Spatial Neglect Therapy With the Augmented Reality App “Negami” for Active Exploration Training: A Randomized Controlled Trial on 20 Stroke Patients With Spatial Neglect

Abstract

ObjectiveTo investigate the efficacy of the augmented reality (AR) app “Negami” as an active exploration training for the treatment of spatial neglect. Improvements of the ipsilesional attention and orientation bias (and resulting contralesional neglect) will be examined in stroke patients with spatial neglect and compared with a control group. DesignRandomized controlled trial with an experimental Negami group, consisting of patients with spatial neglect, and a group of neglect patients receiving standard neglect therapy. SettingThree rehabilitation hospitals. ParticipantsTwenty right hemispheric stroke patients with spatial neglect (N=20). InterventionOver a period of 2 weeks, both groups received 5 training sessions per week (à 25 minutes). Neglect behavior was assessed weekly over a 5-week period, with the Negami therapy group receiving a second follow-up assessment at 1-to-2-month intervals after completion of training. Main Outcome MeasuresLetter Cancellation, Bells Test, Copying Task, Line Bisection Task, and a self-developed “Exploration Test”. ResultsBoth groups improved significantly. While the Negami therapy group improved in 4 of 5 neglect tests used, the standard therapy group improved in only 1 of these tests. We observed significantly better improvement in the Negami group already after the first week of training. This difference was also significant after the end of the training as well as 1 week after the end of training and remained stable 1-2 months after the end of treatment. ConclusionNegami can be used as an effective alternative or addition to current standard neglect therapy, and may even be superior to it.