A virtual environment-based paradigm for improving attention in TBI

Attention deficits are one of the most profound problems facing the traumatic brain injured individual. The traumatic brain injury (TBI) inpatient population in the rehabilitation unit is difficult to study with new technology because it is often very difficult to render and evaluate such interventions in the short time span when a patient is still in the hospital, even though that is precisely the time when clinical attentional therapy is considered most critical. We developed and performed a preliminary test of a haptic/graphic paradigm for improving attention and concentration in early stages of recovery in the TBI inpatient population. Six TBI patients and three healthy controls were exposed to a minimal distraction/minimal interaction environment while reaching for a visual target. Our initial results showed (1) the subjects tolerated the experience, (2) the number of targets acquired in successive one-minute intervals indicated a sustained attention for the task, and (3) haptic interaction in such an environment was well tolerated, engaging, and enjoyable -- often considered a game. These findings have provided the foundation for a larger, intensive, protracted study with repeated treatment.