About the project

Assessments are part of the occupational therapy process and are facilitating the decision making process. Through a prescribed method and organized context, scoring and the interpretation of results, the occupational therapist valid and reliable test result usable in a further therapeutical process. Although assessments are standardized, there is still a human interpretation needed and external variables can affect the results. Subsequently carrying out an assessment is taking time and is very intensive for both the patient and the therapist.

Recently the research from VR in occupational therapy has increased. VR applications for elderly were investigated and there is some evidence that elderly with cognitive and physical impairments can be supported through the use of VR. Also researched is the use of VR in pain-relieve and reducing anxiety. Published reviews are showing best practices in occupational therapy and the efficacy from using VR in cognitive and physical rehabilitation. Those reviews clearly demonstrate the benefits from using VR in comparison with standard treatment, with effects on higher confidence in cognitive and physical ability, higher motivation and stimulation from the patients, more fun during rehabilitation and more safe treatment environment. The review from Shin & Kin (2015) shows that the VR function most researched is the memory, attention and executive control.

Today the technological equipment is enough accessible to use it in reality. Behaviour- cognitive and biometrical parameters can be measured and implemented in game-engines (eg. Unity and Unreal Engine). Also the Head-Mounted-Displays (HMD’s) with eye-tracking are recently cheaper and accessible. Eye tracking makes it possible to get insight in the attention patterns from a person. Biometric parameters can detect which the steps in the process are giving stress. Possible biometrical parameters to invest are physiological arousal, measured through skin conductance.

SIOPA – smart immersive occupational performance assessments - is a project-based scientific research carried out by four partners from Howest: Human Interface technology lab (HITlab), Department Occupational Therapy (ERGO), Department Multimedia and communication (MCT) and Department Digital Arts and Entertainment (DAE).

Through a dynamic cooperation the SIOPA team will develop employable occupational therapy assessments in VR.


For the first version of the assessement tool, we focus on Unilateral spatial neglect (USN), which is characterized by inattention to or inaction in the side of space opposite a brain lesion and affects 23-46% of stroke survivors. The effect of USN is often multimodal and requires skilled clinical staff to diagnose and treat. Currently, USN is assessed through paper-and-pencil tests that lack ecological validity and ignore the effects on activities of daily life. Current mobile head-mounted displays (HMD) in combination with eye tracking have become promising in evaluation and training.

The aim is to develop a novel immersive occupational therapy (OT) assessment tool for patients with USN. This tool has to be mobile and low cost in order to have a broad range of assessment possibilities in any service.

Currently the tool has tasks that assess at functional, activity and participation levels based on the IOF characterization. Further research will assess both feasibility and validity of the assessments.


  • The star cancellation task for the assessment of hemispatial neglect.

  • Simple functional tasks e.g. setting a tray.

  • Participation in daily activities e.g. crossing a street.


  • Biometrics, such as eye-gaze.

  • Virtual reality
    head mounted displays

  • Data analytics


Figure 1: The international classification of functioning, disability, and health (ICF)

Figure 2: Methodology: Through iterative developement and feedback phases, we further improve our proof of concepts and reserach outcomes.

Usecase #1: The star cancellation task

It is a known analytical test in VR, the star cancellation task (VR Star). Eye tracking was added in order to gather extra biometric data and insights. We expect that VR Star will provide multimodal, uniform and more objective data and become more motivating, sensitive and user-centered than existing tools.

Usecase #2: The tray setting task

The tray setting task is a classic task used by occopational therapists to assess USN. Patients with neglect often ommit the objects on one side of the tray, making for an objective assessment based on their object placement scores.

Usecase #3: The road-crossing task

The road-crossing task is a participation task aimed to assess that a patient is capable to walk independently and safely in the streets, by checking if they observe all potential hazards coming from right or left. Attention to traffic lights, vehicles and pedestrians is measured.

Video: The SIOPA application with 3 tasks



Human Interface Technology Lab


Departmant of Occupational Therapy


SmartSpace rehabilitation lab at UZGent

UZ Gent

Universitair Ziekenhuis Gent


Digital Arts and Entertainment Research group


Department of Media and Communications Technology


Get in touch

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