Frequently Asked Questions

Cognitive rehabilitation is a therapeutic approach designed to remediate cognitive functioning or to compensate for cognitive deficits following acquired brain injury. The main goal is to address and improve specific cognitive skills, such as memory, executive function and attention to mention just a few. These skills are the key to carrying out the activities of daily life.

Brain training is the use of different types of exercises (e.g. computerized tasks or serious games) to improve or maintain cognitive functions. Traditionally cognitive training was conducted using paper and pencil exercises; more recently, these exercises have been computerized and now. Cognitive training tools are designed to allow for repetitive practice in order to train specific cognitive skills. Computerized brain training is an effective and safe method that stimulates mental activities to improve cognitive functioning after a brain injury, but it is also beneficial for maintaining a healthy brain and improving emotional well-being.

While brain training is developed for everyone, cognitive rehabilitation specifically focuses on patients with acquired brain injury. Koji’s Quest’s cognitive rehabilitation is designed to aid in the remediation of or compensation for cognitive deficits. When used with the guidance of a healthcare professional, patients receive personalized intensive therapy based on their specific cognitive impairments. On the other hand, Koji’s Quest is so easy to use that people can play the games that they want and when they like even without clinical supervision.

Koji’s Quest is designed as an adventure game in which you travel through various worlds to train different cognitive skills while having fun! You are accompanied by your virtual companion, a dog named Koji. Using Koji’s Quest, acquired brain injury patients can start training the cognitive functions that are necessary in their everyday life. By making the training gamified, easy-accessible, cost-effective and fun, we motivate patients to train again and again without it becoming a chore, but rather an activity they look forward to. Another special component of our software is that Koji’s Quest provides in-game psychoeducation to explain to the user how each skill is related to the different cognitive domains that will be trained by the games.

Koji’s Quest allows people to train cognitive skills including selective and divided attention, long-term, short-term and working memory, visuospatial, calculation, and executive function which encompasses multi-tasking, prioritization and decision making. We are working to expand the cognitive domains. If you would like to keep updated on our latest developments, sign up for our newsletter.

Virtual Reality (VR) is the use of computer technology to create a fully immersive environment. Instead of viewing a screen in front of them, users are placed in an interactive three-dimensional world. We use VR for Koji’s Quest because research shows that using VR in combination with cognitive training is more beneficial for increased neural activation, enhanced attention, and increased motivation.

• The Crystal Calculation Forest is based on Serial 7s subtraction task (Manning, 1982), where people are asked to count backward from one hundred by sevens (i.e., 100, 93, 86, 79, etc.). Since people constantly use numbers in their daily lives, for example, for counting items, telling the time, calculating prices, paying our bills, counting money, cooking and solving simple equations, it is important to train calculation and numerical manipulation.

• Nautilus Underwater Memory is based on the Corsi block-tapping test (Corsi, 1972); short-term memory: repeat a sequence) and on long-term memory paradigms (memorize objects and locations). There are different types of memory. Remembering what you just talked about on the phone is called short-term memory; remembering a telephone number before writing it down is called working memory and remembering the capital of your country is called long-term memory. 

• The Galactic Diamond Belt trains selective attention, which allows an individual to attend to a specific object of interest while ignoring other irrelevant information. Galactic Diamond Belt is based on visual search tasks, including the D2 attention test (Oss, 2005; participants are asked to cross out all target letters that are placed between similar non-target letters during a specific time limit) and the Bells test (Gauthier, Dehaut, & Joanette, 1989; a visual search task that assesses visual neglect by asking the participant to cross out all bells which are placed between distractor items, all equally distributed over 7 columns). An example of selective attention is listening carefully to what someone is saying while ignoring all the other conversations going on in the room.

• Alien Outpost trains divided attention and is based on the Useful Field Of View (UFOV) task. The useful field of view is the visual area over which information can be extracted at a brief glance without eye or head movements. First, participants are instructed to focus on the middle of the screen. Next, target objects are briefly presented in different places, and participants are then asked to detect, identify, and localize them, requiring them to spread attentional load. An example of divided attention is having to focus on the road ahead of you, whilst also noticing things besides you or in your peripheral

• The Mayan Temple trains visuospatial skills and is based on the mental rotation task (Shepard, & Metzler, 1971; participants are asked to mentally rotate two and three-dimensional objects). In daily life, we need visuospatial skills to use a map to get from one place to another, to look at an object and pick it up correctly, in working with tools around the house, or to cross the road.

• The Mystical Lake trains executive functions and is based on the Wisconsin card sorting test (Monchi, Petrides, Petre, Worsley & Dagher, 2001; Berg, 1948) and the mental set and shift test (Jersild, 1927). In both tests people need to shift attention back and forth between different tasks and understand what rule is being applied). In Koji’s Quest our executive functioning game trains flexibility by changing the rules each time the player begins, and introducing dual tasks which require quick shifting of attention and tapping into memory. Executive functioning is crucial in daily life for almost any task, as it is a combination of complex cognitive skills such as inhibition, deduction, multitasking and using metacognition whilst carrying out tasks.

Koji’s Quest is played with controllers. When you activate Interactive Mode, the games can be played with more motor interaction, allowing for motor activities that fit within motor rehabilitation procedures. People are able to use many types of hand and arm movements to perform goal-directed behaviour in the virtual world. This, in turn, stimulates upper limb motor function. Currently we do not have any lower limb activities integrated into Koji’s Quest, but we are looking into it.  

While Koji’s Quest can be played by people of any age, it is important to remember that some VR headset manufacturers state that they are not suitable for children under the age of 13 years old.  Please check the recommendation for your type of headset. If you are not sure, just contact us at hello@neuro-reality.com. 

At the moment you can reach out to us to receive a personal download key to try the beta version of Koji’s Quest. It is completely free. We expect to have our official launch later this year. Just subscribe on our homepage here and we will make sure to keep you up to date on the launch and other exciting developments too!

As people age they typically experience age-related mental decline. Keeping the brain active helps to keep the brain fit and sharp, which has been shown to slow age-related cognitive decline (Rebok et al., 2014). Koji’s Quest can be used, along with other stimulating activities, games and puzzles, to keep the brain active through repetitive, goal-oriented training and mental activities. This not only helps stave off the effects of age-related mental decline, but it also has been shown to improve emotional well-being. However, staying physically fit, and having a good diet, are also important components in staving off age-related mental decline.

Gamified training provides an opportunity for training cognitive skills that are relevant to our daily lives. Training memory could help people more easily remember their grocery list; practicing math skills can help people tell time or count money. For this reason, we expect that training with Koji’s Quest will positively impact daily life activities in the real world that are crucial for an individual’s independence and autonomy. 

Previous research regarding VR-based cognitive training suggests that individuals should play three to five times per week, 30 to 45 minutes per session, for at least 6 weeks (Huang, 2020; Dahlin, Nyberg, Bäckman, & Neely, 2008). A study investigating the durability of cognitive training in older adults showed that a ten-session training (with 60- to 75-minute training sessions) followed by a 4-session booster training (one to three years after the initial training) resulted in improved cognitive abilities specific to the abilities trained (Willis et al., 2006). These results lasted for 5 years after the initial training session. This research also shows that cognitive training in older adults may result in less functional decline over time. All in all, we suggest that it is important to integrate cognitive training into your lifestyle after rehabilitation, even though training does not have to continue permanently as intensive as in the beginning.

The six games currently included in Koji’s Quest are not adapted for individuals suffering from visual neglect. However, our selective attention training can be suitable for neglect, as it forces players to scan the scene. We are currently developing a game specifically designed for hemispatial neglect training. More information will follow soon.

Individuals with deficits in binocular vision are more likely to encounter dizziness or motion sickness due to a visual-vestibular mismatch between what they see in the virtual environment and what is happening in the real world. If you suffer from binocular visual dysfunction, using VR is not recommended. However, you should try it out shortly to see whether or not it causes discomfort.

It seems that by practicing frequently at exactly the right difficulty level, there is room for improvement even after longer periods of time. This isdue to the brain’s ability to rewire itself and create new neuronal connections, called neuroplasticity. However, we cannot guarantee improvement since every acquired brain injury is different. If you would like to know more, please contact us directly at hello@neuro-reality.com. We are happy to help provide any additional information possible.

At NeuroReality, we are constantly conducting research to validate the usage of Koji’s Quest. Additionally, we work with a number or research partners who are also helping to validate Koji’s Quest. As we finalize our studies, we will be happy to share them.  For more information about our ongoing research, please contact hello@neuro-reality.com. Furthermore, there is a large body of scientific literature that shows the promise of brain training and VR interventions for rehabilitation. For that, please visit our scientific literature page.

With some VR experiences, people may experience nausea, loss of spatial awareness, dizziness and disorientation, or trouble focusing. In order to prevent these side effects, we have designed Koji’s Quest so that it can be played seated, standing, without these side effects occurring. There is no need to move around too much, and the point of view from which you view the world, is stable and is based on your own positioning, which reduces the chance for these adverse effects. Additionally, when playing in VR it is always recommended to take a 10 to 15 minutes break every 30 to 45 minutes, to reduce any eye-strain

It is easy to get started even if you aren’t tech savvy! Just grab your goggles, download the game, and begin your training. For instructions on how to install, look at our website and check out the videos that we’ve created. Koji, your digital companion, will guide you on your quests and show you around the world, helping you get used to the new virtual environment. The tutorials are also written in easy to understand language to help ensure that you have a great playing experience. Typically, it takes only one playthrough of the games to understand what you have to do. It’s easy, just give it a try! 

Most people who wear glasses are able to use VR, but it really depends on the type of VR device being used and the size of your glasses. Please contact us through hello@neuro-reality.com for more information.

Koji’s Quest is currently compatible with a variety of VR headsets including Oculus Quest, Oculus Rift S, Oculus Rift, and HTC Vive Focus Plus.We are working on optimization for other VR goggles all the time. If your VR goggles are not listed here, just contact us through hello@neuro-reality.com. We will do our best to accommodate your requests. 

Koji’s Quest is available for standalone (untethered) devices such as Oculus Quest and the HTC Vive Focus Plus. Neither of these VR headsets require a computer. 

If you have a tethered device, one that requires a computer, the minimum recommended PC specifications are: Windows 7 64 bit, Intel i5-4590 equivalent, NVIDIA GTX 970 or AMD R9 290, 8GB RAM, HDMI 1.3 and 3x USB 3.0 plus 1x USB 2.0.

At the moment, Koji’s Quest supports English and Dutch, but we are currently working on Spanish, German and Portuguese too! Do you need Koji’s Quest in another language, let us know through hello@neuro-reality.com and we can add it to our list.  

Koji’s Quest is also available on the computer, however this does not optimize the benefits of playing Koji’s Quest in an immersive VR environment, nor can you do the interactive modes. Additionally, research shows that playing in an immersive VR environment has the additional benefits of increased attention and focus, heightened motivation, and greater neural activation. Therefore, we advise you to play Koji’s Quest in VR!

For the best experience we recommend playing Koji’s Quest in VR. It provides a lot of additional benefits. In fact, research shows that using VR in combination with cognitive training is more beneficial for increased neural activation, enhanced attention, and increased motivation. If, however, you don’t have a VR headset and you still want to try out Koji’s Quest, send us an e-mail at hello@neuro-reality.com to receive a download link to the desktop version of Koji’s Quest.