased working memory and sustained attention from initial to final assessment regardless of the VR device used. These data may suggest better functional independence following VR-based intervention and support the use of non-expensive displays as an alternative to high-end setups commonly used in VR applications devised for rehabilitation purposes.