A telerehabilitation program to improve visual perception in children and adolescents with hemianopia consecutive to a brain tumour: a single-arm feasibility and proof-of-concept trial
Bibliographic record
Abstract
Abstract Background Brain tumour in children can induce hemianopia, a loss of conscious vision, profoundly impacting their development and future prospects, yet no effective intervention exists for this pediatric population. This study aims to explore the feasibility, safety, and potential effectiveness of a home-based audiovisual stimulation in immersive virtual-reality (3D-MOT-IVR) to restore visual perception. Method In a phase 2a, open-labeled, nonrandomized, single arm study, 10 children and adolescents with stable hemianopia were enrolled to perform 20-minute sessions of 3D-MOT-IVR every other day for six weeks from home. We assessed feasibility by monitoring completion rates, remote data transfer, qualitative feedback. Safety was evaluated using validated cybersickness questionnaires. Comprehensive vision assessments were conducted pre- and post-intervention, with follow-ups at 1- and 6-month intervals. Results The home-based 3D-MOT-IVR intervention proved both feasible and safe, with no reported adverse events. All participants completed the prescribed stimulations and the pre- and post- intervention assessment points, 90% completed the follow-ups. Remarkably, the outcomes revealed significant improvements post-intervention: 50% of participants showed enhanced visual perception in their blind field, while 70% exhibited increased reading speed. Importantly, these positive effects were sustained at the 6-month follow-up. A robust correlation emerged between 3D-MOT-IVR performance and improved visual perception in the blind field, emphasizing the intervention’s effectiveness. Conclusion Our findings underscore the feasibility and safety of home-based 3D-MOT-IVR as a potential intervention for hemianopia in children. These promising results lay a strong foundation for a larger randomized controlled trial, offering hope for a meaningful breakthrough in visual rehabilitation for this vulnerable population. Key Points Absence of rehabilitation programs for children with visual field loss consecutive to brain tumour. Design of a home-based, personalized, 3D audiovisual stimulation in virtual-reality. Restoration of visual perception in the blind field after 3D-MOT-IVR. Importance of the Study Many children with a brain tumour suffer from visual field defects (hemianopia) dramatically impacting their cognitive and social growth with difficulties learning, limited mobility and thus restricted participation in physical activities and peer engagement. Later in adulthood, hemianopia affects social interactions and limits employment opportunities. Individuals with this condition present impaired visual scanning and exploration often associated with defective sound localization, deteriorating spatial detection. There is no visual rehabilitation intervention for children with hemianopia. This feasibility/proof-of-concept trial showed that a dynamic audiovisual stimulation in virtual-reality conducted every other day for 6 weeks is a feasible, safe and acceptable intervention, restoring visual perception in the blind field of 50% of the participants and improving activities of daily living. The personalized intervention was administered at home through a remotely controlled virtual-reality device, reducing the burden of disease by limiting in clinic visits and providing specialized care to children living outside urban areas.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".