Virtual reality route learning in people with traumatic brain injury

Volume I contains three research papers. Firstly a systematic review was conducted to investigate the effectiveness of rehabilitation strategies for improving navigation in people with acquired brain injuries (ABI). Secondly, a mixed within and between-subjects experiment was conducted to explore differences in Virtual Reality route learning in people with traumatic brain injury (TBI) compared to a matched control group in relation to landmark type (proximal and distal) and navigation strategies (egocentric and allocentric). Finally, a public dissemination document provides an overview of both the systematic review and empirical paper in a manner suitable for dissemination to relevant stakeholders.The results of the systematic review indicated that there is much variation in the compensatory rehabilitation strategies used to help people with ABI successfully navigate. Compensatory rehabilitation strategies were broadly categorised according to whether they were person-oriented, environmentally-oriented or hybrid approaches. Overall, the conclusions that could be generated was limited by poor methodological quality and thus, more robust research is needed on this topic before an evidence-based navigation rehabilitation strategy can be used in clinical practice. Suggestions as to promising areas for future research are given. Findings from the experimental Virtual Reality route learning study suggested that people with TBI are impaired at route learning using distal landmarks compared to a neurologically-healthy control group. As navigation using distal landmarks has been associated with an allocentric ‘mental map’ strategy using the hippocampus, it is possible that the participants with TBI in this study were impaired at route learning using distal landmarks due to an inability to use their hippocampi to build up a mental map of space. However, as both groups of participants reported using an egocentric ‘associative’ strategy to learn both types of landmark routes, this association needs further exploration