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Visualizing the third dimension in virtual training environments for neurologically impaired persons: beneficial or disruptive?

Wouter van den Hoogen1*, Peter Feys2, Ilse Lamers2, Karin Coninx3, Sofie Notelaers3, Lore Kerkhofs4 and Wijnand IJsselsteijn1

Author Affiliations

1 Game Experience Lab, Human Technology Interaction group, Eindhoven University of Technology, PO Box 513, Eindhoven, 5600MB, The Netherlands

2 REVAL Rehabilitation Research Centre, PHL University College, and BIOMED Biomedical Research Institute, Hasselt University, Agoralaan building A, Diepenbeek, BE-3590, Belgium

3 Hasselt University – tUL – IBBT, Expertise Centre for Digital Media, Wetenschapspark 2, Diepenbeek, BE-3590, Belgium

4 Rehabilitation and MS Centre Overpelt, Boemerangstraat 2, Overpelt, 3900, Belgium

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Journal of NeuroEngineering and Rehabilitation 2012, 9:73  doi:10.1186/1743-0003-9-73

Published: 5 October 2012



Many contemporary systems for neurorehabilitation utilize 3D virtual environments (VEs) that allow for training patients’ hand or arm movements. In the current paper we comparatively test the effectiveness of two characteristics of VEs in rehabilitation training when utilizing a 3D haptic interaction device: Stereo Visualization (monoscopic vs stereoscopic image presentation) and Graphic Environment (2.5D vs 3D).


An experimental study was conducted using a factorial within-subjects design. Patients (10 MS, 8 CVA) completed three tasks, each including a specific arm-movement along one of three directional axes (left-right, up-down and forward-backward).


The use of stereoscopy within a virtual training environment for neurorehabilitation of CVA and MS patients is most beneficial when the task itself requires movement in depth. Further, the 2.5D environment yields the highest efficiency and accuracy in terms of patients’ movements. These findings were, however, dependent on participants’ stereoscopic ability.


Despite the performance benefits of stereoscopy, our findings illustrate the non-triviality of choices of using stereoscopy, and the type of graphic environment implemented. These choices should be made with the task and target group, and even the individual patient in mind.