$\require{mediawiki-texvc}$

연합인증

연합인증 가입 기관의 연구자들은 소속기관의 인증정보(ID와 암호)를 이용해 다른 대학, 연구기관, 서비스 공급자의 다양한 온라인 자원과 연구 데이터를 이용할 수 있습니다.

이는 여행자가 자국에서 발행 받은 여권으로 세계 각국을 자유롭게 여행할 수 있는 것과 같습니다.

연합인증으로 이용이 가능한 서비스는 NTIS, DataON, Edison, Kafe, Webinar 등이 있습니다.

한번의 인증절차만으로 연합인증 가입 서비스에 추가 로그인 없이 이용이 가능합니다.

다만, 연합인증을 위해서는 최초 1회만 인증 절차가 필요합니다. (회원이 아닐 경우 회원 가입이 필요합니다.)

연합인증 절차는 다음과 같습니다.

최초이용시에는
ScienceON에 로그인 → 연합인증 서비스 접속 → 로그인 (본인 확인 또는 회원가입) → 서비스 이용

그 이후에는
ScienceON 로그인 → 연합인증 서비스 접속 → 서비스 이용

연합인증을 활용하시면 KISTI가 제공하는 다양한 서비스를 편리하게 이용하실 수 있습니다.

가상현실기반 비디오게임과 재활운동이 만성기 뇌졸중 환자의 균형 및 일상생활동작에 미치는 영향
Effects of Virtual Reality Based Video game and Rehabilitation Exercise on the Balance and Activities of Daily Living of Chronic Stroke Patients 원문보기

대한물리의학회지 = Journal of the korean society of physical medicine, v.8 no.2, 2013년, pp.201 - 207  

이현민 (호남대학교 물리치료학과)

초록
AI-Helper 아이콘AI-Helper

연구목적: 닌텐도 위를 이용한 가상현실기반 비디오게임 프로그램을 만성기 뇌졸중 환자에게 적용하여 균형능력 및 일상생활동작에 어떠한 영향을 미치는지 알아보고, 뇌졸중 환자의 재활프로그램으로서 적용 가능성이 있는지 알아보고자 한다. 연구방법: 만성기 뇌졸중 환자를 무작위로 가상현실기반 비디오게임 프로그램을 적용한 실험군(n=7)과 적용하지 않은 대조군(n=10)으로 구분하여 연구를 진행하였다. 연구에 참여한 모든 대상자에게 30분의 Bobath therapy와 15분간의 FES 치료를 기본적으로 실시하였다. 이에 더하여 실험군은 가상현실기반 비디오게임 프로그램을 1일 30분이내, 주 5회, 3주간 실시하였다. 대조군은 자전거 운동과 보행훈련으로 30분간 시행하였다. 실험 전 후 눈뜨고 외발서기(OLST; open leg standing test), Timed Up and Go(TUG) 검사, 10m 걷기 검사, Functional Independence Measure(FIM)를 측정하였다. 실험 전과 실험 후 측정값의 차이를 비교하기 위해 Wilcoxon Signed Ranks Test를 실시하였다. 그리고 각 측정값의 변화량에 대한 실험군과 대조군 사이의 차이를 알아보기 위해 Mann-Whitney U Test를 실시하였다. 연구결과: 실험결과는 다음과 같다. 1) 실험군에서는 FIM의 유의한 증가와 TUG, 10m 걷기 검사의 유의한 감소를(p<.05) 보였다. 대조군에서는 OLST의 증가와 TUG, 10m walking test의 감소가 나타났지만 통계적으로 유의하지 않았다. 오직 FIM에서만 유의한 증가가 나타났다(p<.05). 2) 실험 전 후의 실험군과 대조군의 각 측정값들의 평균차를 비교한 결과 실험군은 대조군보다 실험 전 후 OLST, TUG, 10m walking test 차이의 평균은 컸지만 통계적으로 유의하지 않았다. 결론: 이상의 결과로부터 가상현실기반 비디오게임이 만성기 뇌졸중 환자의 동적균형능력 및 일상생활동작 향상에 효과가 있음을 알 수 있었다.

주제어

AI 본문요약
AI-Helper 아이콘 AI-Helper

* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.

제안 방법

  • On the other hand, experiment group showed significant increase in significant decrease in TUG that evaluates dynamic balancing ability, 10m walking test that evaluates walking ability and FIM that evaluates everyday life motion. All the subjects received 30 minutes of Bobath therapy and 15 minutes of FES treatment basically. Nevertheless, control group did not show any significant increase in TUG, 10m walking test and FIM, and that is presumably because the basically provided physical therapy is focused on improving exercise functions and walking function.
  • In addition, experiment group performed virtual reality based video game software 30 minutes a day, 5 times a week for 3 weeks. Control group performed bicycle riding and walking training for 30 minutes. To maintain objectivity of evaluation of patients, physical therapist and work therapist with sufficient experience of 5 year or longer joined as study assistants.
  • For this study, from among hospitalized patients who were diagnosed as stroke by cerebral infarction or intracerebral hemorrhage in MRI or CT in ○○ Hospital in Daegu metropolitan city from May 2011 to August, those who listened to description of the objective and meaning of this study, expressed willingness of voluntary participation and comply with the following selection criteria were chosen as study subjects from with effect variables controlled.
  • To all the subjects who participated in the study, 30 minutes of Bobath therapy and 15 minutes of FES treatment were done. In addition, experiment group performed virtual reality based video game software 30 minutes a day, 5 times a week for 3 weeks. Control group performed bicycle riding and walking training for 30 minutes.
  • In this study, the effects of rehabilitation exercise using virtual reality based video game for 3 weeks on the balancing ability, walking ability and everyday life motion of stroke patients were examined. Study results indicated that improvements were made in TUG that evaluated dynamic balancing ability, 10m walking test that evaluated walking ability and FIM that evaluated everyday life motion.
  • Also in the study by Kim(2005), results of experiment for 4 weeks using IREX indicated decrease in total moving distance and speed, but the decrease was not significant statistically. In this study, the method of using virtual reality based video game, which consists of dynamic motions that move the whole body, is judged as having no significant effects in evaluating static balancing. As for the reason, it can be considered that since in stroke patients, static balancing is more effected by stiffening than adjusting ability of major muscles, functional motion can hardly produce static balancing effect(Rietdyk et al.
  • Equipments for virtual reality based video game were Nintendo Wii game device(Nintendo Inc, Japan) and Nintendo Wii Sports software(Nintendo Inc, Japan). The video game software used in this study are bowling, boxing, baseball and tennis etc, and in performing game, subjects were instructed to perform motions that are done just the way in sports in practice by seizing remote controller in hand.
  • To all the subjects who participated in the study, 30 minutes of Bobath therapy and 15 minutes of FES treatment were done. In addition, experiment group performed virtual reality based video game software 30 minutes a day, 5 times a week for 3 weeks.
  • 00 was used. To compare the difference of OLST, TUG and 10m walking test, and measured value before and after experiment of FIM between experiment group and control group, Wilcoxon Signed Ranks test was done. And to find out the difference of changed amount of each measured value between experiment group and control group, Mann-Whitney U test was done with significance level of α=.
  • To measure static balancing ability, subject stood on land with dominant foot with eyes open and arms folded on bare feet, and when he/she lifted up the other foot, stop watch began measuring the time. Once the subject lowers the foot that he/she lifted or moved the supporting foot, stop watch was stopped, and the time during which dominant foot was supporting was measured(Briggs et al.

대상 데이터

  • Selection criteria include individual without medical history of stroke recurrence, individual with no abnormality in visual and vestibular organ, individual with no medical history of orthopedic surgery disease, individual who can maintain standing posture independently, individual who can understand the contents that researcher instructs, and individual who received 19 points or more in MMSE-K among individuals who passed 6 months or more after being diagnosed as stroke. Finally 20 individuals excluding patients who do not comply with selection criteria were selected as study subjects. The 20 subjects were classified randomly to experiment group of 10 to which virtual reality based video game software was applied and control group of 10 where no virtual reality based video game software was applied to rule out bias of selection.

데이터처리

  • And to find out the difference of changed amount of each measured value between experiment group and control group, Mann-Whitney U test was done with significance level of α=.05.

이론/모형

  • To evaluate dynamic balancing ability, TUG test was done. Specifically subject sitting on a 50cm high chair with armrest was issued an order to ‘start’, and upon issuance of the order, he/she stood up from the chair, walked to 3m location at the front, and after returning, sat on the chair again.
본문요약 정보가 도움이 되었나요?

참고문헌 (23)

  1. Briggs RC, Gossman MR, Birch R et al. Balance performance among noninstitutionalized elderly women. Phys Ther. 1989;69(9):748-56. 

  2. Bryanton C, Bosse J, Brien M et al. Feasibility, motivation, and selective motor control: virtual reality compared to conventional home exercise in children with cerebral palsy. Cyberpsychol Behav. 2006;9(2):123-8. 

  3. Ferrarin M, Brambilla M, Garavello L et al. Microprocessorcontrolled optical stimulating device to improve the gait of patients with Parkinson's disease. Med Biol Eng Comput. 2004;42(3):328-32. 

  4. Fung J, Richard Cl, Malouin F et al. A treadmill and motion coupled virtual reality system for gait training post-stroke. Cyberpsychol Behav. 2006;9(2):157-62. 

  5. Henderson A, Korner-Bitensky NLevin M. Virtual reality in stroke rehabilitation: a systematic review of its effectiveness for upper limb motor recovery. Top Stroke Rehabil. 2007;14(2):52-61. 

  6. Jack D, Boian R, Merians AS et al. Virtual reality-enhanced stroke rehabilitation. IEEE Trans Neural Syst Rehabil Eng. 2001;9(3):308-18. 

  7. Judge JO, King MB, Whipple R et al. Dynamic balance in older persons: effects of reduced visual and proprioceptive input. J Gerontol A Biol Sci Med Sci. 1995;50(5):263-70. 

  8. Keith RA, Granger CV, Hamilton BB et al. The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil. 1987;1:6-18. 

  9. Kim EK, Kang JH, Lee HM. Effects of virtual reality based on game on balance and upper extremity function in chronic stroke patients. Journal of Special Education & Rehabilitation Science. 2010;49(3):131-149. 

  10. Kim JH. Effects of virtual reality program on balance, gait and brain activation patterns in stroke patients. Daegu University. Dissertation of Doctor's Degree. 2005. 

  11. Kwon MJ. The fall circumstance and related factors associated with fall in the stroke patients. J Kor Soc Phys Ther. 2008;20(3):19-28. 

  12. Langhammer B, Stanghelle JK. Bobath or motor relearning programme? A comparison of two different approaches of physiotherapy in stroke rehabilitation: A randomized controlled study. Clin Rehabil. 2000;14(4):361-9. 

  13. Laufer Y, Dickstein R, Resnik S et al. Weight-bearing shifts of hemiparetic and healthy adults upon stepping on stairs of various heights. Clin Rehabil. 2000;14(2):125-9. 

  14. Lee JH, Kang JH, Lee HM. Feasibility of using the Nintendo Wii game for dementia. The Korean Society of Physical Medicine. 2011;6(2):225-33. 

  15. Park JW & Jang SH. The difference of cortical activation pattern according to motor learning in dominant and non-dominant hand: An fmri case study. J Kor Soc Phys Ther. 2009;21(1):81-8. 

  16. Podsiadlo D & Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society. 1991;39(2):142-8. 

  17. Pollock A, Baer G, Pomeroy V et al. Physiothrapy treatment approaches for the recovery of postural control and lower limb function following stroke. Cochrane Database Syst Rev. 2007(1):CD001920. 

  18. Rietdyk S, Patla AE, Winter DA et al. NACOB presentation CSB New Investigator Award. Balance recovery from medio-lateral perturbations of the upper body during standing. North American Congress on Biomechanics. J Biomech. 1999;32(11):1149-58. 

  19. Sackley CMLincoln NB. Single blind randomized controlled trial of visual feedback after stroke: effects on stance symmetry and function. Disabil Rehabil. 1997;19(12):536-46. 

  20. Sharp SA, Brouwer BJ. Isokinetic strength training of the hemiparetic knee: effects on function and spasticity. Arch Phys Med Rehabil. 1997;78(11):1231-6. 

  21. Shin WS & Song CH. Effects of virtual reality-based exercise on static balance and gait abilities in chronic stroke. J Kor Soc Phys Ther. 2009;21(3):33-40. 

  22. Suzuki K, Nakamura R, Yamada Y et al. Determinants of maximum walking speed in hemiparetic stroke patients. Tohoku J Exp Med. 1990;162(4):337-44. 

  23. Warburton DE, Bredin SS, Horita LT et al. The health benefits of interactive video game exercise. Appl Physiol Nutr Metab. 2007;32(4):655-63. 

섹션별 컨텐츠 바로가기

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

AI-Helper 아이콘
AI-Helper
안녕하세요, AI-Helper입니다. 좌측 "선택된 텍스트"에서 텍스트를 선택하여 요약, 번역, 용어설명을 실행하세요.
※ AI-Helper는 부적절한 답변을 할 수 있습니다.

선택된 텍스트

맨위로