Abstract
BackgroundFor safe ambulation in the community, detection and avoidance of static and moving obstacles is necessary. Such abilities may be compromised by the presence of visuospatial neglect (VSN), especially when the obstacles are present in the neglected, i.e. contralesional field.MethodsTwelve participants with VSN were tested in a virtual environment (VE) for their ability to a) detect moving obstacles (perceptuo-motor task) using a joystick with their non-paretic hand, and b) avoid collision (locomotor task) with moving obstacles while walking in the VE. The responses of the participants to obstacles approaching on the contralesional side and from head-on were compared to those during ipsilesional approaches.ResultsUp to 67 percent of participants (8 out of 12) collided with either contralesional or head-on obstacles or both. Delay in detection (perceptuo-motor task) and execution of avoidance strategies, and smaller distances from obstacles (locomotor task) were observed for colliders compared to non-colliders. Participants’ performance on the locomotor task was not explained by clinical measures of VSN but slower walkers displayed fewer collisions.ConclusionPersons with VSN are at the risk of colliding with dynamic obstacles approaching from the contralesional side and from head-on. Locomotor-specific assessments of navigational abilities are needed to appreciate the recovery achieved or challenges faced by persons with VSN.
Highlights
Visuospatial neglect (VSN) is an attentional-perceptual disorder affecting 25% to 30% of persons living with the consequences of a stroke [1,2]
We examined the ability of persons with visuospatial neglect (VSN) to detect moving obstacles and to avoid collisions with such obstacles during a goal directed locomotor task performed in a virtual environment (VE)
Twelve participants with VSN following a first time unilateral supratentorial stroke (Table 1) were recruited from an inpatient rehabilitation centre based on the following inclusion criteria: a stroke confirmed by a Computerised Tomography (CT) scan/Magnetic Resonance Imaging (MRI); a clinical diagnosis of VSN based on the motor free visual perceptual test (MVPT) and/or the Star Cancellation test; an ability to walk independently with or without a walking aid over 10 metres; and motor recovery scores ranging from 3 to 6 out of 7 on the leg and foot impairment inventories of the Chedoke McMaster Stroke Assessment
Summary
Visuospatial neglect (VSN) is an attentional-perceptual disorder affecting 25% to 30% of persons living with the consequences of a stroke [1,2]. It alters the detection and utilisation of relevant visual information from the side opposite to the brain lesion [3]. For safe ambulation in the community, detection and avoidance of static and moving obstacles is necessary Such abilities may be compromised by the presence of visuospatial neglect (VSN), especially when the obstacles are present in the neglected, i.e. contralesional field
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