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A Direct Comparison of Real-World and Virtual Navigation Performance in Chronic Stroke Patients

Published online by Cambridge University Press:  22 March 2016

Michiel H.G. Claessen ,
Johanna M.A. Visser-Meily ,
Nicolien K. de Rooij ,
Albert Postma  and
Ineke J.M. van der Ham
Michiel H.G. Claessen*
Affiliation:
Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
Johanna M.A. Visser-Meily
Affiliation:
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
Nicolien K. de Rooij
Affiliation:
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
Albert Postma
Affiliation:
Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands
Ineke J.M. van der Ham
Affiliation:
Department of Health, Medical and Neuropsychology, Leiden University, Leiden, the Netherlands
*
Correspondence and reprint requests to: Michiel H. G. Claessen, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands. E-mail: m.h.g.claessen@uu.nl
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Abstract

Objectives: An increasing number of studies have presented evidence that various patient groups with acquired brain injury suffer from navigation problems in daily life. This skill is, however, scarcely addressed in current clinical neuropsychological practice and suitable diagnostic instruments are lacking. Real-world navigation tests are limited by geographical location and associated with practical constraints. It was, therefore, investigated whether virtual navigation might serve as a useful alternative. Methods: To investigate the convergent validity of virtual navigation testing, performance on the Virtual Tübingen test was compared to that on an analogous real-world navigation test in 68 chronic stroke patients. The same eight subtasks, addressing route and survey knowledge aspects, were assessed in both tests. In addition, navigation performance of stroke patients was compared to that of 44 healthy controls. Results: A correlation analysis showed moderate overlap (r=.535) between composite scores of overall real-world and virtual navigation performance in stroke patients. Route knowledge composite scores correlated somewhat stronger (r=.523) than survey knowledge composite scores (r=.442). When comparing group performances, patients obtained lower scores than controls on seven subtasks. Whereas the real-world test was found to be easier than its virtual counterpart, no significant interaction-effects were found between group and environment. Conclusions: Given moderate overlap of the total scores between the two navigation tests, we conclude that virtual testing of navigation ability is a valid alternative to navigation tests that rely on real-world route exposure. (JINS, 2016, 22, 467–477)

Keywords

Spatial navigationStrokeVirtual navigation testReal-world navigation testEcological validityNeuropsychological practice
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 22 , Issue 4 , April 2016 , pp. 467 - 477
Copyright
Copyright © The International Neuropsychological Society 2015 

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