Feasibility of virtual reality for assessment of neurocognitive, executive, and motor functions in concussion

The purpose of the research presented in this chapter is to investigate if virtual reality (VR) neurocognitive, executive, and motor function assessment tools are susceptible to practice and fatigue effects similar to those currently used in a linical practice. Fifteen athletically active and neurologically normal Penn State students participated in a VR practice effect study. Another 15 Penn State football players participated in an effect of fatigue study on neurocognitive, balance, and executive functions. Subjects performed VR tests on several occasions. The statistical analysis was conducted to examine the VR measures as a function of testing session(practice effect) and physical fatigue (prior to and after full contact practices).The number and type of the full contacts during the practices were assessed via a specially developed observational chart.There are several major findings of interest. First, all subjects reported the sense of presence and significant mental effort while performing the VR tests. Second, neither effect of testing day (p > 0.05) nor effect of VR testing modality (p >0.05) was revealed by ANOVA. Third, physical fatigue did not influence the VR measures in the majority of football players under study (p > 0.05). However, there was a reduction in several VR performance measures in football players who sustained prior concussive injuries. The findings show that VR testing modalities implemented in this study and aimed to evaluate neurocognitive (spatial memory, attention), motor (balance), and executive functions may be used as a complementary tool in a clinical practice.VR testing modalities under laboratory conditions are easily transferable into field conditions, and can potentially be used as the side-line evaluation of subjects at risk for concussion.