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Licensed Unlicensed Requires Authentication Published by De Gruyter July 21, 2014

Impact of contextual additional stimuli on the performance in a virtual activity of daily living (vADL) among patients with brain injury and controls

  • Evelyne Klinger EMAIL logo , Heni Cherni and Pierre-Alain Joseph


During recent years, researchers showed the feasibility and the interest of using virtual reality (VR)-based activities of daily living (vADL) among patients with cognitive impairments for the recovery of capacities. While interacting, the VR system provides various kinds of information for different purposes, including display of the virtual environment and understanding of the task, and also highlighting the functionalities or delivery of instructions. Generally, in order to improve the patient’s performance, additional cues are provided to enhance information saliency, such as arrows, change of colors, and so on. We give the definition of “contextual Additional Software Stimulus” (cASS) to any additional information related to the interaction and whose absence from the virtual environment does not have any effect on the unfolding of the task. This work was designed to study the effects of cASS on the performance in a daily living simulated task, including purchasing items in the Virtual Action Planning Supermarket (VAP-S). For this purpose, after implementation of cASS in the VAP-S, we carried out experiments, in which 23 healthy subjects (12 M and 11 F) and 12 patients with brain injury (12 M) took part. Results showed that the deliverance of cASS during the virtual task significantly improved some variables that described the performance of healthy subjects and patients with brain injury.

Corresponding author: Evelyne Klinger, Arts et Métiers, ParisTech–EA 1427, 4 Rue de L’ermitage, 53000 Laval, France, E-mail:


This work was carried out with the financial support of Laval authorities (Laval Agglomération and Conseil Général de la Mayenne) and in the framework of the AGATHE project (ANR-09-TECS-002). We thank Marie Dandois, student in Occupational Therapy, who collected the patient’s data at Kerpape Rehabilitation Center, and all the participants in the tests.


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Received: 2013-5-12
Accepted: 2013-7-3
Published Online: 2014-7-21
Published in Print: 2014-9-1

©2014 by De Gruyter

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