Abstract

Traumatic brain injury (TBI) is the most common cause of long-term disability and death among young adults, and it represents an enormous socioeconomic and healthcare burden. Our purpose is to evaluate the effects of a virtual reality training with BTs-Nirvana (BTs-N) on the recovery of cognitive functions in TBI subjects, using the interactive semi-immersive program. One hundred patients with TBI were enrolled in this study and randomized into either the Traditional Cognitive Rehabilitation Group (TCRG: n = 50) or the Virtual Reality Training Group (VRTG: n = 50). The VRTG underwent a VRT with BTs-N, whereas the TCRG received a standard cognitive treatment. Each treatment session lasted 60 minutes and was repeated three times a week for 8 weeks. All of the patients were evaluated by a specific psychometric battery before (T0) and immediately (T1) after the end of the training. VRTG and TCRG had a significant improvement in cognitive functioning and in mood, but only VRTG presented with a significant increase in cognitive flexibility and shifting skills and in selective attention. In conclusion, our results suggest that VR may be a useful and effective approach for the rehabilitation of patients with TBI, leading to better cognitive and behavioral outcomes.

Highlights

  • Traumatic brain injury (TBI) is a condition caused by a mechanical event that causes skull and/or brain damage due to a strong and violent head blow, strong rotations of the head, or penetration of objects in the cranium causing focal or diffuse damage to multiple brain areas [1]

  • Technological innovations have allowed the development of new rehabilitative strategies, such as PC-based rehabilitation or Virtual Reality Training (VRT), which have proven effective in the cognitive rehabilitation (CR) of neurological patients [13,14,15,16]

  • No significant differences were found in age (p = 0 22), sex (p = 0 22), and education (p = 0 69) between Virtual Reality Training Group (VRTG) and Traditional Cognitive Rehabilitation Group (TCRG)

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Summary

Introduction

Traumatic brain injury (TBI) is a condition caused by a mechanical event that causes skull and/or brain damage due to a strong and violent head blow (i.e., falls and sport injuries), strong rotations of the head (i.e., road accidents), or penetration of objects in the cranium (i.e., bullets) causing focal or diffuse damage to multiple brain areas [1]. It is estimated that about 5.48 million people suffer from severe TBI each year (73 cases per 100,000 people) [3]. TBI may affect motor, cognitive, emotional, and psychological functions with a consequent worsening of both patient and his/her caregiver’s quality of life [5]. Growing evidence demonstrates that cognitive rehabilitation (CR), through previously learned skills or new compensatory strategies, is effective in patients with TBI as it enhances cognitive and psychosocial interaction [8,9,10,11,12]. Technological innovations have allowed the development of new rehabilitative strategies, such as PC-based rehabilitation or Virtual Reality Training (VRT), which have proven effective in the CR of neurological patients [13,14,15,16]. Chen et al [17], examining the efficacy of PC-based rehabilitation in TBI

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