Intensive language-action therapy in virtual reality for a rehabilitation gaming system

摘要

One third of stroke patients suffer from language disorders. These disorders severely impair individuals' communication abilities, which impacts on their quality of life. Recently, the Intensive Language Action Therapy (ILAT) emerged as a novel paradigm for aphasia rehabilitation. ILAT is grounded in three main principles: intense practice, overcoming the learned non-use, and an individualized training. In the present study we designed and developed a VR based language rehabilitation tool by integrating ILAT's object request LAG in RGS, a novel paradigm for the rehabilitation of motor deficits after lesions to the central nervous system. RGS is a gaming environment that provides a multimodal, task specific training in virtual reality scenarios. Its special design consists of an intelligent motion detection system that monitors the users' movements. This allows for an active interaction as well as continuous evaluation of the affected limbs. We addressed the question whether aphasia rehabilitation designed within the VR environment of RGS can be an effective tool. The principal purpose of the initial pilot study was to validate the system and to learn whether a virtual adaptation of the ILAT into RGS can trigger positive changes in the linguistic behavior of Broca's aphasia patients. We report the results of a double-case initial pilot study where one acute and one chronic aphasic patient followed five RGSILAT therapy sessions. Before and after the treatment we evaluated their language skills using the Communication Activity Log (CAL) and Western Aphasia Battery (WAB) scales. Results show that the patients learnt how to interact within the VR system. The CAL performance suggests that both patients and their therapist perceived improvements in the communication skills after the therapy. Additionally, the approval and acceptance of the system were high. Based on this initial outcome we will further provide the present RGS-ILAT with substantive technological advancements and evaluate the system to reliably replicate the original ILAT, in order to better understand the potential of the virtual reality based language rehabilitation therapies.