Task performance in virtual environments used for cognitive rehabilitation after traumatic brain injury

Objective: This report describes a reliability study using a prototype computer-simulated virtual environment to assess basic daily living skills in a sample of persons with traumatic brain injury (TBI). The benefits of using virtual reality in training for situations where safety is a factor have been established in defense and industry, but have not been demonstrated in rehabilitation. Subjects: Thirty subjects with TBI receiving comprehensive rehabilitation services at a residential facility. Methods: An immersive virtual kitchen was developed in which a meal preparation task involving multiple steps could be performed. The prototype was tested using subjects who completed the task twice within 7 days. Results: The stability of performance was estimated using intraclass correlation coefficients (ICCs). The ICC value for total performance based on all steps involved in the meal preparation task was .73. When three items with low variance were removed the ICC improved to .81. Little evidence of vestibular optical side-effects was noted in the subjects tested. Conclusion: Adequate initial reliability exists to continue development of the environment as an assessment and training prototype for persons with brain injury.