A Case of Attention Deficit in a Patient with Subarachnoid Hemorrhage which was Successfully Treated by Virtual Reality-Guided Rehabilitation

Masahiro Hamashima; Yuichiro Murakawa; Kyohei Omon; Tetsuhisa Kitamura; Hideo Ishikawa

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A Case of Attention Deficit in a Patient with Subarachnoid Hemorrhage which was Successfully Treated by Virtual Reality-Guided Rehabilitation

VernacularTitle:注意障害を伴うくも膜下出血患者に対して仮想現実技術を用いた介入により注意機能が改善した1例
Author: Masahiro HAMASHIMA ¹ ; Yuichiro MURAKAWA ² ; Kyohei OMON ³ ; Tetsuhisa KITAMURA ¹ ; Hideo ISHIKAWA ⁴
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1. Rehabilitation Center, Eishinkai Kishiwada Rehabilitation Hospital
2. Department of Cerebral and Cardiovascular Rehabilitation, National Cerebral and Cardiovascular Center
3. Division of Occupational Therapy, Graduate School of Medicine, Kyoto University
4. Department of Cognitive Behavioral Science, Kyoto University Graduate School of Human and Environmental Studies
Keywords: virtual reality; environmental adjustment; higher brain dysfunction; stroke; physical therapy
From:The Japanese Journal of Rehabilitation Medicine 2020;():20007-
CountryJapan
Language:Japanese
Abstract: Objective：It is often difficult to provide effective functional training in patients with severe attention deficit caused by organic damage to the brain. Herein, we report a case of attention deficit in a patient with subarachnoid hemorrhage, which was successfully treated by virtual reality (VR)-guided rehabilitation.Methods：A 71-year-old woman was transferred to our hospital for rehabilitation after a subarachnoid hemorrhage. The patient suffered from severe attention deficit. She was unable to follow instructions from therapists and was unable to concentrate on rehabilitation tasks. We attempted VR-guided rehabilitation using mediVR KAGURA (mediVR, Toyonaka, Japan) in order to improve her attention deficit. The training was performed approximately 20 min every weekday, for 4 months in a 360-degree VR environment, with no background image initially. The difficulties in physical and cognitive tasks were adjusted by focusing on the size, range of appearance, and falling speed of each task object, so that even patients with severe attention deficit could respond to these tasks appropriately.Results：After the above-mentioned VR-guided training, the trail making test A, behavioral inattention test, and moss attention rating scale were improved from 300 s (could not complete the test) to 100 s, 119 to 133, and 55 to 98, respectively. In addition, in the clinical assessment for attention, the time required for visual obliteration tests was significantly shortened, and clinical symptoms associated with attention deficit were also improved clinically.Conclusion：VR-guided rehabilitation has the potential to be used as a new therapeutic approach to improve attention deficit.