The Potential of Short-term Visual Memory and Selective Attention Training in Immersive Virtual Reality on Near and Far Transfer Effects in Stroke Patients: Pilot Study

Janavičiūtė-Pužauskė, Jovita; Paulauskas, Andrius; Šinkariova, Liuda · 2026 · Crossref

DOI: 10.1007/s41465-026-00362-8

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Summary

This pilot study investigates the feasibility and effectiveness of short-term visual memory (VSTM) and selective attention training delivered via immersive virtual reality (iVR) for stroke survivors. The research addresses the high prevalence of cognitive impairments in post-stroke patients, which often hinder daily functioning and are frequently overlooked in favor of motor rehabilitation. Specifically, the study aims to determine if iVR-based cognitive training yields near transfer effects (improvements in related cognitive domains) and far transfer effects (improvements in unrelated domains such as emotional state or psychomotor function). The study employed a randomized controlled design with 27 stroke survivors, of whom 20 completed the assessment (13 in the iVR group, 7 in the control group). Both groups received conventional rehabilitation. The iVR group additionally underwent ten 30-minute sessions of VSTM and selective attention training using an Oculus Quest 2 headset. The training involved two tasks set in a virtual kitchen: an object recall task and a sequence recall task, designed to mimic daily activities like shopping to enhance ecological validity. Cognitive functions were assessed using the Addenbrooke’s Cognitive Examination-III (ACE-III), Trail Making Test (TMT), and Medical College of Georgia Complex Figures (MCGCF). Emotional states were measured via the PHQ-9 and GAD-7 scales, while psychomotor function was assessed using the Finger Tapping Test. Results indicated statistically significant improvements within the iVR group across multiple domains. Participants showed enhanced performance in short-term memory, attention, visual search, working memory, task switching, and verbal fluency. Additionally, the iVR group experienced significant reductions in depression and anxiety rates. In contrast, the control group showed no significant cognitive or emotional improvements, with gains limited to non-dominant hand psychomotor functions. The study also noted that seven participants dropped out, primarily due to early discharge or health deterioration. The findings suggest that integrating VSTM and selective attention training into an iVR environment is feasible and effective, contributing to conventional stroke rehabilitation. The observed improvements in diverse cognitive domains and emotional states support the presence of both near and far transfer effects. The authors conclude that iVR training may optimize neuroplasticity through multisensory stimulation and high engagement. However, due to the small sample size and pilot nature of the study, larger randomized controlled trials are necessary to confirm these results and establish iVR as a standard component of cognitive rehabilitation for stroke patients.

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• simulator training transfer