# From Patient to Musician: A Multi-Sensory Virtual Reality Rehabilitation Tool for Spatial Neglect
## 8 Discussion
### Research Questions  
With the available information and insights, answers can be formulated to the research questions first presented in Section 3. * **\"Can MNT be effectively translated in a VR environment?\"** The tests show promising results to support the application of MNT in VR. As indicated by the medical experts in the interviews, the combination of visual and auditory stimuli is beneficial. Combining both triggers and training the patients on both modalities teaches them connections between the two. The results also show some evidence that the addition of auditory stimuli impacts the performance of the exercises. On the one hand, in the _Memory_ task, where users also respond to sound cues, half of the patients show some difference in performance based on where the stimuli are shown. That is, they perform worse for stimuli presented in the far most neglected side. On the other hand, in the _Free-to-Play_ task, where users only respond to visual stimuli, 3 out of 4 patients show significantly worse performance, which can be linked to the USN. However, precaution is warranted with respect to the adoption of the proposed VR system for individuals susceptible to motion sickness and epilepsy in VR. * **\"Can the newly designed VR system be used for the treatment of adults with USN with an acquired brain injury?\"** For the _Scales_ task, not enough evidence is obtained that the mistakes made by the patient are the result of their USN. However, this does not mean that the task serves no purpose or does not train the patients in any way. The patients' attention is gradually guided towards the peripheral area on the neglected side. The data show that all patients successfully form this motion, and by doing so, they are urged to observe their neglected side as well. The patients performed quite differently in the _Memory_ and _Free-to-Play_ tasks. The results of these tasks do show the influence of the USN. In general, they performed worse on their neglected side. This provides sufficient evidence for the assumption that the patients were trained to perform better despite their USN, thereby treating the disorder. Furthermore, two of the patients were reported to perceive improvements in their performance of the different tasks. In conclusion, all patients could perform the exercises and no problems arose in the pilot study that would prevent this solution from being researched further. There is evidence to support the notion that the rehabilitation tasks have some effect on the USN disorder in the patients. However, additional studies are needed to investigate the significance and persistence of these effects. * **\"Will the spatial performance of the patient with an acquired brain injury evolve positively after treatment with the VR system?\"** The two-week limitation of this study prohibits a conclusive answer to this question. However, there is some evidence that suggests intra-session improvements in the exploration of the participants for the _Memory_ and _Free-to-Play_ tasks. Unfortunately, no insights are gathered on the persistence of this effect towards everyday life situations in the long term. One patient did report that they experienced improvements in daily life during the two-week period. It is also crucial to discuss what else could influence the apparent evolution of the head direction during sessions. Indeed, the gradual increase in the average head direction may result from taught behaviour during previous VR exercises. However, it is also possible that the change in the average head direction is the direct consequence of the different sessions themselves. Specifically, as the sessions progressed, the task's difficulty was often increased. A greater difficulty always meant that more notes were presented, and therefore a larger area of the playing area was needed. Thus, stimuli were presented in a larger area, which inherently would force users to explore more towards the neglected side as well. This would also result in an increase in the average head direction.