Visual-spacial recognition disabled person inspecting system, visual-spacial recognition disabled person training system, and space motion supporting system for visual-spacial recognition disabled person

Abstract

To provide: a visual spacial recognition disabled person inspecting system capable of easily, objectively, quantitatively, and minutely inspecting a disability content and level of a disabled person with a visual-spacial recognition disability such as unilateral spatial neglect from a new point of view; and a visual-spacial recognition disabled person training system capable of performing appropriate training from a new point of view according to the content and level of the disabled person with the visual space recognition disability such as the unilateral spatial neglect.SOLUTION: Visual-spacial recognition disabled person inspecting system and training system include a head-mounted display (10) comprising a pair of right and left cameras on a front surface and are configured so as to display, on a screen of the head-mounted display, a group of three-dimensional substances having simulated depth for an obliteration test, one of space neglect inspections, in a proximal space or a distal space for a subject (40).SELECTED DRAWING: Figure 4

Description

[Technical field]

[0001] The present invention relates to an examination system for persons with visuospatial cognitive disorders, a training system for persons with visuospatial cognitive disorders, and a spatial movement support system for persons with visuospatial cognitive disorders, and is suitable for use in examination, training (rehabilitation) or support for daily life activities for persons with visuospatial cognitive disorders. [Background technology]

[0002] Unilateral spatial neglect (USN) is a visual-spatial cognitive disorder that is one of the aftereffects of stroke, and it is a major hindrance to rehabilitation treatment. In particular, unilateral spatial neglect often causes abnormal behavior in patients' daily lives. In the early stages, patients may leave food on the neglected side while eating, not notice a caregiver on the neglected side, or bump into walls or doors while walking. In addition, it is not uncommon for patients to fall and break bones during hospitalization due to attention disorders. Unilateral spatial neglect is one of the causes of patients having difficulty walking and being forced to live in a wheelchair, which leads to a decline in the activities of daily living (ADL) and quality of life (QOL), and is an important issue that must be resolved as soon as possible. However, there are very few rehabilitation treatments for visuospatial cognitive disorders that are a complication of central nervous system diseases, and research and development of rehabilitation equipment to compensate for and improve these functions.

[0003] Under such a background, the present inventors have developed a visual information presentation system by a head mounted display (HMD) using Virtual Reality (VR) technology, and established a visual image presentation method mainly under static conditions for testing or training of visuospatial cognitive disorders (see Patent Document 1). In addition, the present inventors have reported the results of examining brain activity in patients with hemispatial neglect after stroke by performing a Behavioural Inattention Test (BIT) as a cancellation task by combining coordinate conditions (body center, object center) and distance conditions (proximal, distal) in a virtual space created by VR using a head mounted display (see Non-Patent Document 1). [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Patent No. 4721941 [Non-patent literature]

[0005] [Non-Patent Document 1] Akira Kudo, Toshiaki Tanaka, Ryo Kanda, Shio Kato, Shunichi Sugihara, Izumi Yagi, Yusuke Fujiwara, "Examination of frontal cortex activity during erasure task using virtual reality technology in patients with unilateral spatial neglect," 58th Japanese Society of Rehabilitation Medicine (November 2021), S464 Summary of the Invention [Problem to be solved by the invention]

[0006] However, the testing method used in both Patent Document 1 and Non-Patent Document 1 is a line cancellation test, which has limitations in accurately grasping the content and degree of the disorder in individuals with visuospatial cognitive disorders.

[0007] Therefore, the problem that this invention aims to solve is to provide an examination system for individuals with visuospatial cognitive disorders that can easily, objectively, quantitatively, and in detail examine the content and degree of the disorder in individuals with visuospatial cognitive disorders such as hemispatial neglect from a new perspective.

[0008] Another problem that the present invention aims to solve is to provide a training system for persons with visual-spatial cognitive disorders, such as hemispatial neglect, that can provide appropriate training from a new perspective according to the content and degree of the disorder of the person, and can effectively provide rehabilitation treatment and assistance.

[0009] Another problem that the present invention aims to solve is to provide a spatial action support system for persons with visual-spatial cognitive disorders, such as hemispatial neglect, which can improve daily living activities and quality of life by assisting the vision of persons with visual-spatial cognitive disorders and supporting spatial actions. [Means for solving the problem]

[0010] In order to solve the above problems, the present invention provides: It has a head-mounted display equipped with a pair of cameras on the front, This is a testing system for people with visuospatial cognitive disorders that is configured to be able to display a group of three-dimensional objects with pseudo-depth for the erasure test, which is one type of spatial neglect test, in the proximal or distal space of the subject on the screen of the head-mounted display.

[0011] In this testing system for people with visuospatial cognitive disorders, the test is generally conducted with the subject seated in a chair or wheelchair, but it can also be conducted with the subject lying on their back, standing, or while walking.

[0012] A completely shielded head-mounted display may be used, but in order to suppress virtual sickness caused by sudden large movements of the head of a subject wearing the head-mounted display, it is desirable to use an open type that allows peripheral vision in order to utilize the peripheral visual field that is closely related to the sense of balance. Basically, any type of left and right camera is provided on the front of the head-mounted display, and is selected as necessary, for example, a CMOS sensor or a CCD is used. The left and right cameras are usually installed in positions in front of both eyes when the subject wears the head-mounted display on his or her head, so that the optical position of the subject's eyes and the optical position of the camera match. The head-mounted display has a built-in gyroscope for measuring the movement of the subject's head and an infrared sensor for measuring the movement of the eyeball, as necessary. In addition, the head-mounted display typically has built-in speakers, particularly stereo speakers.

[0013] The test system for persons with visual-spatial cognitive disorders typically further includes a controller that is used by the subject to erase the group of solid objects displayed on the screen of the head-mounted display. This controller is generally a hand controller that the subject can hold in his / her hand. By operating this controller, the group of displayed solid objects can be erased. These solid objects are objects that pseudo-express depth using binocular parallax. The solid objects can be selected as needed, and are not particularly limited, but are, for example, cubes, particularly cubes colored in a color such as red. The group of solid objects is, for example, displayed on two or more planes each having a different depth from each other.

[0014] In this testing system for people with visual-spatial cognitive disorders, when performing an erasure test, a proximal space or a distal space can be selected as the space in which a group of three-dimensional objects is displayed on the screen of the head-mounted display. Here, the proximal space is a space close to the body or a space within the reach of the subject, and the distal space is a space away from the body or a space far from the body that is out of reach. Since the proximal space or the distal space can be selected in this way, the content and degree of the disorder of people with visual-spatial cognitive disorders can be tested in detail.

[0015] This testing system for persons with visual-spatial cognition disorders is typically configured to be able to call attention by presenting an attention symbol on the screen of the head-mounted display and / or by sound from the speaker of the head-mounted display when performing an erasure test. The attention symbol may be basically any symbol and may be selected as necessary, for example, a group of arrows indicating a direction in which attention should be called. If necessary, attention may be called by blinking a group of three-dimensional objects. In addition, this testing system for persons with visual-spatial cognition disorders is configured to be able to measure the movement of the subject's head using a gyroscope built into the head-mounted display and / or measure the movement of the subject's eyeballs using an infrared sensor built into the head-mounted display when performing an erasure test. In this way, for example, when performing an erasure test, it is possible to measure the rotation angle of the subject's head and the rotation angle of the subject's eyeballs from the time when one three-dimensional object is erased to the time when the next three-dimensional object is erased, and useful information regarding the content and degree of the disorder of the person with visual-spatial cognition disorders can be obtained from the measurement results. By measuring angles other than the rotation angle of the subject's head, such as the angle of flexion and extension, the angle of left and right lateral bending, etc., or measuring angles other than the rotation angle of the subject's eyeball, the measurement results can provide useful information regarding the pathology of the visuospatial cognitive disorder. This examination system for visuospatial cognitive disorder is configured to set the coordinate system of the image displayed on the screen of the head-mounted display to a body-centered coordinate system or an object-centered coordinate system as necessary. Here, the body-centered coordinate system is a coordinate system in which the subject's own body is the center when recognizing an object, and the object-centered coordinate system is a coordinate system in which the consciousness is always focused on a specific object. In this way, the body-centered coordinate system or the object-centered coordinate system can be selected, so that the content and degree of the disorder of the visuospatial cognitive disorder can be examined in detail. In this examination system for visuospatial cognitive disorder, when performing an erasure test, the activated area of ​​the subject's brain is measured using near-infrared spectroscopy as necessary. In this way, the relationship between the neglect state of the visuospatial cognitive disorder and the functional localization of the brain can be more accurately understood.

[0016] The present invention also provides It has a head-mounted display equipped with a pair of cameras on the front, This is a training system for people with visual-spatial cognitive disorders that is configured to display a group of three-dimensional objects with pseudo-depth in the proximal or distal space of the subject on the screen of the head-mounted display for the erasure test, which is one of the spatial neglect tests.

[0017] In this training system for persons with visuospatial cognitive impairment, for example, after a subject is tested using the above-mentioned testing system for persons with visuospatial cognitive impairment, a training plan is drawn up based on the content and level of the impairment revealed by the test, and the subject walks while being presented with appropriate images in accordance with the training plan, thereby enabling appropriate training or rehabilitation to be performed according to the disability.

[0018] In this invention of a training system for persons with visuospatial cognitive disorders, the matters described in relation to the invention of the testing system for persons with visuospatial cognitive disorders above apply, so long as they are not contrary to the nature of the invention.

[0019] The present invention also provides A head-mounted display equipped with a pair of cameras on the front and the left and right, At least one motion measurement device is attached to the trunk and / or lower limbs of the subject; a computer that wirelessly controls the head mounted display and the motion measurement device in a synchronized manner; having The present invention is an examination system for persons with visual-spatial cognitive disorders, which is configured to display images on the screen of the head-mounted display in a proximal or distal space relative to the subject.

[0020] In the test system for visual-spatial cognitive impairment, typically, it is configured to be able to call attention by presenting an attention symbol on the screen of the head mounted display, by voice from the speaker of the head mounted display, or by vibration stimulation based on the measurement result of the motion measurement device. In this way, it is possible to provide appropriate attention when the subject walks for the test. Furthermore, in the test system for visual-spatial cognitive impairment, typically, it is configured to be able to measure the subject's head movement using a gyroscope built into the head mounted display and / or measure the subject's eye movement using an infrared sensor built into the head mounted display. In this way, it is possible to perform an analysis of the subject's head and eye movement when the subject walks for the test. Typically, different images are displayed on the screen of the head mounted display in the proximal space and the distal space. Also, typically, the head mounted display has a gaze detection function, and detects the direction of the subject's gaze using the gaze detection function, and displays images on the screen of the head mounted display with different reduction ratios and different positions in the left and right directions within the screen depending on whether the subject's gaze angle is upward or downward. In addition, by measuring and analyzing gait analysis data (stance phase time, stride length, walking speed, etc.) and trunk and lower limb joint movements (trunk flexion and extension, hip flexion and extension, knee flexion and extension, ankle dorsiflexion and plantar flexion) during walking, daily activities, etc., using a motion measurement device installed on the trunk and / or lower limbs, it is possible to understand the content and degree of the relationship between the neglect situation in space and the movement disorder through the analysis of the subject's movements during walking, daily activities, etc. For example, the motion measurement device measures the angle of the subject's trunk and the joint angles of the lower limbs, and if the angle and the joint angle deviate from the predetermined angle range, it detects an abnormality and alerts the subject by displaying an attention symbol on the screen of the head-mounted display, and also alerts the subject by voice or vibration stimulation from a vibrator attached to the motion measurement device.Furthermore, the distance of an obstacle in the depth direction is predicted from the images of the pair of cameras of the head mounted display, and when the distance between the subject and the obstacle approaches the predicted distance, a warning symbol is presented on the screen of the head mounted display to warn the subject, and at this time, the subject is warned by voice as to which direction the obstacle is approaching. Basically, any type of motion measurement device may be used and can be selected as needed, but typically, a wireless inertial measurement unit (IMU) is used. The wireless method can be selected as needed, and for example, wireless WIFI, BLUETOOTH (registered trademark), etc. can be used.

[0021] In this invention of a testing system for persons with visuospatial cognitive disorders, the matters described in relation to the invention of the testing system for persons with visuospatial cognitive disorders above apply, unless otherwise stated inconsistent with the nature of the invention.

[0022] The present invention also provides A head-mounted display equipped with a pair of cameras on the front and the back, At least one motion measurement device is attached to the trunk and / or lower limbs of the subject; a computer that wirelessly controls the head mounted display and the motion measurement device in a synchronized manner; having The present invention is a training system for persons with visual-spatial cognitive disorders, which is configured to display images on the screen of the head-mounted display in a proximal or distal space relative to the subject.

[0023] In this invention of a training system for persons with visuospatial cognitive disorders, the matters described in relation to the invention of an examination system for persons with visuospatial cognitive disorders and the invention of a training system for persons with visuospatial cognitive disorders above apply, so long as they are not contrary to the nature of the invention.

[0024] The present invention also provides A head-mounted display equipped with a pair of cameras on the front and the back, At least one motion measurement device is attached to the trunk and / or lower limbs of the user; a computer that wirelessly controls the head mounted display and the motion measurement device in a synchronized manner; having The spatial movement support system for persons with visual-spatial cognitive disorders is configured to be able to display images on the screen of the head-mounted display in a proximal or distal space relative to the user.

[0025] In this spatial action support system for people with visuospatial cognitive disorders, during the user's daily activities including walking, one of the following is performed to alert the user: by displaying an attention alert symbol on the screen of the head mounted display, by audio alerts from the speaker of the head mounted display, or by vibration stimuli based on the measurement results of a action measurement device; by measuring the movement of the user's head using a gyroscope built into the head mounted display and / or by measuring the movement of the user's eyeballs using an infrared sensor built into the head mounted display, if there is an abnormal tilt of the trunk or lower limbs due to the influence of spatial neglect, this is detected and an alert is given to the user; the action measurement device measures the angle of the user's trunk and the joint angles of the lower limbs, and if said angle and said joint angle deviate from their respective predetermined angle ranges, an abnormality is detected and an alert symbol is presented on the screen of the head mounted display to alert the user. In addition to alerting the user, the device can also alert the user by audio or vibration stimulation from a vibrator attached to the movement measuring device, predict the distance to an obstacle in the depth direction from images from the pair of cameras on the head mounted display, and alert the user by presenting an alert symbol on the screen of the head mounted display when the distance between the user and the obstacle approaches that distance, and at this time alert the user by audio as to which direction the obstacle is approaching, or detect the direction of the user's gaze using the gaze detection function of the head mounted display and alert the user by presenting images on the screen of the head mounted display that have different reduction rates and different positions in the left and right directions depending on whether the angle of the user's gaze is upward or downward, thereby preventing the user from colliding with obstacles or approaching dangerous places, thereby improving daily living activities and ultimately improving the quality of life.

[0026] In this invention of a spatial movement support system for persons with visuospatial cognitive disorders, the matters described in relation to the invention of the testing system for persons with visuospatial cognitive disorders above apply, unless otherwise stated inconsistent with the nature of the invention. Effect of the Invention

[0027] According to this invention, in the examination system for visual-spatial cognitive disorders, a group of three-dimensional objects with pseudo-depth for the erasure test, which is one of the spatial neglect tests, can be displayed on the screen of the head-mounted display in the proximal or distal space to the subject, so that the content and degree of the disability of a person with visual-spatial cognitive disorders such as hemispatial neglect can be easily examined objectively, quantitatively, and in detail from a new perspective. In addition, in the training system for visual-spatial cognitive disorders, a group of three-dimensional objects with pseudo-depth for the erasure test can be displayed on the screen of the head-mounted display in the proximal or distal space to the subject, so that a person with visual-spatial cognitive disorders such as hemispatial neglect can be appropriately trained from a new perspective according to the content and degree of the disability, and rehabilitation treatment and assistance can be effectively performed. In addition, in another examination system for visual-spatial cognitive disorders, an image can be displayed on the screen of the head-mounted display in the proximal or distal space to the subject, so that the content and degree of the disability of a person with visual-spatial cognitive disorders such as hemispatial neglect can be easily examined objectively, quantitatively, and in detail from a new perspective. In addition, in another training system for people with visual-spatial cognitive disorders, images can be displayed on the screen of a head-mounted display in the proximal or distal space relative to the subject, so that people with visual-spatial cognitive disorders such as hemispatial neglect can be appropriately trained from a new perspective according to the type and degree of their disorder, and rehabilitation treatment and assistance can be effectively performed. In addition, in a spatial action support system for people with visual-spatial cognitive disorders, images can be displayed on the screen of a head-mounted display in the proximal or distal space relative to the user, so that the vision of people with visual-spatial cognitive disorders such as hemispatial neglect can be assisted and spatial actions can be supported, thereby improving daily living activities and improving the quality of life. [Brief description of the drawings]

[0028] [Figure 1] 1 is a schematic diagram showing a testing system for persons with visuospatial cognitive impairment according to a first embodiment of the present invention; [Diagram 2] 1 is a schematic diagram showing a configuration of a head-mounted display constituting an examination system for persons with visuospatial cognitive impairment according to a first embodiment of the present invention; [Diagram 3] FIG. 1 is a front view showing a hand controller constituting the testing system for persons with visuospatial cognitive disorders according to the first embodiment of the present invention. [Figure 4] 1 is a schematic diagram showing an arrangement when a test is performed using a testing system for persons with visuospatial cognitive impairment according to a first embodiment of the present invention; [Diagram 5] 1 is a plan view showing the arrangement of a subject and a motion analysis camera when a test is performed using the testing system for persons with visuospatial cognition disorders according to a first embodiment of the present invention. FIG. [Figure 6] FIG. 1 is a schematic diagram showing a proximal space and a distal space as display spaces for a cancellation task displayed on a screen of a head-mounted display when a test is performed using a testing system for persons with visuospatial cognitive disorders according to the first embodiment of the present invention. [Figure 7] 1 is a schematic diagram showing a state in which a screen of a head-mounted display is divided into nine when a test is performed using the testing system for persons with visuospatial cognitive disorders according to the first embodiment of the present invention; [Figure 8] FIG. 11 is a schematic diagram showing a test performed using a testing system for persons with visuospatial cognitive disorders according to the first embodiment of the present invention, in which cubes are displayed in the proximal space in nine divided regions on the screen of a head-mounted display, and the test subject attempts to erase them with a hand controller. [Figure 9] FIG. 1 is a schematic diagram showing a test subject attempting to erase cubes in distal space displayed in nine divided regions on the screen of a head-mounted display using a testing system for persons with visuospatial cognitive disorders according to the first embodiment of the present invention, with the subject attempting to erase them with a sphere. [Figure 10] FIG. 1 is a schematic diagram showing a state before a cube is displayed in each of nine divided areas on a screen of a head-mounted display and an attention-calling message is issued when a test is conducted using the testing system for persons with visuospatial cognition disorders according to the first embodiment of the present invention. [Figure 11]FIG. 1 is a schematic diagram showing a state in which a cube is displayed in each of nine divided areas on the screen of a head-mounted display and attention is drawn by moving arrows when a test is performed using the testing system for persons with visuospatial cognition disorders according to the first embodiment of the present invention. [Figure 12] FIG. 1 is a schematic diagram showing how, when conducting an examination using an examination system for persons with visuospatial cognition disorders according to the first embodiment of the present invention, the nine divided areas on the screen of a head-mounted display are divided into a left area, a central area, and a right area, and the subject's gaze distribution is examined for each area when a cube is displayed in each area in distal space. [Figure 13] FIG. 1 is a schematic diagram showing how the nine divided areas of the screen of a head-mounted display are divided into a left area, a central area, and a right area when conducting an examination using an examination system for persons with visuospatial cognition disorders according to the first embodiment of the present invention. [Figure 14] FIG. 1 is a schematic diagram showing how the angle of rotation of the subject's head and the angle of rotation of the eyeballs are measured each time a cube displayed on the screen of a head-mounted display is erased when a test is performed using the test system for persons with visuospatial cognition disorders according to the first embodiment of the present invention. [Figure 15] FIG. 1 is a schematic diagram showing typical results when a test is performed using the testing system for persons with visuospatial cognition disorders according to the first embodiment of the present invention, measuring the angle of rotation of the subject's head and the angle of rotation of the eyeballs each time a cube displayed on the screen of a head-mounted display is erased. [Figure 16] FIG. 11 is a schematic diagram showing the results of measuring the subject's gaze distribution in the proximal space when erasing a cube displayed on the screen of a head-mounted display during an examination using an examination system for persons with visuospatial cognition disorders according to the first embodiment of the present invention, comparing the results for a normal erasure task with those for an erasure task using attention calls, for each region of the screen. [Figure 17]FIG. 11 is a schematic diagram showing the results of measuring the subject's gaze distribution in distal space when erasing a cube displayed on the screen of a head-mounted display during an examination using an examination system for persons with visuospatial cognition disorders according to the first embodiment of the present invention, comparing the results for a normal erasure task with those for an erasure task using attention calls, for each region of the screen. [Figure 18] FIG. 11 is a schematic diagram showing the results of measuring the angle of rotation of the subject's head and the angle of rotation of the eyeballs in the proximal space when erasing a cube displayed on the screen of a head-mounted display during an examination using the examination system for persons with visuospatial cognitive disorders according to the first embodiment of the present invention. [Figure 19] FIG. 11 is a schematic diagram showing the results of measuring the angle of rotation of the subject's head and the angle of rotation of the eyeballs in distal space when erasing a cube displayed on the screen of a head-mounted display during an examination using the examination system for persons with visuospatial cognitive disorders according to the first embodiment of the present invention. [Figure 20] 1 is a schematic diagram showing a group of cubes having different depths presented on a screen of a head-mounted display when a test is performed using the testing system for persons with visuospatial cognitive disorders according to the first embodiment of the present invention. FIG. [Figure 21] FIG. 21 is a schematic diagram showing the results of measuring the erasure rate for each depth when a cancellation test is performed by displaying a group of cubes having different depths from each other as shown in FIG. 20 in an object-centered coordinate system on the screen of a head-mounted display when a test is performed using the testing system for persons with visuospatial cognition disorders according to the first embodiment of the present invention; [Figure 22] FIG. 2 is a schematic diagram showing the results of a cancellation test in distal space for each region of the screen of a head-mounted display when a test is conducted using the testing system for persons with visuospatial cognitive disorders according to the first embodiment of the present invention. [Diagram 23] 1 is a drawing-substitute photograph showing a state in which brain activity during the performance of a deletion task is examined by near-infrared spectroscopy in a testing system for persons with visuospatial cognitive impairment according to the first embodiment of the present invention. [Figure 24] FIG. 11 is a schematic diagram showing a training system for persons with visuospatial cognitive disorders according to a second embodiment of the present invention. [Diagram 25]11 is a schematic diagram showing a state in which an inertial measurement unit is installed on a subject undergoing training in a training system for persons with visuospatial cognitive impairment according to a second embodiment of the present invention. FIG. [Figure 26] FIG. 13 is a schematic diagram showing a walking animation created by installing an inertial measurement device on a subject undergoing training in a training system for persons with visuospatial cognitive disorders according to a second embodiment of the present invention and acquiring angles of each part. [Figure 27] 13 is a drawing-substitute photograph showing the state of a room photographed by cameras 11 and 12 of a head-mounted display 10 in a training system for persons with visual-spatial cognitive disabilities according to a second embodiment of the present invention. [Figure 28] 13 is a drawing-substitute photograph showing a state in which an attention-calling symbol is displayed on the screen of the head-mounted display 10 in a training system for persons with visuospatial cognitive disorders according to a second embodiment of the present invention. [Figure 29] 13 is a photograph in lieu of a drawing showing the state before the gaze direction is detected using the gaze detection function of the head-mounted display 10 and the appearance of the field of view is changed in a training system for persons with visual-spatial cognitive disorders according to the second embodiment of the present invention. [Diagram 30] 13 is a photograph in lieu of a drawing showing how the field of view appears when the gaze direction is detected using the gaze detection function of the head-mounted display 10 in a training system for persons with visual-spatial cognitive disorders according to the second embodiment of the present invention and the field of view is changed up and down. [Diagram 31] 13 is a drawing-substitute photograph showing how an attention-calling symbol is displayed on the screen upon automatic detection of an obstacle by the stereo camera of the head-mounted display 10 in a training system for persons with visual-spatial cognitive disorders according to a second embodiment of the present invention. [Diagram 32] FIG. 13 is a schematic diagram showing how a subject's attention is called by audio and vibration stimuli when the subject's direction of travel deviates while walking in a training system for persons with visuospatial cognition disorders according to a second embodiment of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0029] Hereinafter, a mode for carrying out the invention (hereinafter referred to as an "embodiment") will be described with reference to the drawings.

[0030] First Embodiment [Testing system for people with visual-spatial cognitive disorders] Fig. 1 shows an examination system for persons with visuospatial cognitive impairment according to a first embodiment. As shown in Fig. 1, this examination system for persons with visuospatial cognitive impairment has a head-mounted display 10 equipped with a pair of left and right cameras 11, 12 on the front, and a computer 20 for controlling the operation of the head-mounted display 10, including turning the cameras 11, 12 on and off and controlling the display of images on the display. The head-mounted display 10 can be controlled by transmitting and receiving signals via wireless communication between the head-mounted display 10 and the computer 20.

[0031] FIG. 2 shows the configuration of the head mounted display 10. Note that illustration and description of a band used when mounting the head mounted display 10 on the head are omitted. As shown in FIG. 2, a pair of left and right cameras 11, 12 (stereo cameras) are provided on the front of the head mounted display 10, that is, at positions optically corresponding to the eyes e1, e2 when the subject mounts the display, and a pair of left and right displays 13, 14 are provided at positions optically corresponding to the eyes e1, e2, and infrared sensors 15, 16 are provided at positions optically corresponding to the eyes e1, e2. The cameras 11, 12 are adapted to recognize real space. When the cameras 11, 12 are turned off, the display is in VR mode, and when the cameras 11, 12 are turned on, the display is in AR (augmented reality) mode. The operation of the head mounted display 10, including turning the cameras 11, 12 on / off and the operation of the displays 13, 14, can be controlled by transmitting and receiving signals through wireless communication between the head mounted display 10 and the computer 20. Although not shown, the head mounted display 10 has a built-in gyroscope, which can be used to obtain the rotational movement of the head. In addition, the eye movements of both eyes e1 and e2 can be measured by measuring the line of sight with infrared sensors 15 and 16. This makes it possible to analyze the movements of the eyes and head when the subject erases a group of three-dimensional objects for testing. The head-mounted display 10 has two built-in speakers (stereo speakers) and can alert the subject by sound.

[0032] The computer 20 usually has a computer main body (processing / control device) and a display. The computer 20 may be a desktop type or a notebook type. The processing / control device has a processor, a main memory, an auxiliary memory, etc. As the auxiliary memory, various types of devices such as a solid state drive (SSD) or a hard disk drive (HDD) can be used, and may be built into the processing / control device or may be external. A predetermined program using a predetermined programming language is stored in this auxiliary memory. When this program is executed, the program is read from the auxiliary memory to the main memory, or downloaded from the Internet, etc., and the program is executed by the processor, or the program is executed on a server connected by a network. Although not shown in the figure, input devices such as a keyboard and a mouse and other peripheral devices may be connected to the processing / control device as necessary.

[0033] In this testing system for people with visuospatial cognition disorders, when a group of three-dimensional objects with pseudo-depth for a deletion test, which is one of the spatial neglect tests, is displayed on the screen of the head-mounted display 10, a hand controller (also called a control stick) 30 as shown in Fig. 3 is used for the subject to perform an operation to delete the three-dimensional objects. As shown in Fig. 3, the hand controller 30 has a spherical part 32 at the tip of a handle 31. Then, the user can delete the three-dimensional object by holding the handle 31 in the hand and placing the spherical part 32 over the three-dimensional object to be deleted.

[0034] FIG. 4 shows the layout when the test system for persons with visuospatial cognitive impairment is used. As shown in FIG. 4, when using the test system for persons with visuospatial cognitive impairment, the subject 40 sits in a chair 50. That is, the test is performed in a seated position. The chair 50 has a backrest so that the posture of the subject 40 can be stabilized. Note that subjects 40 who require a wheelchair are tested while sitting in the wheelchair. During the test, the head-mounted display 10 is attached to the head 41 of the subject 40, and the subject 40 is asked to grasp the handle 31 of the hand controller 30 with his / her dominant hand, or with the non-paralyzed hand if the dominant hand is paralyzed.

[0035] In order to record the movements of the subject 40 during the examination, a motion analysis camera 60 is installed to photograph the subject 40 from the front. FIG. 5 is a plan view showing this arrangement. A Web camera is used as the motion analysis camera 60, and the captured images are sent to and stored in the computer 20. The distance between the subject 40 and the motion analysis camera 60 can be selected as necessary, but is, for example, about 2 m.

[0036] In this system for testing people with visual-spatial cognitive disorders, a program using a predetermined programming language is designed to display a group of three-dimensional objects with pseudo depth in a proximal or distal space to the subject 40 on the screen of the head-mounted display 10 as a cancellation task for a cancellation test, which is one of the tests for spatial neglect. That is, the subject 40 can freely select whether to display the group of three-dimensional objects in a proximal or distal space. In addition, the head-mounted display 10 is configured to allow the coordinate system for displaying the group of three-dimensional objects on its screen to be set to a body-centered coordinate system (a coordinate system in which the subject's own body is the center for recognizing objects) or an object-centered coordinate system (a coordinate system in which the consciousness is always focused on a specific object). That is, the subject can freely select whether to display the group of three-dimensional objects in a body-centered coordinate system or an object-centered coordinate system. This setting can be easily performed by the examiner, for example, by operating the keyboard, mouse, etc. of the computer 20.

[0037] Fig. 6 shows the proximal space and the distal space relative to the head 41 of the subject 40. The positions at which the peripheral tasks are displayed in the proximal space and the distal space are selected as necessary, but Fig. 6 shows, as an example, a case in which the depth distance from the head 41 of the subject 40 is displayed at three levels of 35 cm, 45 cm, and 55 cm in the proximal space, and the depth distance from the head of the subject 40 is displayed at three levels of 4 m, 4.3 m, and 4.5 m in the distal space.

[0038] FIG. 7 shows the screen of the head mounted display 10. As shown in FIG. 7, as an example, the screen is divided into 9 equal regions (regions 1 to 9) of 3×3 in length and width, and one cube is displayed as a three-dimensional object in each region. In this case, these regions are arranged, for example, within a range of 90° in the horizontal direction (45° on either side, left or right) and 50° in the vertical direction (25° on either side, up or down). In the erasure test, nine cubes are displayed at a time, and the depth in each region is displayed randomly. Three trials of the erasure task are performed, and a total of 27 cubes are erased.

[0039] An erasure method when an erasure task is displayed in the proximal space will be described. As shown in FIG. 8, cubes with different depth distances and a spherical part 32 at the tip of the handle 31 of the hand controller 30 are displayed in the proximal space as an erasure task. The hand controller 30 is projected in the same spatial coordinates as the real space. The cube closest to the head 41 is projected at a position 35 cm away. The size of the cube is, for example, 5 cm on a side. The projected spherical part 32 of the hand controller 30 is overlapped with the cube to perform erasure.

[0040] A method of erasure when an erasure task is displayed in the distal space will be described. As shown in FIG. 9, cubes with different depth distances are displayed in the distal space as an erasure task. In this case, the cubes are erased by projecting a sphere onto the screen of the head-mounted display 10, not the hand controller 30, and overlapping the projected sphere with the cube. The cube closest to the head 41 is projected at a position 4 m away. The size of the cube is 20 cm on each side. The sphere is projected 20 cm in front of the cube. On the screen, the sphere moves in a space from 3.8 m to 4.6 m away from the head.

[0041] When erasing the erasure task, an attention-calling symbol can be presented to the subject 40 on the screen of the head-mounted display 10 to call his / her attention. For example, in the case where the screen when no attention-calling is performed is as shown in FIG. 10, an arrow (colored in yellow, for example) pointing to the center of the screen can be presented as an attention-calling symbol on the right side of the screen of the head-mounted display 10 as shown in FIG. 11. Attention can also be called by blinking a cube. In addition to presenting the attention-calling symbol, or instead of presenting the attention-calling symbol, the subject 40 can also be called by playing a sound from a stereo speaker.

[0042] The results of an actual test performed on a subject 40 who is a hemispatial agenesis patient using this testing system for persons with visuospatial cognitive disorders will be described.

[0043] [Test 1] The head mounted display 10 used was manufactured by HTC. The spatial coordinate values ​​of the hand controller 30, the angle of the head 41 of the subject 40, and the angle of the eyeball by eye tracking can be measured, and the sampling frequency of each data is 50Hz. The viewing angle of the head mounted display 10 is 120 degrees, and a three-dimensional space of 4m wide x 4m high x 4m deep is projected onto the screen, and the change in the projected image due to the movement of the head and trunk, and the movement of the hand controller 30 are synchronized with the real environment in VR.

[0044] By performing a task of erasing cubes projected in the proximal and distal spaces using the head-mounted display 10, we clarified the neglect symptoms in each space and examined the effect of attention calls on the neglect state. The cubes in the proximal space were projected at distances of 0.35 m, 0.45 m, and 0.55 m from the head 41 of the subject 40, within the reach of the subject 40. The cubes in the distal space were projected on concentric circles with the head 41 at the center, at distances of 4 m, 4.3 m, and 4.6 m from the head 41 of the subject 40.

[0045] For each of the proximal and distal spaces, the screen is divided equally into nine regions as shown in FIG. 7, and one cube with depth is randomly projected into each divided region. Nine cubes are displayed at a time, and three trials of the erasure task are performed in one spatial condition, with a maximum of 27 cubes being projected into each of the proximal and distal spaces. The cube display size and the method of erasure of the cube are slightly different between the proximal and distal spaces. The cube in the proximal space is a cube with a side length of 5 cm, and the erasure is performed by displaying the hand controller 30 on the screen and overlapping the spherical part 32 of the projected hand controller 30 on the cube for one second to erase the cube. The hand controller 30 is projected at the same spatial coordinate position as in the real space. In the distal space, the cube is 20 cm on a side, and a sphere is displayed on the screen instead of the hand controller 30. The sphere is projected at a distance of 3.8 m from the head 41 of the subject 40, and the cube is erased by superimposing the sphere on the cube for one second. Alternatively, for example, a laser beam is emitted from the avatar of the hand controller 30 (on the screen of the head mounted display 10) or the actual hand controller 30, and the laser beam hits the cube, and the cube is erased after a certain fixed time (for example, 3 seconds, each set time is adapted to each subject 40) has elapsed. At this time, the position at which the cube is recognized as being gazed upon is set by the radius of the periphery from the center of the cube, and it is recognized that the cube can be erased. For example, if a patient with hemispatial neglect is mild, it is easy to recognize the neglect, so the cube can be erased by gazing only at the center point of the cube, but if the patient with hemispatial neglect is severe, the examiner can set it so that the cube can be erased by gazing anywhere on the entire cube.

[0046] The attention-calling system is configured so that an arrow moves from the right edge to the left edge on the screen of the head-mounted display 10 during the erasure task.

[0047] Within the head mounted display 10, cubes are projected concentrically in both the proximal space and the distal space.

[0048] The test was started with the subject 40 seated in a chair 50, wearing the head-mounted display 10 on his head 41, and holding the handle 31 of the hand controller 30 in his right hand. With the head-mounted display 10 attached to his head 41, the subject 40 faced forward and performed calibration of the spatial coordinates. During this time, a therapist fixed the head 41 from behind, restricting the movement of the head 41 during the calibration.

[0049] The cancellation task was performed under normal conditions without any attention prompts, followed by the cancellation task using the attention prompt system. The order of performing the proximal or distal space was randomized for each of the 40 subjects.

[0050] Subject 40 was a group of eight patients (average age: about 72 years) with unilateral spatial neglect due to cerebrovascular disease who were able to cooperate with the experiment, as shown in Table 1. The patient information showed that there were no problems with the visual field required to perform this test.

[0051] [Table 1]

[0052] In the test, the number of cubes that were projected onto the space, up to 27 in number, were erased was recorded. For the analysis, the space was divided into three parts, the left side, the center, and the right side, and the number of cubes that were erased in each area was compared for each condition. The maximum number of cubes erased for each divided space was 9. For each of the 40 subjects, the number of erasures was calculated for each of the four conditions, the normal task in the proximal space, the task using attention, the normal task in the distal space, and the task using attention, and the average value for each condition was calculated. A comparison was made between the normal task and the task using attention for each of the left, center, and right areas of the proximal and distal spaces. Statistical procedures were performed using the Shapiro-Wilk test to check the normality of the values ​​and the F test to check for equality of variance. If normality and equality of variance were confirmed, a T test was performed, and if not, a Wilcoxon signed rank sum test was performed. The significance level was set at 5% or less. In addition, effect size was calculated (using R's compute.se) using Cohen's d when normality was confirmed, and Cliff's Delta when normality was not confirmed. Effect size indicates the magnitude of the difference in the test results, and effect sizes of 0.2, 0.5, and 0.8 can be interpreted as small, medium, and large indicators, respectively.

[0053] (Gaze distribution) As the distribution of gaze from the start to the end of each task, the change over time of the sum of the head angle and eyeball angle was extracted. The result is shown in Figure 12. The extracted gaze distribution data was converted into the percentage of the gaze remaining in each of the three areas of the space: left, center, and right. As shown in Figure 13, the extension of the head 41 of the subject 40 was set to 0 degrees, and the range of 15 degrees to the left and right was set to the center, 15 degrees or more to the right, and -15 degrees or less to the left. The average value was calculated from the percentage of gaze distribution in each area obtained for each subject 40, and the three areas were compared for the normal task and the task using the attention call in the proximal space, and the normal task and the task using the attention call in the distal space. The statistical procedure was performed in the same manner as the distribution of the number of erasures.

[0054] (Relationship between head and eye movement angles) In an analysis based on gaze distribution, it is not possible to consider whether visual search during the task is performed by head 41 movement, eye movement, or both. Therefore, apart from gaze distribution, we looked at the relationship between the movement angle of head 41 (head rotation angle) and the movement angle of the eyes (eye rotation angle) (see Figure 14). An example of the relationship between head rotation angle and eye rotation angle is shown in Figure 15. The greater the slope of the approximation curve shown in Figure 15, the greater the movement of the eyes to the same side as the head 41. Using the angle data of head 41 and eyes extracted during the task, the movement angle was calculated using the following procedure.

[0055] (1) Extract the data for each left and right angle from the time the cube was first erased to the time the cube was finally erased. (2) Calculate the amount of displacement of each angle data of the head 41 and the eyeballs when the cube is eliminated, and each angle data when the next cube is eliminated. (3) Using the head and eye movement angles in the left and right directions for each cube erasure for the eight subjects, correlations (Spearman rank correlation coefficients) were examined for the proximal and distal spaces for the normal task and the task using attention. In addition, a test of the difference in correlation coefficients for each space was performed (r.test using R's psych).

[0056] (result) (1) Number of deletions In the proximal space, the mean scores for the normal erasure task were 7.63±2.91 on the left, 8.50±1.00 on the center, and 8.88±0.33 on the right, while the mean scores for the attention-based erasure task were 7.63±2.96 on the left, 8.88±0.33 on the center, and 8.88±0.33 on the right. In comparing the normal erasure task and the attention-based erasure task, the Wilcoxon signed rank sum test showed no significant differences on the left (P=1), center (P=0.371), and right (NaN). On the other hand, in terms of effect size, Cliff's Delta tended to show a weak effect in the center space on the left (0), center (0.28), and right (0) (Table 2).

[0057] [Table 2]

[0058] In the distal space, the mean scores for the normal erasure task were 4.50 ± 3.24 on the left, 6.50 ± 1.50 on the center, and 6.88 ± 1.54 on the right, while the mean scores for the attention-based erasure task were 6.50 ± 2.50 on the left, 7.38 ± 1.22 on the center, and 7.63 ± 1.22 on the right. In a comparison of the normal erasure task and the attention-based erasure task, the mean scores were 0.0255 on the left, 0.111 on the center, and 0.197 on the right, with a significant difference in the left space. In addition, the effect sizes tended to be moderate in all spaces, with Cohen's d showing 0.59 on the left, 0.64 on the center, and 0.54 on the right (Table 3).

[0059] [Table 3]

[0060] (2) Distribution of gazes Figure 16 shows the results of measuring the gaze distribution in the proximal space in a normal erasure task and a deletion task using attention. The distribution ratio of gaze was 20.15 ± 8.81 on the left side, 36.29 ± 12.63 on the center, and 43.56 ± 17.19 on the right side in the normal erasure task in the proximal space, while the distribution ratio was 31.14 ± 10.55 on the left side, 41.79 ± 14.16 on the center, and 27.06 ± 9.20 on the right side in the deletion task using attention. In comparing the normal erasure task and the deletion task using attention, the T-test showed a significant difference in the left side (P = 0.00391) and right side (P = 0.0778), and the Wilcoxon signed rank sum test showed a significant difference in the center (P = 0.844), with a significant difference in the left side. Regarding effect sizes, Cohen's d was on the left (1.13) and right (1.34), and Cliff's Delta was in the middle (0.23), showing a tendency to stronger effect sizes in the left and right spaces.

[0061] Figure 17 shows the results of comparing the gaze distribution in the distal space measured in the normal erasure task and the erasure task using attention. In the normal erasure task in the distal space, the average was 15.55 ± 10.18 on the left side, 47.83 ± 13.67 on the center, and 36.62 ± 11.65 on the right side. In the erasure task using attention, the average was 31.60 ± 9.11 on the left side, 41.27 ± 8.92 on the center, and 27.13 ± 9.51 on the right side. In the comparison between the normal erasure task and the erasure task using attention, the results were significant in the left side (P = 0.0187) and center (P = 0.0642) by T-test, and the right side (P = 0.0547) by Wilcoxon signed rank sum test. In addition, effect sizes tended to be moderate in the central and right spaces, with no significant differences in Cohen's d (1.66) and central (0.57) and in Cliff's Delta (0.47) for the left and right spaces, respectively.

[0062] (3) Relationship between head and eye movement angles Regarding the relationship between the left and right head and eye movement angles, in the proximal space, the normal erasure task (r = 0.129, P = 0.0757) and the attention-based erasure task (r = 0.412, P = 1.82 × 10 -9 ) As shown in Figure 18A, the normal erasure task showed no significant difference in the non-correlation test, and no correlation was observed. On the other hand, as shown in Figure 18B, the normal erasure task using attention showed a moderate positive correlation. In addition, the correlation coefficient difference test between the normal erasure task and the erasure task using attention was (Z=3, P=0).

[0063] In the distal space, the normal erasure task (r = 0.348, P = 4.95 × 10 -5 ), and the erasure task with a reminder (r=0.644, P=0). As shown in Figure 19A, a weak positive correlation was observed in the normal erasure task. On the other hand, as shown in Figure 19B, a moderate positive correlation was observed in the erasure task with a reminder. In addition, the correlation coefficient difference test between the normal erasure task and the erasure task with a reminder was (Z=3.4, P=0).

[0064] (4) Discussion In this study, the symptoms of spatial neglect were clarified by performing an erasure task using a head-mounted display 10, and the effect of an attention system on the symptoms of spatial neglect was examined. The effects on the symptoms of spatial neglect were examined in terms of the number of erasures per space, which captures direct changes in the task, the distribution of gaze, which shows the bias of visual search in the space to perform the task, and the relationship between the head and the eyes, which is a strategic feature in visual search. The main findings of this study were that when attention was used, the number of erasures showed a significant increase in the left area of ​​the distal space. In addition, the distribution rate of gaze significantly increased the rate of gazing at the left area of ​​the proximal and distal spaces. Furthermore, in the relationship between the left and right movement angles of the head and the eyes, a moderate positive correlation was observed in the proximal and distal spaces, and the difference in the correlation coefficient was also significant. This suggests that the use of attention when displaying an erasure task on the screen of the head-mounted display 10 may have an effect on gaze at the left area. It also suggests that the strategy of the visual search itself may be affected.

[0065] Below, we will consider the impact of warnings on each analysis result.

[0066] (4-1) Number of deletions A comparison of the number of erasures in the normal erasure task in the proximal space and the erasure task using attention calls showed no significant difference in the left, center, or right sides. However, when looking at the effect size in the center, there was a tendency to show a weak difference, and it does not seem to deny the possibility that the number of erasures increases by using attention calls. In addition, the number of erasures in each area of ​​the proximal space was high in the daytime erasure task, and it is possible that it was difficult to produce a difference that would allow a keen understanding of the effects of attention calls.

[0067] In a comparison of the number of erasures in the normal erasure task and the erasure task using attention in the distal space, the number of erasures increased significantly on the left and center. In addition, the effect size tended to show moderate differences in all spaces. These results suggest that attention may improve the performance of the erasure task in the distal space.

[0068] Compared to distal space, the weaker neglect symptoms in proximal space were similar to previous reports that showed no neglect symptoms in proximal space. The erasure task is characterized by the integration of perception and movement as a task execution accompanied by actual movement after visual perception, and it is possible that neglect symptoms in proximal space were mild due to factors related to the egocentric motor task.

[0069] The fact that there was a tendency to observe a certain difference in the effect size in the number of erasures when attention was used in both proximal and distal spaces suggests that attention may have some effect on visual search.

[0070] Comparing the number of deletions makes it possible to grasp the state of neglect. On the other hand, other analyses are needed to examine the strategic factors that lead to deletion.

[0071] (4-2) Distribution of gazes The measurement of eye movements in patients with spatial neglect is considered a useful means of evaluation to complement existing paper-and-pen tests, and to obtain knowledge about spatial working memory. In this study, we examined the distribution of gazes, and found that in the proximal space, gazes were more likely to be distributed to the center and right side than to the left side in the normal erasure task. In the erasure task using attention, the distribution of gazes to the center and left side increased with a decrease in the distribution of gazes to the right side, and the distribution of gazes to the left side increased significantly compared to the normal erasure task. In addition, the effect size tended to show a strong difference between the right and left sides. These findings suggest that attention may induce gazes to move from the right to the left side.

[0072] In the distal space, in the normal erasure task, gaze distribution was greater on the center and right side than on the left side, as in the proximal space. When the attention task was used, gaze distribution on the right side decreased, while gaze distribution on the left side significantly increased. Furthermore, the effect size showed a strong difference on the left side, and tended to show moderate differences in the center and right sides. This suggests that attention may have induced gaze from the right to the left in the distal space as well.

[0073] The reason why the distribution of gaze changed from right to left regardless of whether it was in proximal or distal space by using the attention call is thought to be due to the characteristics of the attention call used in this study. In this attention call system, an arrow image displayed on the screen of the head-mounted display 10 moves continuously from right to left, and by tracking the arrow image, attention to the left side is induced. The effectiveness of visual scanning training and smooth eye movement has been reported as interventions for spatial neglect. It is thought that the attention call system used in this study, by tracking the arrow image from right to left, had the same effect as left-side visual scanning using smooth eye movement.

[0074] Analysis of the distribution of gaze directions showed that, as in previous reports, it is possible to detect neglect symptoms by measuring eye movements, and that it is possible to detect behavioral changes at a perceptual level by raising awareness.

[0075] (4-3) Relationship between the head and eyes In the proximal space, no correlation was found between the head and eyes in a normal elimination task, but a correlation was found in a elimination task using attention, and a difference was also found in the test of the difference in correlation coefficients. The fact that no correlation was found between the head and eyes in a normal elimination task suggests that the perceptual strategies used in visual exploration by spatial neglect patients may differ from patient to patient. On the other hand, in rehabilitation for spatial neglect, there are known methods that induce attention to the left space by not only eye movement but also head and trunk rotation. This suggests that the perceptual strategy for the left space may require not only eye movement but also coordination between the eyes and other body parts, and the results of this study suggest that the perceptual strategy itself may be impaired.

[0076] In the distal space, both the normal erasure task and the attention-based erasure task showed a positive correlation, and the attention-based erasure task showed a greater tendency toward a positive correlation, with a difference also observed in the test of the difference in correlation coefficients. This suggests that attention during the erasure task may promote coordinated action of the head and eyes.

[0077] The correlation between the head and the eyes during the normal elimination task was different in the proximal and distal spaces. It is difficult to clearly distinguish from the results of this study whether different perceptual strategies are used depending on the difference in spatial conditions, whether each patient has their own characteristics in the perceptual strategy, or whether the perceptual strategy itself is impaired. On the other hand, in the elimination task using attention, both the proximal and distal spaces showed a positive correlation, which may have a positive effect on the perceptual strategy during the elimination task.

[0078] (5) Summary This test makes it possible to examine neglect symptoms in different spaces in a elimination task using the head-mounted display 10, and may also be able to extract characteristics of perceptual strategies in spatial exploration. In addition, the attention system may have a positive effect on spatial neglect. The attention system not only draws attention to the ignored space, but may also affect the perceptual strategy itself in exploration.

[0079] [Test 2] Subject 40 was a representative patient (83 years old) with hemispatial neglect due to cerebrovascular disease who was able to cooperate with the experiment. The patient's information showed that there were no problems with the visual field required for carrying out this experiment. The Brunnstrom stage was V for both upper and lower limbs. The Functional Independence Measure (FIM) was 52 for motor items and 32 for cognitive items. The Mini-Mental State Examination (MMSE) was 26. In addition, the line cancellation test in the BIT test scored 24 out of a possible 36 points. The Catherine Neglect in Activities of Daily Living test showed that the patient had a score of 10 out of 10. The Bergego Scale (CBS score) included six items indicating mild neglect of the left side, such as bumping into people or objects on the left side, for a total score of 6.

[0080] The experimental procedure was as follows: first, an object elimination test using the head mounted display 10 was conducted, in which the subject had to eliminate a group of cubes with different depths, and hemispatial neglect was evaluated. The experimental environment is as shown in Figs. 4 and 5. The experiment was conducted in a private room isolated from the surroundings. The subject 40 was in a seated position on a chair. During the experiment, the subject 40 wore the head mounted display 10 on his head 41, and held the hand controller 30 in his dominant hand or, if he had paralysis, in his non-paralyzed hand. In order to record images during the experiment, a camera 60 for motion analysis was placed in front of the subject 40 (at a distance of about 2 m). An infrared sensor was placed to measure the spatial coordinates of the head mounted display 10 and the hand controller 30. The object placement during the object elimination test was determined as the horizontal distance when the bisecting point of the line connecting the left and right eyeballs was set as the origin (hereinafter, the origin). As shown in Figure 20, a group of cubes for the erasure task was placed in the proximal space at distances of 35 cm, 45 cm, and 55 cm in depth from the head 41 of the subject 40. The group of cubes was evenly arranged within the visual field, with 6 rows horizontally, 6 rows vertically, and 3 rows at the back, for a total of 108 cubes, with 36 cubes in each row. Coordinates were input so that the distance between each object was evenly arranged. The 36 objects in each row were randomly arranged. Each cube had the same shape and was colored red.

[0081] (Analysis method) For the object elimination analysis, the cubes were divided into three regions. As shown in Figure 20, the cubes were placed at three different depths (35, 45, and 55 cm) and divided into a right region, a center region, and a left region at each distance. The elimination rate was defined as the ratio calculated by dividing the number of cubes placed in each region by the number of cubes that were eliminated.

[0082] The test results are shown in Figure 21. Regarding the object erasure rate, the healthy subjects (five people, ages 20-60) all scored perfectly in body- and object-centered coordinates. The patient with unilateral spatial neglect in this study scored perfectly in body-centered coordinates. In object-centered coordinates, at 35 cm, a location relatively close to the subject, the left area was 60%, and the center and right areas were 100%. At 45 cm, the left area was 0%, the center area was about 80%, and the right area was 90%, and at 55 cm, the left area was 0%, the center area was about 20%, and the right area was 60%.

[0083] Regarding depth, the erasure rates showed the same tendency of left region < center region < right region at three distances from the subject: 35 cm, 45 cm, and 55 cm. In addition, the erasure rate was the lowest at the furthest distance of 55 cm among the three distances. As a result, the test using this head mounted display 10 revealed neglect situations at depth that could not be revealed by the BIT test, and showed a tendency consistent with the neglect situations that appeared in the CBS test. In addition, gaze movements unique to each individual also occurred.

[0084] [Test 3] In Test 3, the effectiveness of visual stimuli as attention-attracting was verified. Subject 40 was the same as the subject in Test 2. The erasure task was also the same as in Test 2.

[0085] Figure 22 shows the results of measuring the average number of erasures in the distal space for each area on the left, center, and right side of the screen, without and with visual stimuli due to the attention of the arrow movement. As shown in Figure 22, the average number of erasures significantly increased in the left area of ​​the distal space when attention was used. Regarding the gaze direction, the gaze rate significantly increased in the left areas of the proximal and distal spaces when attention was used. In the data on the head and eye angles, a moderate positive correlation was observed in the proximal and distal spaces when the attention system was used. The results of this study suggested that the use of the attention system may promote visual search in the left direction and reduce neglect symptoms. In addition, the use of the attention system suggested the possibility of allowing search by coordinated movements of the head and eye movements and changing the strategy of visual search. From the above, we have demonstrated the effectiveness of attention as a sensory feedback, especially by visual stimuli, and found the possibility of using this system for dynamic walking and ADL support as rehabilitation and assistive devices.

[0086] [Test 4] In test 4, brain function activity was analyzed while using the head mounted display 10.

[0087] (1) Subjects and experimental equipment Near-infrared spectroscopy (NIRS) is used to measure and analyze brain activation areas and clarify functional localization with and without the use of a head-mounted display 10. Near-infrared spectroscopy is a non-invasive examination method that makes it possible to map and evaluate the functional localization of the cerebrum over a wide area.

[0088] The subject was a patient with hemispatial neglect (67 years old), who had no problems with the visual field required for this study. The Brunnstrom stage was V for both upper and lower limbs. The FIM score was 116. The MMSE score was 30. The line cancellation test in the BIT test was scored out of 36 points. The CBS score included seven items of mild neglect on the left side, such as bumping into people or objects on the left side, for a total score of 7 points.

[0089] (2) Experimental procedures and analytical methods The procedure consisted of object elimination, and brain activity during the task was measured and analyzed using a NIRS device. The task was repeated four times, with each session lasting approximately five minutes, with a one-minute break between tasks. The subject sat in a quiet chair and rested for five minutes, after which the task began. As shown in Figure 23, the NIRS measurement sites were the left and right inferior frontal gyrus to middle frontal gyrus. The sampling rate for collecting data using NIRS was 50 Hz.

[0090] Regarding the analysis method, as a brain activity measurement analysis during peripheral task performance, NIRS captures changes in hemoglobin concentration associated with changes in cerebral blood flow that depend on neural activity in the brain, and oxygenated hemoglobin (oxy-Hb) is said to be the best indicator of blood flow changes, so in this test, oxy-Hb was also used as an indicator of brain activity during the task. In this task, the measurement site was the inferior frontal gyrus to the middle frontal gyrus, which is said to be activated during exploratory behavior. The analysis was performed using the average oxygenated hemoglobin value. It was calculated by the cumulative average method of oxy-Hb values ​​for a period equivalent to 10 seconds during the task. The calculated values ​​are shown to four decimal places. The average values ​​of oxy-Hb values ​​under the two conditions during task performance were compared statistically using Wilcoxon's signed rank sum test for all 8 channels.

[0091] (3) Brain activity during task movement measured by NIRS Regarding the results of brain function measurements during the erasure task, the average oxygenated hemoglobin value in the vicinity of the inferior frontal gyrus during the task performance time of the object erasure test in this experiment was calculated. Table 4 shows the values ​​in the vicinity of the left and right inferior frontal gyrus during task performance in the body-centered coordinate system and object-centered coordinate system of patients with hemispatial neglect. All values ​​except for the vicinity of the right inferior frontal gyrus were higher in the object-centered coordinate system. In addition, the object-centered coordinate value was significantly greater than the body-centered coordinate value.

[0092] [Table 4]

[0093] In this task, both healthy subjects (5 subjects, ages 20-60) and patients with hemispatial neglect showed greater brain activity than at rest. In addition, brain activity tended to be more active in object-centered coordinates than in body-centered coordinates. This may be because the head-mounted display 10 was a display that focused only on objects, and the subject's concentration was increased in natural environmental conditions, which may have activated the brain more. In addition, unlike healthy subjects, the subject's brain activity was low in the object-centered area of ​​the paralyzed side, showing a difference from the healthy side. The patient's primary disease was hemorrhage near the right frontal lobe, so the brain activity was low in the area close to the paralyzed area. In the future, by measuring and analyzing the activation status of the paralyzed side of the brain over time before and after rehabilitation, it may be possible to evaluate the effect of rehabilitation on visual cognitive impairment and predict the patient's future recovery.

[0094] As described above, according to the first embodiment, the testing system for persons with visuospatial cognitive disorders is configured to be able to display a group of three-dimensional objects with pseudo-depth for the erasure test, which is one of the spatial neglect tests, in the proximal or distal space of the subject 40 on the screen of the head-mounted display 10, so that the content and degree of the disorder of persons with visuospatial cognitive disorders such as hemispatial neglect can be easily tested objectively, quantitatively, and in detail from a new perspective.

[0095] Second embodiment [Training system for people with visual-spatial cognitive disorders] The training system for persons with visuospatial cognition disorders according to the second embodiment can be configured in the same manner as the testing system for persons with visuospatial cognition disorders according to the first embodiment, except that instead of presenting the subject 40 with a group of three-dimensional objects for a cancellation test for testing, the subject 40 is presented with a group of three-dimensional objects for training.

[0096] According to the second embodiment, it is possible to provide appropriate training from a new perspective according to the type and degree of a visual-spatial cognitive disorder of a person with a disability such as hemispatial neglect, thereby enabling rehabilitation treatment and assistance support to be carried out effectively.

[0097] Third embodiment [Training system for people with visual-spatial cognitive disorders] FIG. 24 shows a training system for a person with a visual-spatial cognitive disability according to a third embodiment. As shown in FIG. 24, this training system for a person with a visual-spatial cognitive disability includes a head-mounted display 10 that a subject 40 wears on his / her head 41, a computer 20 for controlling the operation of the head-mounted display 10, including turning on / off the cameras 11 and 12 and controlling the display, and a wireless inertial measurement unit 70 that is installed on the trunk and lower limbs of the subject 40. The head-mounted display 10 and the inertial measurement unit 70 can be synchronously controlled by transmitting and receiving signals between the head-mounted display 10 and the inertial measurement unit 70 and the computer 20 via wireless communication. This training system for a person with a visual-spatial cognitive disability is configured to display an image on the screen of the head-mounted display 10 in a proximal or distal space relative to the subject 40.

[0098] FIG. 25 shows the arrangement of the inertial measurement units 70 installed on the subject 40 when the subject 40 is trained (daily life activities including walking) by this training system for the visuospatial cognitive impaired. When using this training system for the visuospatial cognitive impaired, the head-mounted display 10 is attached to the head 41 of the subject 40, and the inertial measurement units 70 are installed on the trunk and lower limbs of the subject 40, and further on the head 41. FIG. 25 shows an example of the installation positions of the inertial measurement units 70 on the subject 40. When the inertial measurement units 70 are installed on the trunk of the subject 40, a total of three units are installed at approximately equal intervals in a line along the midsagittal section from the chest to the abdomen. When the inertial measurement units 70 are installed on the lower limbs of the subject 40, a total of four units are installed on the parts corresponding to the femurs and tibias above and below the knee joints of both legs. When the inertial measurement units 70 are installed on the head 41 of the subject 40, they are installed at the back of the head. In this way, a total of eight inertial measurement units 70 are installed on the subject 40. By installing these inertial measurement units 70 on the subject 40, the angles of the head 41 and trunk of the subject 40 and the joint angle of the knee joint of the lower limb can be measured, and the measurement information can be transmitted to the computer 20. If the measured angles of the head 41 and trunk and the joint angle are outside the respective preset angle ranges, the computer 20 detects this as an abnormality and can provide the subject 40 with a vibration stimulus by a vibrator built in the inertial measurement unit 70 to call his / her attention. For example, the default value of the joint angle of the knee joint is -10 degrees to 120 degrees. At the same time as or separately from this vibration stimulus, a voice can be used to call the attention of the subject 40 by a stereo speaker built in the head mounted display 10. For example, a walking animation can be displayed on the display screen of the computer 20 as shown in FIG. 26. In FIG. 26, A1, A2, etc. correspond to A1, A2, etc. shown in FIG. 25.

[0099] In this training system for people with visual-spatial cognitive disorders, a stereoscopic image of the real space can be displayed by the cameras 11 and 12 of the head-mounted display 10. An example is shown in FIG. 27. The real environment can be expanded by adding virtual visual information to real-world information. In addition, the position and angle of the line of sight, and the distance to an obstacle when there is one, can be displayed. An attention symbol can be displayed on the screen. The attention symbol can be moved three-dimensionally, rotated relative to the front, the number can be changed between 1 and 10, the color can be changed linearly, the transparency can be changed, and the animation of the symbol can be changed. An example using an arrow as the attention symbol is shown in FIG. 28.

[0100] In this training system for visual-spatial cognitive disorders, the head-mounted display 10 can reduce images captured by the cameras 11 and 12 to a preset image size, and can move the image up and down and left and right as well as at a preset image size reduction rate. In addition, since the ignorance state changes between the distal and proximal in a three-dimensional space with depth, different images can be presented in the distal and proximal spaces. Specifically, when the head-mounted display 10 is attached to the head 41 and the head and neck are held in an extension of, for example, 5 degrees or more for three seconds, the image is reduced and moved in the distal direction. When the head and neck are held in the opposite direction, for example, flexed by 5 degrees or more for three seconds, the image is reduced and moved in the proximal direction, making it possible to present different images in the distal and proximal directions. The visual information presentation method can be remotely controlled by the examiner, and the examination training program can be changed. Regarding the sensory feedback function, as a system for alerting spatial neglect patients, a symbol capable of attracting attention is presented three-dimensionally within an image presented on the screen of the head-mounted display 10, and the attention-calling symbol can be moved statically or dynamically. In addition, attention can be simultaneously called by voice. Vibration stimulation to the subject 40 can be performed by a vibrator built in the inertial measurement unit 30.

[0101] An example of the use of this training system for visual-spatial cognitive disorders will be described. FIG. 29 shows the actual view when the subject 40 is in a room (normal). As shown in FIG. 30, the gaze detection function of the head-mounted display 10 is used to detect the gaze direction of the subject 40, and the view can be changed depending on the angle at which the subject is currently looking. For example, as shown in the upper left part of FIG. 30, when the subject 40 is looking upward (the gaze angle is upward), that is, when the subject is looking at a distal space, the view is reduced to, for example, 80% and shifted to the right by 20%. On the other hand, as shown in the lower left part of FIG. 30, when the subject 40 is looking downward (the gaze angle is downward), that is, when the subject is looking at a proximal space, the view is reduced to, for example, 70% and shifted to the right by 30%. In both the distal space and the proximal space, a neglected area occurs on the left side of the screen, and a left-facing arrow is displayed to call attention to this neglected area. Since this may also be related to the up and down movement of the head, it is preferable to be able to switch between distal and proximal while also measuring head movement and analyzing the relationship with gaze movement. In other words, while some subjects 40 look up and down only with their gaze, there are also subjects 40 who look up and down in conjunction with their head and gaze, so it is preferable to be able to handle both subjects 40 whose head and gaze are not linked and subjects 40 whose head and gaze are linked.

[0102] In this training system for people with visual-spatial cognitive disorders, the distance of an obstacle in the depth direction can be predicted from stereo camera images captured by cameras 11 and 12 of a head-mounted display 10. When an obstacle approaches, a warning symbol is displayed on the screen to alert the subject 40. The obstacle detection range is in three places on the left, right, and center of the field of view, and the warning symbol is displayed in the area where the obstacle is closest. If necessary, the obstacle can be highlighted with a mesh. An example is shown in Figure 31. At the same time, a voice warning can be issued to inform the subject of which direction the obstacle is approaching.

[0103] Also, if danger is detected when the subject 40 moves from the front to the back or from left to right while walking, an animation pattern that calls attention may be displayed. Also, for example, if there is a risk of the subject 40 colliding with a wall while walking indoors, an attention symbol can be displayed by displaying an arrow in the direction of the wall. Also, if there is a risk of the subject 40 colliding with the corner of a bed while walking indoors, an area attention symbol indicating an area including the corner of the bed can be displayed.

[0104] 32, if a subject 40 is asked to walk and the walking direction deviates from the planned direction of travel, for example to the right, the deviation is detected by an inertial measurement unit 70 installed on the subject 40, and the information is sent to the computer 20, which in turn sends a signal to the head-mounted display 10, and a voice message is issued by a stereo speaker stating, "You have deviated to the right, please return to the original position." At the same time as issuing the voice message, or independently, a vibration stimulus can be applied by a vibrator built in the inertial measurement unit 70 installed on the right foot on the same side as the deviation, to alert the subject that the walking direction has deviated to the right.

[0105] The head-mounted display 10, inertial measurement unit 70, and sensory feedback (image presentation, attention alerts, object detection, proximal and distal focus, etc.) can be wirelessly remotely controlled by the computer 20, and data from the head-mounted display 10 and the inertial measurement unit 70, etc. can be stored in the cloud if necessary.

[0106] According to the third embodiment, the image on the screen of the head mounted display 10 can be displayed in the proximal or distal space relative to the subject 40, and the image can be displayed by selecting the proximal or distal space to perform training. In addition, the line of sight detection function of the head mounted display 10 can be used to detect the direction of the subject 40's line of sight, and it can be determined whether the field of view is upward (line of sight angle is upward) or downward (line of sight angle is downward) depending on the angle at which the subject is currently looking. In response to this, the size and position of the image displayed on the screen can be changed and a warning symbol can be presented at an appropriate position, thereby training the subject 40. In addition, the inertial measurement unit 70 installed on the subject 40 can measure the angle of the head 41 and the joint angle of the knee joint of the lower limbs, and thus it is possible to detect deviations in the direction of travel during walking and to give various warnings to the subject 40 according to the results, and therefore training can be performed while safely performing daily living activities including walking. In addition, in this training system for visual-spatial cognitive disorders, the head-mounted display 10 and a walking app using the inertial measurement unit 70 are synchronously linked, and it is possible to call the subject's 40 attention to the proximal or distal areas that he or she wants to see in accordance with the walking (zooming and moving images, dynamic arrows and focused flashing on objects, and visual, audio, and vibration alerts when abnormal walking or obstacles are detected). In addition to visual stimuli, audio guides and vibration stimuli can be used to further encourage attention to ignored areas. As an example of synchronization between the head-mounted display 10 and a walking app using the inertial measurement unit 70, (1) the head-mounted display 10 switches between proximal and distal areas at a certain interval, and when the subject 40 is concentrating on the distal area on the head-mounted display 10, the proximal area is tentatively presented on a small screen somewhere above, to the side, or below the right of the screen, and can be switched by moving the head 41 of the subject 40 up and down. (2) In accordance with the walking speed, the switching between proximal and distal areas is also made faster when the speed is fast. The deviation in walking is also adjusted according to the speed by presenting an attention-calling symbol on the screen of the head-mounted display 10 or by providing a vibration stimulus (for example, if the normal walking speed is about 1 m per second and the switching between proximal and distal takes 3 seconds, if the speed is 2 m per second, the switching can be set to take 1 or 2 seconds).As a result, it will be possible to provide appropriate training from a new perspective according to the type and degree of a disability of a person with visuospatial cognitive impairment such as hemispatial neglect, and to provide effective rehabilitation treatment and assistance.

[0107] Fourth embodiment [Spatial movement support system for people with visual-spatial cognitive disorders] The spatial movement support system for persons with visuospatial cognitive disorders according to the fourth embodiment can be configured in the same manner as the training system for persons with visuospatial cognitive disorders according to the third embodiment, and is used by the user in daily life activities including walking.

[0108] According to the fourth embodiment, by assisting and supporting the vision of a person with a visual-spatial cognitive disorder such as hemispatial neglect and supporting spatial movements, it is possible to improve daily living activities and quality of life.

[0109] Fifth embodiment [Testing system for people with visual-spatial cognitive disorders] The testing system for persons with visuospatial cognitive disorders according to the fifth embodiment can be configured similarly to the training system for persons with visuospatial cognitive disorders according to the third embodiment, with the difference being that instead of presenting images, etc. to the subject 40 for training, images, etc. are presented to the subject 40 for testing.

[0110] According to the fifth embodiment, the content and degree of a visual-spatial cognitive disorder such as hemispatial neglect can be easily and objectively, quantitatively, and in detail examined from a new perspective.

[0111] Although the embodiment of the present invention has been specifically described above, the present invention is not limited to the above-mentioned embodiment, and various modifications based on the technical concept of the present invention are possible.

[0112] For example, the numerical values, configurations, shapes, arrangements, materials, methods, etc. described in the above-described embodiments are merely examples, and numerical values, configurations, shapes, arrangements, materials, methods, etc. different from these may be used as necessary. [Explanation of symbols]

[0113] 10...head mounted display, 11, 12...camera, 13, 14...display, 15, 16...infrared sensor, 20...computer, 30...hand controller, 31...handle, 32...spherical part, 40...subject, 41...head, 50...chair, 60...motion analysis camera, 70...inertial measurement unit

Claims

1. It has a head-mounted display equipped with a pair of cameras on the front, This is an examination system for persons with visual-spatial cognitive disorders that is configured to display a group of three-dimensional objects with pseudo-depth for the erasure test, which is one of the spatial neglect tests, in the proximal or distal space of the subject on the screen of the head-mounted display.

2. 2. The testing system for persons with visual-spatial cognitive disorders according to claim 1, further comprising a controller used by said subject to erase said group of three-dimensional objects when they are displayed on the screen of said head-mounted display.

3. 2. The testing system for persons with visual-spatial cognitive disorders as described in claim 1, which is configured so that, when conducting the elimination test, a warning symbol can be displayed on the screen of the head-mounted display and / or a voice warning can be issued from a speaker of the head-mounted display.

4. 2. The testing system for persons with visual-spatial cognitive disorders as described in claim 1, which is configured to measure the movement of the subject's head using a gyroscope built into the head-mounted display and / or measure the movement of the subject's eyeballs using an infrared sensor built into the head-mounted display when conducting the elimination test.

5. 2. The testing system for persons with visual-spatial cognitive disorders according to claim 1, wherein the coordinate system of the image displayed on the screen of the head-mounted display can be set to a body-centered coordinate system or an object-centered coordinate system when the erasure test is performed.

6. 2. The testing system for persons with visuospatial cognitive impairment according to claim 1, wherein the activation areas of the subject's brain are measured using near-infrared spectroscopy when the elimination test is performed.

7. 2. The testing system for visual-spatial cognitive disorders as described in claim 1, wherein, when the elimination test is performed, the angle of rotation of the subject's head and the angle of rotation of the subject's eyes are measured from the time when one of the three-dimensional objects is eliminated to the time when the next three-dimensional object is eliminated.

8. It has a head-mounted display equipped with a pair of cameras on the front, This is a training system for individuals with visual-spatial cognitive disorders that is configured to display a group of three-dimensional objects with pseudo-depth for the erasure test, which is one of the spatial neglect tests, in the proximal or distal space of the subject on the screen of the head-mounted display.

9. A head-mounted display equipped with a pair of cameras on the front and the left and right, A plurality of motion measurement devices are installed on the trunk and / or lower limbs of a subject; a computer that wirelessly controls the head mounted display and the motion measurement device in a synchronized manner; having An examination system for persons with visual-spatial cognitive disorders configured to display images on the screen of the head-mounted display in a proximal or distal space relative to the subject.

10. 10. The testing system for persons with visual-spatial cognitive disorders according to claim 9, wherein different images are displayed on the screen of the head-mounted display in the proximal space and the distal space.

11. 10. The system for testing persons with visual-spatial cognitive disorders according to claim 9, wherein the motion measurement device is a wireless inertial measurement device.

12. The head-mounted display has a gaze detection function, and detects the direction of the subject's gaze using the gaze detection function, and displays images on the screen of the head-mounted display having different reduction ratios and different left-right positions on the screen depending on whether the subject's gaze angle is upward or downward.

13. 10. The testing system for persons with visual-spatial cognitive disorders as described in claim 9, wherein the motion measuring device measures the angle of the trunk and the joint angles of the lower limbs of the subject, and detects an abnormality if the angle and the joint angle deviate from a predetermined angle range, and alerts the subject by presenting a warning symbol on the screen of the head-mounted display, and also alerts the subject by voice or vibration stimulation from a vibrator attached to the motion measuring device.

14. 10. An inspection system for persons with visual-spatial cognitive disorders as described in claim 9, wherein the distance to an obstacle in the depth direction is predicted from images from the pair of cameras of the head-mounted display, and when the distance between the subject and the obstacle approaches that distance, a warning symbol is presented on the screen of the head-mounted display to alert the subject, and at this time, the subject is alerted by audio as to which direction the obstacle is approaching.

15. A head-mounted display equipped with a pair of cameras on the front and the back, A plurality of motion measurement devices are installed on the trunk and / or lower limbs of a subject; a computer that wirelessly controls the head mounted display and the motion measurement device in a synchronized manner; having A training system for persons with visual-spatial cognitive disorders configured to display images on the screen of the head-mounted display in proximal or distal space relative to the subject.

16. 16. The training system for persons with visual-spatial cognitive disorders according to claim 15, wherein different images are displayed on the screen of the head-mounted display in the near space and the distal space.

17. The training system for persons with visual-spatial cognitive disorders as described in claim 15, wherein the head-mounted display has a gaze detection function, and detects the direction of the subject's gaze using the gaze detection function, and displays images on the screen of the head-mounted display having different reduction ratios and different left-right positions on the screen depending on whether the subject's gaze angle is upward or downward.

18. 16. A training system for persons with visual-spatial cognitive disorders as described in claim 15, wherein the motion measurement device measures the angle of the trunk and the joint angles of the lower limbs of the subject, and detects an abnormality if the angle and the joint angle deviate from a predetermined angle range, and alerts the subject by presenting a warning symbol on the screen of the head-mounted display, and also alerts the subject by voice or vibration stimulation from a vibrator attached to the motion measurement device.

19. A training system for persons with visual-spatial cognitive impairment as described in claim 15, wherein the distance to an obstacle in the depth direction is predicted from images from the pair of cameras of the head-mounted display, and when the distance between the subject and the obstacle approaches that distance, the subject is alerted by presenting an attention warning symbol on the screen of the head-mounted display, and at this time, the subject is alerted by audio as to which direction the obstacle is approaching.

20. A head-mounted display equipped with a pair of cameras on the front and the back, A plurality of motion measurement devices are installed on the trunk and / or lower limbs of a user; a computer that wirelessly controls the head mounted display and the motion measurement device in a synchronized manner; having A spatial action support system for people with visual-spatial cognitive disorders, configured to display images on the screen of the head-mounted display in a proximal or distal space relative to the user.

21. The spatial action support system for persons with visual-spatial cognitive disorders according to claim 20, wherein different images are presented on the screen of the head-mounted display in the near space and the distal space.

22. The head mounted display has a gaze detection function, detects the direction of the user's gaze using the gaze detection function, and presents images on the screen of the head mounted display having different reduction ratios and different positions in the left and right directions on the screen depending on whether the angle of the user's gaze is upward or downward.

23. The spatial action support system for persons with visual-spatial cognitive disorders as described in claim 20, wherein the motion measurement device measures the angle of the user's trunk and the joint angles of the lower limbs, and detects an abnormality if the angle and the joint angle deviate from a predetermined angle range, and alerts the user by presenting a warning symbol on the screen of the head-mounted display, as well as alerting the user by sound or vibration stimulation from a vibrator attached to the motion measurement device.

24. A spatial action support system for persons with visual-spatial cognitive impairment as described in claim 20, wherein the distance to an obstacle in the depth direction is predicted from images from the pair of cameras of the head-mounted display, and when the distance between the user and the obstacle approaches that distance, a warning symbol is displayed on the screen of the head-mounted display to alert the user, and at this time, the user is alerted by audio as to which direction the obstacle is approaching.

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