# From Patient to Musician: A Multi-Sensory Virtual Reality Rehabilitation Tool for Spatial Neglect
## 9 Conclusions  
Currently used rehabilitation methods for USN often fail to take into account the heterogeneity of the syndrome by solely focusing on the visual modality. MNT shows great potential to bridge this gap, incorporating multiple modalities in the training process. The use of VR in rehabilitation has shown many advantages over traditional methods as it facilitates the modification of the therapy and allows for increased data collection regarding therapy progress. Therefore, the authors designed, developed and evaluated a novel VR therapy tool for MNT. This paper investigated the feasibility of the tool for the rehabilitation of patients diagnosed with USN. The resulting proof of concept was evaluated during a two-week pilot study with four clinical patients and compared to the results of four non-clinical test users. The results of the study indicated that the patients with USN were capable of performing the four rehabilitation tasks and indicated increased enjoyment. Next, the results showed that non-clinical test users performed significantly better than clinical users with respect to task performance, which indicates that the system is able to discern between users with USN and users without USN. Furthermore, this result indicates that the tasks were challenging the patients. Nonetheless, for each task, the patients were able to respond to their entire environment and the presented triggers successfully. Over the course of 2 weeks, patients were shown to increasingly adjust their head direction towards their neglected side for the _Memory_ and _Free-to-Play_ tasks, presumably to improve their task performance. These results indicate that the VR tool managed to successfully translate MNT to a virtual environment and that the tool shows promise for the rehabilitation of USN. Moreover, the participating medical experts of this study responded positively to the developed tool. They believe that it will be a useful tool at an early rehabilitation stage. However, it should be noted that the sample size was limited to four clinical patients and four non-clinical test users. Additionally, the measures used in this study were solely focused on head rotation and task performance. In conclusion, the tool developed by the authors is a valuable contribution to the current research on rehabilitation for USN as it is the first system to apply MNT in a VR environment. The promising results show increased enjoyment in the patients and sufficient challenges in the tasks. However, the tool and the evaluation have their limitations, specifically the limited sample size and limited metrics. With the enthusiasm to continue the research, future work should, therefore, focus on validating these results over a longer rehabilitation period with a larger sample. Moreover, due to the heterogeneity of the syndrome, future work should explore the incorporation of personalisation and gamification to fulfil the needs of the patients and further increase enjoyment during the rehabilitation process. Conceptualisation, J.H., S.C., E.V., C.V.L. and F.D.B. ; methodology, J.H., S.C., E.V. and C.V.L. ; software, E.V. ; validation, J.H., S.C. and C.V.L. ; formal analysis, J.H. and S.C.; investigation, S.C. and E.V. ; data curation, J.H. and E.V. ; writing--original draft preparation, J.H., S.C. and E.V. ; writing--review and editing, J.H., S.C., C.V.L., F.D.B. and F.D.T. ; visualisation, J.H. and S.C.; supervision, F.D.T. All authors have read and agreed to the published version of the manuscript. This research received no external funding. The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of Ghent University Hospital on 19 March 2021 [B6702021000166]. Informed Consent Statement: Informed consent was obtained from all subjects involved in the study. The data are not publicly available due to privacy and ethical concerns.